Spirituality in Nursing

    Humans are holistic creatures, which consist of biological, psychological, social and spiritual elements (Indonesian Ministry of Health, 2016). This certainly requires nurses to look at various health responses to patients' pain comprehensively by providing holistic services. Holistic services are services provided by health workers by paying attention to clients from all components such as biological, psychological, social, cultural and spiritual (Dossey in Yusuf et al., 2016). Meeting spiritual needs is an inseparable part of nursing care practice. Patients' spiritual care can be fulfilled if nurses are able to develop aspects of their spirituality (Gultom et al., 2020). The development of a spiritual identity in nurses will help nurses to be more sensitive to the spiritual needs of patients (Khoiriyati, 2008).
Although spirituality is an important aspect of holistic care, it is often neglected to provide proper spiritual care. Survey results related to nurses' perceptions of spirituality and spiritual care among 4,054 respondents in the UK found that only 5.3% (213) nurses felt that they were able to meet the spiritual needs of patients at any time (McSherry & Jamieson, 2011). Aesthetic research and Jannah (2016) at a hospital in Indonesia found that the implementation of spiritual nursing care was still in the poor category (59.7%). In addition, the Health Service Ombudsman in the UK also reported that there were nurses who were less sensitive and did not show a therapeutic attitude towards people who were sick or vulnerable (Abraham, 2011).
Lack of integration of spirituality in nursing care can be caused by the difficulty of individual nurses to conceptualize spirituality in nursing. The Royal College of Nursing (2011) has also warned every nurse not to impose religious or spiritual beliefs and values ​​that nurses have on patients and their families. This shows that it is important for nurses not to view spirituality as an attempt to change patient beliefs towards certain beliefs. Mistakes in conceptualizing spirituality can be caused by a lack of adequate training related to spiritual care which causes nurses to lack self-confidence (McSherry & Jamieson, 2011). This shows that nurses do not understand spirituality and its relevance to patients and patient families (Timmins & Caldeira, 2017).
 Not involving spirituality in nursing care can reduce the quality of the nursing care provided (McSherry, 2011). This is because failure to conceptualize spirituality in nursing will have an impact on a nurse's failure to develop interpersonal relationships and affection with patients as a center of care (Clarke, 2013). In addition, inaccuracy in carrying out spiritual care can also result in the spiritual care given to be not individualistic and holistic (Mcsherry, 2004).    
Professional standards encourage every nurse to pay attention to the spiritual needs of patients (International Council of Nurses, 2012). Research has proven that a spiritual approach to meeting patient needs can improve patient health outcomes (Koenig, 2013). Meeting the spiritual needs of the patient by supporting the patient to understand the illness and injury they are experiencing can also help relieve the pressure felt by the patient and provide a sense of calm that can help patients face difficulties (Weathers et al., 2016).
A spiritual approach can be taken by listening to patients to determine what is important to them (Milligan, 2011). This is because each patient gives different meanings to spirituality, so it is important for nurses to be guided by any information provided by the patient (Timmins & Caldeira, 2017). In addition, the spirituality approach also requires nurses to be able to establish supportive relationships with patients when patients try to understand what the pain is and the meaning of the people around them (McSherry & Jamieson, 2013).

    The spiritual needs of patients or their families will arise especially when they face health problems or life problems such as chronic illnesses, diseases that can limit their lives, to death (Daaleman, 2012). Life-threatening or crippling diseases can make patients lose their meaning and purpose in life or forget that previously they had developed their meaning and purpose in life (Puchalski in Rogers & Wattis, 2015). One of the functions of nurses in understanding the concept of spirituality in nursing is to be able to support the spiritual needs of patients and families (Timmins & Caldeira, 2017). Supporting the fulfillment of the patient's spiritual needs in an appropriate way such as following the direction of the patient in exploring and assessing their spirituality can help nurses determine the expectations, meaning and goals of the patient's life while the patient is sick (Rogers & Wattis, 2015).

REFERENCE

Abraham, A. (2011). Care and compassion? Report of the Health Service Ombudsman on ten investigations into NHS care of older people. In Fourth report of the Health Service Commissioner for England Session.

Clarke, J. (2013). Spiritual Care in Everyday Nursing Practice: A New Approach. Red Globe Press.

Daaleman, T. P. (2012). A health services framework of spiritual care. Journal of Nursing Management, 20(8), 1021–1028. https://doi.org/10.1111/j.1365-2834.2012.01482.x.A

Gultom, R. P. J., Siagian, H. S., & Sitorus, D. H. (2020). Evaluasi peranan faktor spiritualitas perawat di dalam mendukung aspek spiritual pasien rawat inap di Rumah Sakit Imelda Medan. Jurnal Ilmiah Farmasi Imelda, 4(1), 21–27. http://jurnal.uimedan.ac.id/index.php/JURNALFARMASI/article/view/361

International Council of Nurses. (2012). The ICN Code of Ethics for Nurses.

Kemenkes RI. (2016). Modul Bahan Ajar Cetak Keperawatan: Kebutuhan Dasar Manusia 1. Kementerian Kesehatan RI.

Khoiriyati, A. (2008). Perawatan spiritual dalam keperawatan : Sebuah pendekatan sistematik. Jurnal Mutiara Medika, 8(1), 48–51. http://journal.umy.ac.id/index.php/mm/article/view/1654

Mcsherry, W. (2004). Meaning of spirituality : implications for nursing practice. Journal of Clinical Nursing, 13, 934–941. https://doi.org/10.1111/j.1365-2702.2004.01006.x

McSherry, W. (2011). The Royal College of Nursing Spirituality Survey: Challenges and Opportunities for Nursing.

McSherry, W., & Jamieson, S. (2011). An online survey of nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(11–12), 1757–1767. https://doi.org/10.1111/j.1365-2702.2010.03547.x

McSherry, W., & Jamieson, S. (2013). The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 22(21–22), 3170–3182. https://doi.org/10.1111/jocn.12411

Milligan, S. (2011). Addressing the spiritual care needs of people near the end of life. Nursing Standard, 26(4), 47–56. https://doi.org/10.7748/ns2011.09.26.4.47.c8730

Rogers, M., & Wattis, J. (2015). Spirituality in nursing practice. Nursing Standard, 29(39), 51–57. https://doi.org/10.7748/ns.29.39.51.e9726

Royal College of Nursing. (2011). Spirituality in Nursing Care: A Pocket Guide.

Timmins, F., & Caldeira, S. (2017). Understanding spirituality and spiritual care in nursing. Nursing Standard, 31(22), 50–57. https://doi.org/10.7748/ns.2017.e10311

Weathers, E., McCarthy, G., & Coffey, A. (2016). Concept analysis of spirituality: an evolutionary approach. Nursing Forum, 51(2), 79–96. https://doi.org/10.1111/nuf.12128

Yusuf, A., Nihayati, H. E., Iswari, M. F., & Okviasanti, F. (2016). Kebutuhan spiritual : Konsep dan Aplikasi Dalam Asuhan Keperwatan (1st ed.). Mitra Wacana Media.