Spiritual practice examples
You may find the following case studies and exercises helpful in exploring spiritual care further.
Case study 3
- Mr Singh Bhuller is a practising Sikh. The wearing of religious symbols and prayer are fundamental. Mr Singh is concerned that his customs and daily rituals will not be maintained while in hospital.
Case study reflections:
- You are the admitting nurse working on a busy, general surgical ward. Can you identify the general principles that would help Mr Singh to continue observing his religious practices while in your care?
- You may have considered the following: don’t make assumptions about what Mr Singh might need; ask him or his family. This will require developing a relationship with Mr Singh or his family
- Simply ask, for example: “Mr. Singh, could you tell me about your daily practice? It would interest me to know and it will help me to find ways to enable you to practise it. Is there anything else that you think you might need?”
- Be mindful that the experience of being in hospital and impending surgery may have provoked anxiety for Mr Singh. Daily practice might be one way that he copes with or overcomes those anxieties
- Exploring those anxieties may also be helpful for Mr Singh.
Case study 4
- Martha is 56 years old. At the age of 50, she was diagnosed with pre-senile dementia. The signs and symptoms had been associated with stress. However a CT scan confirmed organic changes and the diagnosis. Prior to her diagnosis she had been a highly successful businesswoman. Her final position was director of a large international company. Despite being successful Martha had a strong belief and faith in a god but did not attend any formal religious organisation
- In her spare time Martha had enjoyed a range of activities such as travel, painting and regular cross-country runs in the country. Martha liked to spend time on her own reflecting and keeping in touch with the creative aspects of her personality. The slow progression of the disease meant that Martha was very much aware of the deteriorative nature of the illness and the result that this might have upon her life
- As the disease progressed she was unable to maintain her interests and activities. She became withdrawn and isolated within her own inner world. Familiar faces and locations lost their meaning. Martha’s modesty and privacy were lost as she began to become incontinent. Her entire personality changed, resulting in aggressive outbursts, and on several occasions household objects were thrown around the room. Martha had become the complete opposite to everything in which she believed.
Reflections:
- What spiritual needs does Martha have?
- What can be done to try to address these needs?
Possible answers:
Spiritual need: identity. Intervention: try and look beyond the appearance of Martha now to see the Martha who once was. The family’s story as well as photographs will help the nurse to reconnect with her identity. Helping the family will also be a way of caring for Martha.
Spiritual need: rediscover belief and faith in God. Intervention: Martha may need to remember old faith experiences. ‘Re-membering’ through religious activity is a means by which one is reconnected to previous experiences in a way that involves more than five senses. Talk to family about what practices were meaningful to Martha prior to her illness and try to facilitate these. Consider involving a chaplain with Martha/family’s permission. Chaplains have extensive training and experience of praying for, with and alongside others. Establishing whether some religious practice – for example, reading of scripture and/or prayer would be helpful to Martha.
Spiritual need: meaning and purpose. Intervention: Together with Martha and family, identify activities that could bring meaning and purpose such as art, walking and try to facilitate these. Possibly use photographs of her trips abroad to encourage discussion. Consider displaying some of Martha’s paintings by her bedside.
Spiritual need: love and belonging. Intervention: encourage visits from old friends and work colleagues. Maintain dignity and modesty. Consider means of minimising incontinence and deal with this sensitively when it occurs.
Reference: McSherry W (2006) Making sense of spirituality in nursing and health care practice, London: Jessica Kingsley Publishers.

