Nurses’ lived experience of spirituality in relation to helping patients cope with loss in situations of chronic and terminal illness

This qualitative study explores spiritual issues in relation to coping with loss in situations of chronic and terminal illness. An Heideggerian hermeneutic phenomenological approach was chosen as the most appropriate methodology for exploring nurses’ lived experience of utilising spirituality as a means of helping patients cope with loss. My prior knowledge both brought me to the subject of study and influenced my interpretation of data. To ensure transparency of method this prior knowledge is outlined in my fore-structure of understanding.

A purposive sample of 12 registered nurses, 5 from hospice, 4 from community practice and 3 from a nursing home setting participated in semi-structured interviews. A stepped process of analysis of interview texts produced overarching themes which are illustrated with excerpts that collectively produce a ‘thick enough description’ intended to facilitate understanding of my interpretation of data by those who chose to read this study. Findings were illuminated by drawing on existing theoretical knowledge and concepts.

My research diary and notes at interview constituted a research journal that recorded how my knowledge and understanding developed through my reflection on, and reflexive response to interview data. In this way my research journal was used to illuminate the research process.

There are an increasing number of studies that consider spirituality in healthcare and how patients’ spiritual needs can be recognised and fulfilled. However, this study provides a different perspective, in particular, examples of how nurses’ development as persons may render them not only a spiritual resource in themselves, but also, contribute to how they become proficient in spiritual care in situations of loss. There were four overriding ways in which the development of this aptitude was evident. Firstly, belief provided them with a means of coming to an understanding of why things happen and so helped them accommodate repeated exposure to patients’ grief. Secondly, being a spiritual carer involved establishing a relationship with patients through ‘connected’ communication. Thirdly, becoming proficient in spiritual care was reflected by an increasing maturity in engaging with patients’ real life and death issues, which was sustained by taking ‘time out’ to reconnect with the self. Finally, belonging to a team whose culture reflected a spirit of reciprocal support was crucial when patient care was emotionally demanding.