This Practice Question has been published with the kind permission of the Royal College of Nursing.
With Christmas drawing near, it is timely to consider our celebration of cultural and religious festivals and recognise that they take place throughout the year. Notable dates this year include May 17, October 26, December 22 and December 25. These dates, Buddha Day, Diwali, Yule and Christmas respectively, have considerable significance for many members of our society and celebrating them can be of great spiritual importance. The 2001 census reveals that 70 per cent of people claim to have a religious or spiritual affiliation (Office for National Statistics 2001).
While it may be unrealistic to celebrate every significant day for every patient, we know that assessment of a person’s spiritual needs should be an integral part of our professional assessment (Department of Health 2002). However, spiritual events and meanings give rise to wellbeing (Elliott 2011) and our assessments should include examining the spirituality of those we care for.
This practice question has been published with the kind permission of the Royal College of Nursing.
Evidence shows that nurses do not always recognise the spiritual needs of their patients and they are often unable or ill equipped to assess and provide for individual needs (Elliott 2011). Most healthcare assessments include broad categories relating to nominal religion. Frequently this becomes a request involving a simple answer from a patient, but an individual’s spirituality could be complex and, by its nature, personal. Patients may not feel comfortable discussing their faith with staff because interpreting their spiritual beliefs may not have been something they have ever had to articulate before.
What to ask
Furness and Gilligan (2010) suggest we should ask such questions as:
- What do spiritual and religious beliefs mean to you?
- What role does religion play in your life?
- In addition, staff should:
- Provide opportunities to discuss religious and spiritual beliefs.
- Listen to the resident or patient.
- Recognise that the patient or resident is the expert.
- Respond creatively to his or her needs.
- Seek out information.
- Be genuinely interested and respectful.
- Become aware about their own beliefs and responses to others.
- Be open and willing to revise their own beliefs and values.
- This framework helps us to understand the needs of those people who recognise and align themselves to particular religions.
No religion
But what of the 30 per cent who were identified in the census as having no religious or spiritual dimension to their lives? It is worrying to imagine someone without a faith having to endure the celebration of major religious events such as Christmas, the presence of which can loom from early December. They might be encouraged to join in carol singing, watch nativity plays, and be surrounded by gaudy decorations and people eating to excess.
If patient assessment were to include what particular aspects of faith, belief or values mean to them, then we would know how they manifest that belief and what celebrations, if any, they would like to be part of and those they prefer to avoid.
By simply recording ‘Muslim’, or ‘Hindu’ or ‘Church of England’ in patients’ notes we may be subjecting people to all sorts of events and activities that have no meaning to them. So before we cajole people to join in the celebration of Christmas dinner, we should find out what arrangements there are for those for whom this event has no meaning or enjoyment.
References
Department of Health (2002) Guidance on the Single Assessment Process for Older People. DH, London.
Elliott R (2011) Spirituality, mental health nursing and assessment. Journal of Community Nursing. 25, 3, 4-9.
Furness S, Gilligan P (2010) Social work, religion and belief developing a framework for practice. British Journal of Social Work. 40, 7, 2185-2202.
Office for National Statistics (2001) Census 2001. ONS, London.