A Journal Article A Week (28.01.11): “Emergency nurses’ provision of spiritual care”

Rob Fraser at Nursing Ideas has an excellent project:

Think you have made all your news years resolutions? Think again. This year one of my goals is to keep up with more nursing research issues and trends, if I had an area of practice I would stick with that. To make this happen I am trying to read at least 1 journal article a week, the follow up to that is to share that with others. This can be done in different ways, Twitter, blogging, or even emailing it to people I think might be interested.

My goal is to blog one day a week with an update on the challenge and to share what I read. The hope is that I will do this one day of the week, and I’m going to try and choose a specific day to force myself to be consistent. However, if I really want follow through with this goal I am going to need some encouragement, but more importantly I am hoping to find partners in crime. If you are interested sign up below for what your goal for keeping up with research is and how you will share it. I’m going to post a list at the end of the month with whoever signs up. That way we can keep tabs on each other and possibly share around good articles. I will also be using Mendeley, to share the article in this group feel free to join.

I’ve joined and to kick things off, here’s mine:

APA citation: McBrien, B. (2010). Emergency nurses’ provision of spiritual care: a literature review. British Journal Of Nursing (Mark Allen Publishing), 19(12), 768-773. Retrieved from EBSCOhost.

The Skinny: Spirituality is a crucial part of nursing care, but too often in the emergency department setting, it’s ignored despite intense, intimate and frequent interactions with patients.

Money Quotes:

“However, the commentators conclude that spirituality is an important part of nursing care, but that it is seldom put into practice (Doyle, 1992; Oldnall, 1995). Benett (1997) believes that while nurses are educated and equipped to care physically, psychologically and socially for patients, spiritual care seems to be neglected. A number of reasons for this neglect have been identified, which include the absence of guidelines for the practice of spiritual care, the lack of an agreed definition of the term ‘spiritual’, and the fact that the spiritual dimension is not formally integrated within programmes of nursing education.”

“However . . . results revealed that nurses spent little time connecting with their patients. Nurses in Byrne and Heyman’s (1997) study describe a communication strategy of ‘popping in and out’ used to avoid spending lengthy periods of time spent with patients. The nurses also saw ‘getting patients through the department quickly’ as a more pressing issue than providing psychological support. Perhaps unsurprisingly, a lack of time was the reason indicated more than any other as the factor that influenced the respondents’ ability to connect with their patients and ultimately provide spiritual care.

Environmental factors such as reduced staffing levels or lack of privacy or quiet can have a negative effect on the provision of spiritual care (Ross, 1997). Nystrom et al (2003) observed that, within an emergency department, patients’ expectations of holistic and high-quality care from nurses were quickly reduced to expectations of perfunctory, physical interventions. Moreover, Nystrom et al (2003) suggested that participants refrained from complaining about the quality of care to protect their own integrity.

Pryce (1994) identifies some of the issues that hinder the application of spiritual care in the A&E department. The barriers she identifies are communication, fragmented care, task allocation, and nursing documentation. Indeed, the resultant effect of such barriers is that caring becomes ‘doing to’ rather than ‘caring for’. In a similar vein, Castledine (1993) believes that A&E nursing is faced with a dichotomy between technical competence and traditional supportive nursing. Furthermore, he identifies a holistic approach to the individual patient and family, collaborative decision-making and a more flexible humane environment as areas of A&E nursing in need of development.”

New Insight: Expert practice — meaning technological and clinical proficiency — in the emergency department should lead to greater skill in providing in spiritual care. In other words, how can you provide spiritual care when you can’t tell a sinus rhythm from a fib?

Why You Should Care: Providing spiritual care gives patients sense of well-being and spiritual connectedness as well as increasing professional satisfaction for nurses.

Next Week: “Effectiveness of gerontologically informed nursing assessment and referral interventions for older persons attending the emergency department: systematic review.”