So-called spirituality in nursing.

I have written before on secular spirituality (Bigger, 2008), that is describing the deep inner selves people have. My model distinguishes this representation of the inner self from belief in [God, the supernatural] and the associated doctrinal content of religious creeds. The problem is that the term spiritual has for centuries linked with religious piety so misunderstandings are easy. Although originally the spirit was the breath, the evidence of life itself and the question is, what can life be at its deepest and fullest. Ours is the first century trying to express this in humanistic and not religious language. We have to make the choice whether to reclaim the word spiritual, or jettison it.

Wilfred McSherry (2006) applies spirituality as a practical concept to nursing and health care. He argues that nursing was a spiritual enterprise of caring (a vocation) but has become mechanistic. Spirituality contains the word ritual within it (actually this is etymologically irrelevant, a coincidence) so  justifies references to religion. However he attempts a definition of everyday spirituality using a football made of hexagonal panels as his model (that is, a representation of thought map). Laying aside ‘belief in God or Supreme Being’ we are left with thinking, feeling, relating and expressing.

Thinking – self awareness, view of the world, attitudes, meaning, purpose

Feeling – hope, inner strength, security, fears, expectations, experiencing life

Relating – harmonious relationships, trust, forgiveness, love

Expressing – creativity, expressing values and beliefs

Of course these intertwine and operate together. Our attitudes and sense of meaning involves other people; our feelings are tied into our relationships with others, and we express our deep thoughts and concerns to others. So this list is well described by the philosopher John Macmurray (1961) as Persons in Relation.

This list is expressed in positive terms, what a human could be at best. It could also be described as inner psycho-social (or personal/relational) wellbeing. The list could have a negative aspect where these criteria are missing. McSherry (2006:59) calls this spiritual distress, or the lack of personal/relational wellbeing or personal/relational dysfunction.

McSherry argues that nursing should take an holistic view, and embeds his view of broad spirituality within this. This perhaps overcomplicates something which should be simple. Nursing involves caring, which includes not only caring for but also caring about. This means that doctors, nurses and all other staff aim to identify and satisfy reasonable needs, emotional as well as physical. Given the nature of ‘emotional work’, this needs to be interpreted unsentimentally. That this caring does not always take place is receiving considerable publicity at the moment. The message to care about patients is simple; clouding it with the language of spirituality just obfuscates the issue.

Reference: WIlfred McSherry, Making Sense of Spirituality in Nursing and Health Care Practice, Jessica Kingsley, 2006.