Dante’s epic poem Inferno is one of the defining works of the Western canon. The vivid imagery of the nine circles of hell has been endlessly referenced, reread, illustrated, and used to instill the fear of God in Christians for over seven hundred years. Dante’s conception of the universe is commonly known as a straightforward representation of the Medieval view of the afterlife. However, it has lately been suggested that it is actually a dramatized allegory for Dante’s spiritual reawakening. Thus, Inferno can be categorized as a spiritual autobiography depicting the soul’s transition from a state of damnation to one of grace.
The poem starts with Dante standing in the woods, “gone from the path direct” (Dante & Cary, 1866, p. 1). Three animals block his path up the mountain. The spirit of the Roman poet Virgil, sent by Dante’s love Beatrice, appears to guide Dante. He must go through hell and purgatory to finally enter heaven. If the reader interprets the text through the lens of allegory, it becomes clear that Dante has been motivated by his love for Beatrice to recognize the morally compromised state of his life and alter it: “love brought me thence” (Dante & Cary, 1866, p. 9). However, he must abolish his personal sins of ambition and malice to do so. Despite their paganism, the classical authors of Ancient Rome, quintessentialized in Virgil, will guide Dante in understanding virtue and what it means to live a good life. As the start of his spiritual autobiography, Canto I captures Dante’s decision to pursue goodness despite the difficult spiritual transformation it requires.
Dante and Virgil enter hell and witness the grotesque torment of the eternally damned according to the sins they committed during their lifetime: never-ending icy rain, eternal whipping, burning tombs. He is “o’erpower’d by pity” for the sinners within certain circles, and his “cry prevail’d by strong affection urg’d” (Dante & Cary, 1866, p. 25, 26). However, alongside biblical and mythological figures, Dante notices his contemporaries, such as former popes and political rivals. When he meets Filippo Argenti, the man who exiled him, Dante feels only disgust: “curs’d spirit! tarry thou” (Dante & Cary, 1866, p. 40). In response, Virgil kisses his cheek and praises him for being “justly disdainful” (Dante & Cary, 1866, p. 40). As its member, Dante had been blind to the sinful nature of society and had merely accepted it as an unavoidable reality. During this spiritual transformation, Dante is forced to turn a critical eye towards the world he lives in and recognize the seriousness of their crimes against God. Initially, he feels pity for the punished because he became enamored with sin himself and still relates to their moral incapability to remain pious. However, Dante eventually learns to condemn and despise wrongdoers, thus erasing the sinful urges within himself. Dante’s journey through hell describes his recognition of sin and acknowledgment of its gravity and consequences.
In conclusion, people today still battle their immoral urges and strive to live a virtuous life, just like Dante and all preceding generations. This is the reason the epic poem has kept a stronghold over human imagination since the fourteenth century. However, our conceptualization of these desires has vastly changed. We do not seek virtue out of fear of divine punishment but because of the inherent value of notions such as justice, equality, and human rights. Therefore, to fit our modern sensibilities, we need to recontextualize Dante’s graphic journey through hell as an allegory for personal transformation rather than an unambiguous description of the universe. The first part of The Divine Comedy is a spiritual autobiography depicting Dante’s epiphany and recognition of sin’s consequences.
Brujas and Curanderas and the Mexican culture are two inseparable entities; brujas simply stands for witches while Curanderas symbolizes healers. In this provocative essay, the author becomes a voice for Mexic-Amerindian women that were repressed for centuries by the dual censorship of being female and brown-skinned. The authors use the Xicansma as a surrogate language for Chicana feminism that incorporates mestiza women on both sides of the border: the working poor, wives, and mothers whose cultural roots have been ignored as completely as have been their desires, dreams, and struggles to be heard.
Culture and Spirituality
The author depicts the conflict between indigenous culture and spirituality and western culture and the catholic religion. The abolishment of the Blesses me Ultima conjures up serious issues about banning books because of controversial issues.
The abolition challenges the very nature of democracy and the tradition of respecting the diversity of religious and political thought in the U.S.
The story of a six-year-old Antonio Marez, who grows up in New Mexico in the 1940s, is highlighted, where Ultima is ushered into their homestead. Ultima is a curandera, a woman that is familiar with herbs and the accompanying cures of the ancients, that is so miraculous in the curing process. The Ultima also dared to lift the curses laid by brujas; she does this by exorcising the evil the witches planted in the people to make them sick. The curandera is consequently misunderstood based on his potential prowess and instead suspected of practicing witchcraft herself.
Mexican America Healing
The native Mexicans are deeply rooted in practicing the Mexican American folk medicine otherwise known as curanderismo, this culture is historically imperative in the health care structure as far as the healing techniques are concerned. The authors present a friendly perspective of not only how curanderismo is practiced but also how it is learned and passed on as a healing tradition. In the cultural setup of the Mexicans, curanderos continue to be in demand despite the lifesaving abilities of modern medicine,
Curanderismo is ingrained in the Catholic culture introduced from Spain much more than it is rooted in anything else, which is rather disappointing to newcomers who would like to correlate divergently, perpetuating a myth that things are rather otherwise. The precepts of sickness and health have been ingrained into a cluster of beliefs that incorporate the elements of classical Greek medicine, and the malevolent power of witches, have highlighted that curanderismo and the contemporary modes namely El Nino Fidencio and Pedrito Jaramillo as the main influencers of curanderismo.
Beliefs
A prologue has been predisposed by the Greek humoral medicine that was invigorated during the Spanish resurgence through a wide-ranging consultation of the Latin translations of Galen and Hippocrates on the art of healing. Myriad beliefs and practices have greatly influenced curanderismo; this includes medieval and European witchcraft, early Arabic medicine and health practices, Judea-Christian religious beliefs (symbols and rituals), Native American herbal lore, and health practices, modern beliefs about spiritualism and psychic phenomena, scientific medicine, and the bible.
Curar means to heal, whereas curanderismo is otherwise known as holistic or folk healing normally administered by a curandero (male healer) or a curandera (female healer). Curanderismo comes out in three levels. The material, the spiritual, and the mental. The material puts more emphasis on objects such as candles oil and herbs. The spiritual cuddles a conduit through which healing takes place. The mental focuses on psychic healing. To accomplish the treatment of various diseases, these three phases require rituals that are patterned. Part of the Curanderismo is the belief that the curandero (a) has been bestowed as a gift (don) to heal others.
Feminism
The feminine, in this case, plays her role as an intuitive, irrational, mad woman to illustrate that the characters which Man defines as Woman’s essence, and which, as a result, he uses to make woman inferior, can indeed be liberating since they allow women to affirm the value of her femininity. Constructionist perspectives have been advanced by women who argue that the liberation of women cannot be realized through an essentialist position that celebrates those characters of women assigned by men, but rather through the celebration of the multiplicity of women’s identities. Two positions are therefore evident as opposites within the feminist politics of liberation and are often pitted against each other with essentialists and constructionists each trying to improve the validity of their positions.
The writer depicts marginalized women in the written context with a close focus on spirituality. Spirituality involves a complex interlock that regards race, gender, and class issues. The binary relationship is depicted when mythical and ritualistic images and ideas in the move to cross boundaries involving institutionalized religions and female spirituality and how women of color participate and create within those spaces.
Religions
Catholicism is a religious structure that ushers divergent and denying credence considering race, gender, and class issues. While many women have struggled with their identities as feminists and Catholics, in this novel Loca does not struggle. Loca enters into space where here spirituality can no longer neatly fit into prescribed and pre-conceived hierarchical categories. Locas’ intimacy with Mary exists in a new space that greatly differs from the Catholic teachings. Christianity on the other hand denies women the experience of seeing themselves as divine beings, as long as they shall endeavor in praying to a male god, hence can never attain divine space on the inside, they will also not be able to empower themselves politically in their public and private worlds. The Mexican American community has been pictured both negatively and positively, in Chicano politics and culture. The catholic has been criticized as an agent of colonization, while Chicana feminists have criticized the Church’s central role in promoting restrictive roles for women. Hispanic neighborhoods are littered with magic all around. Little things, like being touched by strangers to prevent the evil eye; holy water, salt, and various powders and potions that are splotched in and around the house to bless and protect it.
References
Cabral. Facundo (1994). El paraíso no está perdido, sino olvidado. Guadalajara: Emilio Valencia. Castillo, Ana. “Brujas and Curanderas”: A Living Spirituality.”
Canada and Furman define spirituality as the heart of helping, which entails act of empathizing and caring for another human being. It is having the pulse of compassion that drives the energy of service delivery. There is a tie between spirituality and healing. Spirituality is the driving force of the social workers and strengthens them not to feel empty, tiresome and lifeless when delivering their services. Spirituality helps them thrive to successfully face the challenges that come along their precincts.
Topics on spirituality and religion have continuously gained popularity over time. Media have written stories on religion and political affiliations, moral and social issues concerning abortion, homosexuality and biotechnological advancement such as human cloning in the laboratories. Recently, much has been brought to limelight by the media, especially on issues regarding the role of religion on war and terrorism.
Additionally, the media have publicized the inspirational spiritual lives of great leaders such as Dalai Lama of Tibetan Buddhism and Nelson Mandela the former South African President. In a statement, spirituality has become the major theme in the global market (Canada & Furman, 2010).
Scholars have examined the correlation between religion and health in the recent past. Undoubtedly, religion plays an integral role in most aspects of life, including health. The main concern is how the research findings can improve the clinical practice. Spirituality differs from religiousness. Religiousness refers to the degree of involvement to religion. It is an expression of spirituality, which encourages a person’s and religious well being.
This paper looks into the relationship between relation, spirituality and health. It will also delineate the importance of integrating spirituality in the Hong Kong clinical practice. Using Empirical studies from other nations, the paper will present the role of religion and spirituality in clinical practice. Lastly, it will look into the barriers of integrating the two aspects into the clinical practice.
Relationship between spirituality, religion and health
Despite the diverse and tremendous amount of research over the recent past on the correlation among spirituality, religion and health, it is still not exactly known how they relate. It is still unknown on the mechanisms by which religion and spirituality positively or negatively influence the overall well-being of an individual.
However, the topic remains an incredible research field. High quality studies can offer credible psychological, social, behavioral and biological mechanism on how religion and spirituality connect to health (Ness & Larson, 2002). Nevertheless, the available theological findings indicate that the relationship between spirituality and health has been cycled between institutions since the time in history. In the past diseases have been associated with bad luck:
The most advanced civilizations of ancient times (Assyrian, Chinese, Egyptian, Mesopotamian, and Persian) equated physical illnesses with evil spirits and demonic pos- sessions. (Lee & Newberg, 2005, p. 1)
Treatment, therefore, entailed casting out these spirits. Physicians and health practitioners then were viewed as religious groups irrespective of the source of their healing power. Recently, there has been increased interest in understanding the effects of assimilating spirituality in the medical field.
Much has been covered by popular news magazines and televisions on the interplay of religion and health. Additionally, research reveals that most patients highly regard religion and wish that their physicians could discuss religious issues with them (Lee & Newberg, 2005).
This remains an imperative topic in Hong Kong. Hong Kong have the right is protected by the law and various other relevant legislative bodies. There are diverse religious groups in Hong Kong Special Administrative Religion (HKSAR) SUCH AS Hinduism, Buddhism, Taosim, Confucianism, Islam, Judaism, Christianity, and Sikhism. All these groups have a significant number of adherents. The religious groups also offer other services apart from religious instructions, including schools and health care facilities (Koenig & Cohen, 2002).
The path of spirituality in Hong Kong Clinical practice
The paths are guided by various Eastern philosophical religious traditions. Psychological decenter has been identified as the most contemporary relevant attainment of spirituality. According to Daoist philosopher Zhuangzi, spirituality is the act of forgetting oneself to contemplate the welfare and the equality of all things. It is the act of thinking of others first.
Spirituality in work contemplates on the mechanisms in which it can be resourced to promote the well-being and harmony within an individual, the society and the entire world. Spiritually sensitized social worker addressed the ways in which the entire community can seek a sense of meaning, connectedness as they aim to attain the highest aspirations, and they work together to overcome challenges and gaps in the resources (Castanheira et al., 2010).
Individuals express spirituality in religious or non religious ways across the nation. Healthy spirituality encourages individuals and communities to create a purposefulness, personal integrity, joyful, peaceful and contented coherence of overall world being. It engenders respect and support extending to other people.
It encourages the establishment of mutual support, philanthropic activity to appreciate diversity. However, many are times when the concept of spirituality is distorted and misdirected to beliefs, attitudes and behavioral activities that result to hopelessness, oppression and discrimination in the society (Canda, 2009).
In this context of spirituality, it is high time for the Hong Kong Medical industry to emulate other nations by establishing ethical principles and standards such as USA’s National Association of Social workers (NASW) and the international association of schools of social work and International Federation of social Workers (IASSW/IFSW).
These principles are put in a way that they set in a way to encourage and challenge each of the workers to exercise full responsibility and rightfully in order to enhance social stability between the citizens, spiritual perspectives and the sociopolitical aspects (Canda, 2009).
Spiritual health workers enable them to utilize their expertise to help patients to recover by attending biological, physiological and spiritual needs. It assists the worker to utilize his or her strengths and environmental resources in a socially and ecologically responsible manner improving his or her service delivery. Additionally, spiritually sensitive workers will deliver services in fairness, particularly when dealing with the vulnerable and oppressed groups in the society.
This way, they will fight environmental racism, international social injustice or any intercultural conflicts prevailing in the nation that can be detrimental to the ecological systems of the universe. Additionally, integrating spirituality in the health care unit will ensure that medical practitioners treat all patients compassionately and respectfully irrespective of cultural differences, or religious diversity.
They address the patients with utmost professionalism responsive to the values of the patient and the community at large. This will enhance respectful connections across differences establishing a common ground for harmony and cooperation in Hong Kong (Lee & Newberg, 2005).
Medical practitioners honor the universal human needs bringing in purpose, morality to sustain doctor-patient relations, which boost self-determination in the effort to fight communicable and non communicable diseases as a community’s global responsibility. The healthy relationship is important for growth of clinical practice. This is because it facilitates the collaboration between the religious and non religious spiritual support systems.
In turn, it strengthens, restores and sustains the well-being of the patient, families and the entire society bringing in the issue of communality. Furthermore, spirituality increases professional competence for effective practice, especially in regard to explicit use of religious and non- religious spiritual beliefs, rituals and other prevailing therapeutic practices.
Medical practices across the diverse traditions and cultures equip the practitioner with the relevant knowledge and skills so that the practitioner can perform his duties with respect to the values and preferences of the patient’s traditions. This helps the spiritual practitioner to understand on how to cooperate and collaborate with the community-based health practices with spiritual support of the culturally competent healers (Canda, 2009).
Empirical studies on Role of religion and spirituality in Clinical practice
Various investigations done indicate that religion and spirituality takes an integral part many individuals’ lives. Americans are dominantly God fearing people: “Over 90% of American adults say that they pray and believe in God or a higher being, two-thirds are members of churches or synagogues, 40% attend religious services regularly” (Lee & Newberg, 2005).
Religion gives hope to an individual; it helps to set the mood right. When one has a strong will to live even through hard times, he or she forms the right attitude and approach towards life. Having the right attitude helps one to keep on moving in the right direction.
At least, 75% of patients wish the physician would integrate spiritual issues in their medical field such as discussing their religious faith with them. Not many physicians acknowledge the relationship between religion and healing. Research points out inadequate time, inadequate training and difficulty of identifying with the specific patients’ spiritual issues as the main discrepancies that hinders integration of religion into clinical practice (Lee & Newberg, 2005).
However, various scholarly reviews show a relationship between morbidity and mortality.
In G. W. Comstock and K. B. Partridges (1972) analysis of 91,000 people in a Maryland county, those who regularly at- tended church had a lower prevalence of cirrhosis, emphysema, suicide, and death. (Canda, 2009, p. 1)
Several other studies after also revealed that religion and higher religiosity had a beneficial effect on blood pressure. It has been shown that mortality and morbidity are affected by: “religion, biological, behavioral and socioeconomic differences” (Canda, 2009, p. 1).
For instance, a study of contemplative monks in the Netherlands showed that mortality compared with the general population varied with time during the 1900s. Another study elsewhere showed that: Greater morbidity and mortality have been reported among Irish Catholics in Britain, which may reflect their disadvantaged socioeconomic status there. (Canda, 2009, p. 1).
A number so scholars have shown that being religious help one to recover fast especially after a major surgery. Oxman’s and colleagues research in 1995 on 232 open-heart surgery patients indicated that absence of strength and comfort from religion as consistent predictors of mortality. Similar studies carried out have shown the same results. In study on African-American Women suffering from breast cancer also indicated that longer survivability to religious patients (Anon, 2006).
Behavior and lifestyles accounts for the above observed effects of religion on health. Studies in Israel showed that secular citizens had poor eating habits whereby they fed on food rich in saturated fatty acids, high levels of cholesterol, triglycerides and low-density lipoproteins as compared to the religious ones. Additionally, religion involvement is associated with the increased use of preventive measurements such as use of seat belts.
Religion also plays a large role in preventing sexual immorality. Study by McCree at al. (2003) showed that religion played a significant role in ensuring that young were open to each and could literary discuss any topic. These young people were found to have clear understanding of HIV, proper birth control methods and risks associated to unprotected intercourse. However, the findings are not universal as in some religion traditions and environments suppress open discussion of topics related to sexuality (Lee & Newberg, 2005).
Religious groups are the major sponsors of the majority of hospitals and health care clinics. This implies that the religious groups promote and provide access to better health.
Additionally, Religious belief provides greater meaning in people’s lives. This helps the patient to cope better with their diseases. Religion views suffering from different perspectives: “many major religions have deemed illness and suffering the result of sin, many also believe that pain and suffering can be strengthening, enlightening, and purifying the individual” (Koenig & Cohen, 2002).
It gives hope of restoration to the patient as pain and suffering is inevitable. They are test the virtue that stimulates spiritual growth and defines human life. However, religions differ on how they confront illness. For instance, Buddhists believe in enduring pain Whilst Hindus stress the understanding and detaching from the pain. Muslims and Jews resist of fight the pain whilst Christians seek atonement and restoration/redemption (Koenig & Cohen, 2002).
Barriers of assimilating spirituality and religion in Hong Kong Clinical practice
Spiritual experiences are not easily articulated verbally. Sometimes they may not even be acknowledged by the individual experiencing it. It is highly personal such that it is not easily revealed to others. Religion has also been associated with negative effects: For instance, some religion directly opposes certain health care procedures such as transfusions or birth control procedures.
An example is that of a research carried out by Mitchell and colleagues in 2002 indicated that religious beliefs delayed African-American from seeking medical intervention to diagnose breast lumps (Ho & Ho, 2007). In other occasions, religious laws or dicta can be misinterpreted to justify oppressive behavior causing psychological anguish to the patients.
In some cases, spiritual abuse such as telling a patient sinner that they will burn in eternally among others can complicate patient illness (Ming-Shium, 2006). There is a need therefore for doctors to counter such kind thinking and ensure that any person attended to him or her follows strictly prescription.
Another major dilemma is the training of the medical practitioner in order to understand the different community based beliefs. The government will be forced to chip in for the faith communities in order to provide the aid desperately needed by the community.
Conclusion
Media have publicized heavily religious and political affiliations, moral and social issues concerning abortion, homosexuality and biotechnological advancement such as human cloning in the laboratories. Additionally, much has been discussed on issues regarding the role of religion on war and terrorism.
This calls for Assimilation of spirituality and religion in Hong Kong Clinical practice to promote harmony locally and globally. Also, it is aimed at strengthening the available resources by incorporating spirituality and religion into the social practice. The move aims at addressing obstacles and gaps in the society brought by tradition and cultural beliefs and practices. Spirituality and religion in the health sector will be used to impede nepotism or social injustice.
Evidently, by using each community own religious and spiritual traditions and practices properly, it will result to empowerment, beauty and wisdom in the society eradicating great discrimination that prevailed before. Integrating Spirituality and religion to clinical practice will conceptualize the strengths and resources of the Hong Kong communities in the aim of transforming challenges to opportunities for the society’s welfare.
Healthy spirituality and religion will encourage individuals and communities to develop a purposefulness, personal integrity, joyful, peaceful and contented coherence of overall world being.
The move will engender reverence and support extending to other people and encourages the establishment of mutual support, philanthropic activity to appreciate diversity. It will facilitate impeding concept distortion and misinterpretation of spirituality and religious concepts by beliefs, attitudes and behavioral activities eradicating hopelessness, oppression and discrimination in the society and in the world.
It is advisable that doctors should have different knowledge on how different religion viewed treatment. Such an information is crucial to the doctor as he or she will be in a position make the right judgment which does not conflict the patient belief system.
References
Anon. (2006). Religion and Health: Effects, Mechanisms, and interpretation. Spirituality and Health. Web.
Canada, E. R. & Furman, L. D. (2010). Spiritual diversity n social work practice: the heart of Helping, New York, NY: Oxford University press.
Canda, E. (2009). Spiritually Sensitive social Work: An overview of American and International trends. American and International trends. Web.
Koenig, H. G. & Cohen, H. J. (2002). The link between religion and health. New York. Oxford University press.
Lee, B., & Newberg, A. (2005). Religion and Health. A review and critical analysis. Vol 40, No 2p 443-59. Web.
Ming-Shium, T. (2006). Illness: An opportunity for spiritual growth. The journal of alternative and complementary medicine. Vol 12; 101026-33. Web.
Ness, P., & Larson, D. (2002). Religion, Senescence, and mental Health: The end of life is not the end of Hope. Am J Getiatr Psychiatry 10:4; 386-97. Web.
The chosen study delves into the effect spirituality might have on the rehabilitation process. For this reason, its main aim is the investigation of practitioners views on the role spirituality plays in the counseling of adults with congenital and acquired disabilities (Pandya, 2017). The author assumes that the given aspect could be crucial for the final results and might help to meet the social goal by improving the state of a person.
Importance
The choice of the given article is preconditioned by the outstanding topicality of the issue which the author touches upon in the paper. People with congenital and acquired disabilities remain vulnerable and suffer from the significant deterioration of the quality of their lives. For this reason, the investigation of the impact spirituality might have on the rehabilitation process becomes the top priority for researchers as it might help to improve the situation significantly.
Method
The given study is organized in the form of a survey that is distributed among practitioners who work with disabled people. The author admits the fact that the given data collection method is extremely important for the final result as it helps to use relevant information related to spirituality and its impact on rehabilitation counseling (Pandya, 2017). For this reason, the results of the survey could be used to prove the authors idea and demonstrate the necessity of further investigation of the sphere.
Participants
The survey was distributed among 1,269 practitioners in the field of disability (Pandya, 2017). The choice of participants was preconditioned by several factors. First, their experience and competencies were taken into account as they are crucial for the relevance of data. Second, respondents from 15 countries were involved to guarantee a comprehensive investigation of the issue. Finally, their significant number preconditioned the improved credibility of results and created the ground for the further investigation of the topic.
Findings
In the course of the investigation, the author concludes that spirituality should be considered a crucial factor that impacts the rehabilitation process. Results also demonstrate that the majority of practitioners have a positive attitude to spirituality. These facts evidence the great significance of spiritually sensitive approaches and justify their use in practice to assist people with disabilities in their recovery.
Discussion
The article could be considered an important step in the investigation of the rehabilitation counseling and the impact different factors have on it. The author takes spirituality as one of the tools which could be used to assist patients in their recovery. He explores an unusual perspective on the issue and states that in case the given aspect is considered, people living with disabilities demonstrate better results and are more probable to meet the social goal (Pandya, 2017). However, the study could be improved. For instance, it is possible to introduce two control groups to compare the impact spirituality has on patients and their relations with practitioners. The usage of this pattern will help to collect additional data needed for further research.
Evaluation of Results
Altogether, the results of the study become important for further investigation of the sphere of rehabilitation counseling as they introduce a new perspective on the traditional issue. Moreover, the credibility of data preconditions the relevance of the research and its increased practical utility.
Future Research
However, there is still much to be learned about the sphere of counseling as the role of other factors and their impact on practitioner-patient relations remain unclear, and the study does not answer how these could be incorporated into real practice.
Reference
Pandya, S. (2017). Spirituality in rehabilitation counseling of adults with physical disabilities: Views of practitioners across countries. Rehabilitation Counseling Bulletin. Web.
Nursing profession is a service oriented profession and involves taking care people all through the life. This is a profession that provides an essential service to humankind. The career possibilities for nurses are endless and it is a profession that offers exciting challenges and boundless career opportunities. Practicing as a Nurse can be both psychologically tough at the same time it can be also rewarding. The setting in which nurses work include hospitals, clinics, schools, wellness centers, long-term care facilities, home settings, and temporary help agencies. Additionally, nurses also concentrate in specific fields such as: Neonatal, Labor and Delivery, Intensive Care, Operating Room, Cardiac Care, Geriatric, Pediatric, Oncology, Rehabilitation, Occupational Health, Pulmonary, Diabetes, and others. Each of these specializations need the development of specific skills required for care by nurses.
Main body
In 1859, Florence Nightingale the founder of modern nursing expressed her meaning of nursing as “the goal of nursing is to put the patient in the best condition for nature to act upon him primarily by altering the environment”. This is the same thought that motivates most of the nurses and I have also got similar thoughts. Though it is the physicians that take care of a patient’s physical well being, nurses play important roles of consolers, comforters and counselors. Patients are more comfortable to share their true feelings with a nurse than their physicians. Nurses are the only ones who provide care to patients 24/7, and this is the reason why nurses are perhaps the best friend of a patient. No matter what patients are going through, they’re always there to thank the nurses who take care of them.
The art of nursing is seen in the care that nurses provide for patients. Nurses collectively join physicians in practicing the art of healing. Everyday nurses apply their skill, knowledge and care during their practice. Because of this, the sick people get better, and terminally ill are able to receive comfort through medicine, emotional and spiritual support from the nurses. Most of the patients get the best possible treatment and care even at the end of life journey.
The Science of Nursing involves Evidence – Based Nursing and Nursing Informatics. Evidence Based Nursing (EBN) is the method using which nurses make clinical decisions. When using EBN nurses uses the best sources of research evidence, their clinical expertise and patient preferences to solve the challenges that they face. The clinical problems they identify as the driving force for clinical change which improves health care quality. According to the definition given by Lindberg (2004), “EBN is the clinical decision making based on the best available scientific evidence, together with clinical nursing expertise and taking into account patient preferences and available resources”.
As technology has entered all other fields it has entered the nursing field also. Computerization in very common in most of the health care institutions and therefore nurses need to have good computer knowledge. Nursing Informatics is a recently developed field that combines nursing skills with computer expertise. This field is the modern technology that aids with documenting and communicating the service or care provided. Today, in most of the hospitals the records have less information and most of it is stored in computers which is a total different situation from 80s and 90s. It is often seen nurses in the hospital work with mobile computers in the patients’ room. Therefore, recent years have seen several advancement using latest technologies. The nurse compensates for what the patient cannot do, while teaching them how to care for themselves. With the death and dying, I allow as much independence as long as possible. Dignity and comfort is maintained to the end of care.
Nursing is a self-motivated profession or as an art of science with a growing body of knowledge that is supported by research within the profession. Nursing mainly focuses on supporting human beings to overcome the health challenges they face all through their life. Modern nursing teaching approaches with new technology-based teaching and learning assignments increase student attainment, including retention, motivation, and class participation; improve learning and significant thinking, provide instructional reliability, and augment clinical education. One of the key role of the nurse as a health care contributor has been one as a patient educator. Knowledge management is the unambiguous and systematic organization of fundamental knowledge and its related processes. It necessitates turning personal knowledge into knowledge for learners-at-large through the organization of information across guidelines.
In United States changes in the health care system, caused nursing to evolve into multiple level of practice because of the increasing cost and dramatic advances in scientific knowledge. In many jurisdictions, Advanced Practice Registered Nurses (APRNs) are practicing separately and performing procedures previously reserved for physician practice. Nurses with advanced skills are looking for specialized and economic recognition through certification and authority to practice. But lack of stability in education, titling, credentialing, program accreditation, scope of practice and compensation have puzzled the public, legislators, regulators and nurses themselves, and have stalled efforts to make full use of assistance of APRNs to health care.
Extra professional education is necessary for an APRN to carry out within a scope of practice beyond customary registered nursing practice. With graduate level education, a nurse further develops conceptual and vital thinking, at an advanced level, knowledge of research and its explanation for practice, and the required necessary therapeutic skills. Graduate education is generally required to produce competent, independent professionals. Criteria for APRN Certification Programs (2002) identify critical elements of advanced practitioner education. According to the criteria, APRNs should graduate from a formal graduate advanced practice program with a concentration in the advanced nursing practice specialty consistent with the certification that the individual is seeking and in accordance with the National Task Force Professional nursing organizations have supported the recognition of advanced nursing practice through the mechanism of voluntary certification.
The principle of Criteria for Certification Programs is that an examination must be appraised in light of its planned purposes. Criteria used to evaluate an examination’s sufficiency will differ depending on its intended use. Nurse practice acts make out boundaries of practice. Such as, the granting of regulatory authority should be specific to the practice area. Licensed APRNs are also responsible for practice that reflects the state of the science and the evidence-based rule that form the standard of care. This standard requires ongoing aptitude and quality improvement.
Negligence to control advanced nursing practice creates potential hazards for the public. Without licensure, complex activities requiring a high level of specialized knowledge, and independent decision-making may be performed by persons without sufficient training and skill. However, professionals are in general not held legally accountable for their practice if they do not have the license. For most boards of nursing, the current approach to licensure involves reliance on educational credentials, certification examinations and the information provided by the applicant. Therefore, support of educational institutions, accrediting bodies, credentialing organizations, regulators and licensees is essential to produce the best result for the health care of the public (National Council of State Boards of Nursing, 2002).
In general, the vision that nurses have is one in which each and every patient is treated equally with dignity and respect always. For this purpose the health care institutions have systems that are designed for the benefit of individual needs. At the same time the work performed by nurses is valued and respected. From a nursing perspective the main points that aid nurses achieve the vision are as follows: development of care plans that are focused on patient and measures as part of performance management and the clinical governance agenda. Secondly, the development of leadership based on personal growth and principles and last but not the least the development of new clinical career and competency framework for nursing (Kitson, 2001). In order to achieve these visions there is a need for a paradigm shift in the values, priorities, policies, and power associations in the health service.
In 2002, nurses were raised to such a position that they are able to influence healthcare policy and legislation. Today there is a greater need to develop leadership skills among nurses together with the clinical skills. For this purpose new nursing training schedules needs to function on operating the latest technology and complex medical equipment. However, it is not always possible that nurses are able to use all the knowledge and expertise when they are the bedside (Valentine, 2002).
Nursing requires strong, consistent and knowledgeable leaders, who are visible, inspire others and support professional nursing practice. Leadership plays a key role in nursing profession as it is one of the most important elements in creating quality professional practice environments. And only under this leadership wing can new nurses start their professional life. Nurses need to understand that the main leadership qualities that they need to develop is as follows – to be the providers of quality care, propagating teamwork, articulate communicator, counselor, risk taker, role models and visionary. It is important to remember that it is only with effective nursing leadership that nursing practice and effective health care policies can be shaped and influenced in future (Antrobus and Kitson, 1999).
Creative thinking is an important link in the teaching-learning process, as it is a very important aspect that enhances problem solving in nursing practice (Kalischuk and Thorpe, 2002). Today, there are several health care units that have initiated programs that consist of arts and creativity. Researchers have found that due to the unique links with patients, nurses play a vital role in bringing creative arts into patient care (Lane, 2005).
The importance of communication skill for professional nursing practice is well recognised. When communications are good, information flows smoothly, delivering clear messages that people can easily understand and act on. When it is not, confusion leads to misunderstanding, inaction or wrong actions. Any mistakes in communication among the nursing staff can lead to serious problems. There is a growing demand for nurses with skills to treat patients with multifaceted care needs. The traditions in which people communicate have deep effects on those who are around them. Peplau (1952) redefined nursing as an interpersonal, interpretive practice (Tilley, 1999). Peplau created one of the first statements of principles for the study of nursing as a communicative practice. Nurses must take action on the basis of the meaning of events to them, on the base of their instant understanding of the environment and performances that emerge in a particular rapport. However, the patient may act on the basis of his illness to him. “The interaction between nurse and patient is fruitful when a method of communication that identifies and uses common meanings is at work in the situation” (Peplau, 1952). The impact of this outlook of the nursing has been deep over the last 50 years and there has been a revolution in research and theory on communication processes in health care.
In reality, there are a lot of studies gone into nursing and communication skill needed for a nursing practitioner. Therefore, it is vital for practitioners to understand the main tendencies and topics in the learning of communication, so as to integrate this information within professional practice. Communication is an influential life-changing activity and a varying outcome can come out from the method of caring for others depending on the way communication is managed. Information on the National Health Service in the UK (Ombudsman, 2003) and various studies have revealed inadequate communication in health care was the major source of patient discontent (Caris-Verhallen et al 1999). According to Fredricksen (1999), “in what manner nurses speak, write, gesture, use signs and images and react to the spoken, written and non-verbal communication of others have a major effect on the quality of health care”. Indeed, health care and communication goes hand in hand.
Modern nursing is changing with new roles and working practices. As mentioned earlier, professional nursing is an art and applied science. Nursing is a self-motivated profession or as an art of science with a growing body of knowledge that is supported by research within the profession. Today, the nursing profession is serious problem of shortage of staff that it becomes difficult for giving the patients the best risk free environment. The worldwide nursing shortage is a matter of concern to every one.
If we look at the healthcare industry, it is growing fast when compared to other industries. The reduction in the number of nursing leaders may result in influencing the shortage of nursing staff as studies have found that nursing leaders can bring in flexibility in the profession. Today there is a real scarcity of nursing staff in major research and teaching hospitals and there is a great concern about the scarcity of nursing staff (Singhapattanapong, 2002).
Conclusion
In conclusion, it can be said that nursing is a profession that involves taking care of patients with utmost care and using the latest technologies. All the efforts focus on creating a best environment for the recovery process of patients. Basically, nursing faculty needs to make use of their critical thinking, creativity, problem-solving and effective communication skills. Nurses also need to be understanding towards the cultural diversity while they are delivering therapeutic care. Modern nurses need to be leaders, coordinators, teachers and practitioners. Additionally there are several responsibilities that they have to specialize. With the increasing demand for nursing staff all over the world, it is important that more and more people get trained and get into this noble profession. In simple terms, this is the only profession in which nurses focus on helping individuals, families and communities in achieving, re-achieving and maintaining optimal health.
References
Antrobus, S. and Kitson, A., (1999). Nursing Leadership: Influencing and shaping health policy and nursing practice. Journal of Advanced Nursing 29, 746-753.
Fredricksen L. (1999) Modes of relating in a caring conversation: a research synthesis on presence, touch and listening. Journal of Advanced Nursing 30(5):1167–1176
Kalischuk, R.G. and Thorpe, K. (2002) Thinking creatively: from nursing education to practice. J Contin Educ Nurs. 33(4):155-163.
Kitson, A. (2001) Nursing leadership: bringing caring back to the future. Quality in Health Care10: ii 79-84.
Lane, M.R. (2005) Creativity and spirituality in nursing: implementing art in healing. Holist Nurs Pract. 19(3):122-125.
Lindberg, C. (2004). Evidence-Based Nursing: Advancing the art and Science of Nursing Practice. New Jersey Nurse Research Corner, 2004.
National Council of State Boards of Nursing (2002). Regulation of Advanced Practice Nursing. 2002 National Council of State Boards of Nursing Position Paper.
Peplau H. (1952) Interpersonal Relations in Nursing. Putnam, New York. pp 283–284
Singhapattanapong, S. (2002). Nurse shortage hurts UCLA Medical Center. UCLA Daily Bruin, 2002, p.1.
Tilley S. (1999) Altschul’s legacy in mediating British and American psychiatric nursing discourses: common sense and the ‘absence’ of the accountable practitioner. Journal of Psychiatric and Mental Health Nursing 6: pp 283–285
Valentine, S.O. (2002) Nursing Leadership and the New Nurse. Journal of Undergraduate Nursing Scholarship Vol. 4, No. 1, 2002.
The field of nursing has experienced significant changes within the realm of the delivery of competent nursing care to all patients within the past two decades. Much of the recent changes can be seen in the trend towards holistic care of all patients irrespective of race, ethnicity, gender, religious affiliation, and other important characteristics. The notion of holistic care is one that involves the construct of spirituality.
In treating patients, it is prudent for a nurse to assess the spiritual needs of the patient. In fact, the Joint Commission on Accreditation for Health Care Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF) mandates that all nursing facilities conduct a spiritual assessment and incorporate the provision of care aimed at meeting the spiritual needs of their patients into their nursing care plan (Galek, Flanneily, Vane & Galek, 2005).
Galek, Flanneily, Vane & Galek (2005) posit that there are seven major constructs to examine when one assesses the spirituality of the patient—conceptualizing the constructs of belonging, meaning, hope, the sacred, morality, beauty, and acceptance of dying paints a clear picture of the spiritual needs of a patient and can serve as a means of determining the deficits within the realm of spirituality. This picture can then be used to create a nursing care plan that addresses the whole patient in a manner that proves to be beneficial to the patient.
It was noted that the construct of spirituality was one that proved very esoteric in nature, and it was one that had to be operationally defined. In an attempt to conceptualize this construct, it is prudent that the literature on the subject is closely examined. This investigation yielded the discovery of several topologies on which a conceptualization of spirituality can be based and can utilize the notion that individuals who suffer from a terminal condition can obtain the optimal benefit from holistic care. This operates based on the presumption that individuals who are in the process of dying can benefit from embracing their spirituality. In so doing, acceptance of the inevitable is facilitated, and the stress level of the patient is kept at a minimum.
In examining the construct of spirituality as a means of determining the needs of a patient who is approaching the end of his/her life, six general themes emerged, and a six-category topology emerged. The most fundamental aspect of this topology was the notion that religion played a vital part in the paradigm of spirituality. Religion was examined in the formal sense of the word, and it was determined that prayer and transcendence were important components to a spiritual existence.
Additionally, many patients exhibited the notion that there was life beyond existence on earth. The thought of such an existence served to facilitate a feeling of comfort, happiness, and peace. Furthermore, values such as hope and faith proved significant. It was determined that it was prudent that the patient communicates their conceptualization of these constructs to health care providers (Galek, Flanneily, Vane & Galek, 2005).
Galek, Flanneily, Vane & Galek (2005) were able to develop an assessment tool that served as a precursor to any treatment plan. The assessment tool consisted of a 29 item four-point scale which examined the constructs of Love/belonging/ respect, divinity, positivity/gratitude/hope/peace, meaning and purpose, mortality and ethics, appreciation of beauty, resolution/death, and control. This tool is able to recognize deficits in any or all of the aforementioned areas and will aid the nurse in devising a culturally competent treatment plan for the patient.
McEwen (2005) examined the notion of spirituality, and in so doing, the concept of nursing intervention was explored. In this vein, the constructs of spiritual growth facilitation were examined, and proposed interventions included active listening, the reading of scriptures, the creation of a journal, establishing a connection with God, instilling faith, and other similar measures. Incorporating these interventions with a patient involves a certain level of trust on the part of the patient in that religion and spirituality are entities that are extremely personal to many individuals.
In order for the patient to be able to share his/her religion with a nurse and for the nurse to act responsibly in rendering spiritually sensitive care, there must be a dyadic relationship which is built on the notion that both the nurse and the patient are operating in the best interest of the patient.
In examining the notion of how I would incorporate spirituality as an approach to the holistic care of the patient, I would have to say that I would first conduct an assessment of the spirituality of the patient utilizing the assessment tool developed by Galek, Flanneily, Vane & Galek (2005). This tool proves to be effective in detecting the various aspects of a patient’s spirituality. After the administration of this assessment tool, I was addressing the areas of deficit utilizing an eclectic approach that is based on the needs of the patient as well as the capability of the patients to respond to certain methods of intervention.
For instance, a patient may be very spiritual, but he/she may not be religious. In deriving my intervention, I would take that into consideration, and in lieu of reading the bible to that patient, I would possibly engage in therapeutic communication and active listening as a means of learning about the patient’s spirituality. Essentially my intervention would be very individualistic and guided by the needs of the patient and his/her willingness to participate in the method of intervention.
When dealing with the aspects of spirituality and religiosity, it is prudent to examine interventions that the patient is willing to explore as these aspects of an individual are very personal. I consider myself to be a spiritual individual but object to the notion of organized religions. For a patient with a similar belief system, scripture reading may prove to be counterproductive. For a patient who is very religious, the reading of scriptures may prove to be very beneficial. It all depends on both the comfort level of the nurse and that of the patient. It is prudent that those levels be examined when rendering spiritually competent care. It is important to keep in mind that irrespective of the intervention used, the whole goal of holistic nursing care is to assure that the physical, psychosocial, as well as spiritual needs of the patient, are met.
Indigenous population refers to the category of individuals who have lived at a particular place for a long time. Indigenous people exhibit loyalty to their cultures by holding to its teachings (Kirk, 2008). Despite the pressure experienced by such people from external powers, they remain faithful to what their cultures dictates. On the contrary, non-indigenous people are flexible in their undertakings. Therefore, this paper aims at examining the indigenous spiritual health and medication. In the effort to explain the above, the paper will include the differences in medical care between indigenous and non-indigenous categories.
The effect of spiritual belief and medical care
People residing at diverse locations around the globe have varied beliefs concerning their health. However, these beliefs pose great challenges to medical practitioners while treating them. In explaining this statement, the examination of Latinos, which is an indigenous group found in United States will be essential (Kirk, 2008). Despite the diversity of the different groups that constitute the Latinos, studies show that they possess common cultural practices. Amongst the practices exercised by this cultural group, which intensifies the treatment process includes; their beliefs in folk illnesses, supernatural beings, magic, as well as witchcraft (Kirk, 2008). As opposed to the non-indigenous groups, Latinos depict a strong belief in existence of illnesses, which they argue that no hospitals remedy can help in curing them. In most cases, this group of people majorly seeks refuge from traditional healers.
The socio-economic conditions on medical care
In trying to define the indigenous health, it is fundamental to comprehend that the physical, social, as well as the psychological health is key in the overall individual’s well-being. However, despite the similarities witnessed in the health of varied indigenous groups, studies designate a wide gap amid this category and the non-indigenous groups (Kirk, 2008). The decline in the socio-economic conditions of most indigenous groups has adversely affected their health. During the colonial times, most indigenous groups experienced some key transformations.
The colonial powers possessed great interest in acquiring most of their resources. They, therefore, culminated into settling at the fertile lands leaving the inhabitants poor. They also suffered significantly from the political autonomy. It is apparent that these invaders brought with them numerous dreadful diseases, which left a large proportion of their inhabitants dead (Lueckenotte, 2006). Consequently, their poverty further contributed to their powerlessness to access the most basic care. Concurrently, the non-indigenous groups could access all the necessary health services. Thus, it is clear that the economic position of such groups adversely influence the medical practices given to them.
Cultural beliefs affecting the medical care
Literatures show that health professionals undergo many challenges while attending to indigenous people. Organist a, Marin & Chun (2009), illustrates a life story of a certain family in the U.S. The cultural practices of the population from which the family ailed from did not acknowledge the use of medical care in treating ailments (Organista, Marin & Chun, 2010). Therefore, their daughter fell sick. According to them seeking for medical solutions did not linger their minds (Austin & Boyd, 2010). However, a neighbor’s advice helped them change their stand on the matter, thus taking her to a health centre. The doctor diagnosed her with epilepsy, treated, and discharged her. Because of their neglect to follow medication, she finally died.
Conclusion
In conclusion, it is clear that, cultural practices, spiritual beliefs, as well as socio-economic factors contribute significantly to difficulties in offering healthcare to the indigenous groups as opposed to non-indigenous groups. The Latinos of the U.S. are an appropriate example of a group that failed to belief in hospital related remedies in taking care of illnesses. This means that even after seeking medical advice they may end up neglecting it thus the challenge for the health practitioners.
References
Austin, W. & Boyd, M. (2010). Psychiatric & mental health nursing for Canadian practice. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
Kirk, W. (2008). Encyclopedia of public health. New York, NY: Springer publishers.
Lueckenotte, A. (2006). Gerontologic nursing. Philadelphia, PA: Elsevier Health Sciences.
Organista, P., Marin, M. & Chun, M (2010). The psychology of ethnic groups in the United States. Thousand Oaks, CA: Sage.
Anewalt (2009) defines compassion fatigue as the physical, spiritual, and emotional depletion experienced by health care providers, first respondents, and emergency room personnel while giving care to patients in significant physical and emotional distress. The term appeared for the first time in literature over two decades ago when Joinson coined it in reference to the ‘loss of the ability to nurture’ (1992) among nurses working in emergency care settings. By then, Joinson was conducting her seminal work on the effects of burnout on nurses in the emergency care department. Joinson noted that compassion fatigue was closely related to burnout and that it mainly affected people in care-giving roles. According to Anewalt (2009), the main indicators of compassion fatigue include: detachment, reduced self-worth, hyper-arousal, avoidance of activities, and hopelessness, among others. Figley (2003) further notes that the symptoms of compassion fatigue may last for more than a month and that they are likely to permeate the mental, behavioral, physical, and spiritual facets of the care-giver’s life.
The five concepts of compassion fatigue
The five concepts of compassion fatigue as outlined by Figley (2003) are cognitive, spiritual, emotional, somatic, and behavioral.
Cognitive
Caregivers experience reduced self-esteem, concentration, and perfectionism. They are also likely to demonstrate signs of apathy. Since caregivers are so preoccupied with the trauma faced by patients, thoughts of self-harm or indeed harming others are not uncommon (Figley, 2003).
Spiritual
The horrific trauma associated with compassion fatigue can shake the care-giver’s faith to the point that him/her questions the meaning of life or whether God exists and why he lets good people to suffer. As a result, caregivers can experience loss of self-satisfaction and purpose. In addition, they are also likely to lose their faith in God.
Emotional
Compassion fatigue is often accompanied by the following symptoms: emotional lows and highs, hypersensitivity, and feelings of helplessness and powerlessness (Figley, 2003). Caregivers suffering from compassion fatigue are also likely to feel depressed and guilty.
Somatic
Compassion fatigue is directly related to somatic symptoms such as dizziness, profuse sweating, a compromised immune system, shock, tachycardia, and difficulty in breathing (Figley, 2003).
Behavioral
Examples of behavioral symptoms that are likely to accompany compassion fatigue include: irritability, anger outburst, hyper-vigilance, moodiness, impatience, poor self-care, sleep disturbances, losing items, loss of appetite, and withdrawal from clients, family and friends (Figley, 2003).
Nature of the problems and their causes
According to Collins and Long (2003), the onset of compassion fatigue can be very sudden. The exposure to patients facing traumatic experiences can trigger symptoms of compassion fatigue care-givers. This happens when caregivers are unable to separate their individual feelings of anxiety and stress from the trauma suffered by the patient (Thomspon, 2013).
Slocum-Gori et al. (2011) describe compassion fatigue as the emotional cost that caregivers have to pay for taking care of patients. According to Yang et al. (2012), compassion fatigue occurs when caregivers are over-involved in patient trauma. Some professionals have been reported to abandon traumatized patients under their care when they are overwhelmed by the effects of compassion fatigue. Compassion fatigue comes about in response to the stress experienced by the caregivers. It comes abruptly without warning and could be characterized by isolation, confusion, and helplessness. Caregivers who cannot cope with and adapt to the condition are likely to suffer psychologically and physically. Consequently, their quality of life reduces (Yang et al., 2012). If caregivers do not receive professional help, they become depressed. Some of them may even contemplate leaving the profession altogether.
Compassion fatigue is the by-product of care giving. It refers to the emotional, physical, spiritual, behavioral and mental exhaustion experienced by a caregiver as a result of recurrent exposure to traumatized patients. Caregivers suffer from compassion fatigue through one of the several ways. Primary, it occurs due to a traumatic stress that comes about after the caregiver has experienced trauma firsthand. Secondly, there is traumatic stress that comes about after the caregiver is directly exposed to a traumatized patient. Such traumatic experiences include witnessing the death of a patient (Florida Center for Public Health Preparedness, 2004); emphatic transmission that comes about after the caregiver has listened firsthand to the narrative of patients and clients who have undergone trauma (Florida Center for Public Health Preparedness, 2004); and anxiety transmission from the patient.
Physical, emotional and spiritual needs of the caregiver
Caregivers need to find a balance between their physical, emotional, and spiritual wellbeing. The caregiver’s individual wellbeing is important and this can be achieved by setting professional boundaries. At times, caregivers should learn to say no, especially when they feel drained physically, emotionally, and spiritually (Showalter, 2010). Breaks or time off would be a good thing to replenish the caregiver’s emotional reserves. Meditation, prayers, and partaking in spiritual rituals and practices would help caregivers to attain spiritual nourishment.
Coping strategies and resources to help caregivers deal with compassion fatigue
Although prevention strategies and resiliency can be quite effective, sometimes it is very hard to prevent compassion fatigue. The good news is that compassion fatigue symptoms respond very well to treatment (Yang et Al., 2012). On the other hand, the healing process can be slow. The first step to recover from compassion fatigue involves accepting that one is suffering from the condition. To cope with compassion fatigue, a caregiver requires access to professional help. This could be in the form of a professional counselor or a mentor. Additionally, the caregiver’s supervisor in the workplace could also prove useful by offering personalized intervention strategically. The personal intervention plan should only be executed following the successful completion of the assessment.
First, it is important to identify the resources available to the caregiver at the workplace to help him/her deal with compassion fatigue. Some workplaces have implemented an Employee Assistance Program (EAP), whose role is to improve work-life balance, reduce stress as well as give assistance to employees suffering from such conditions as compassion fatigue. Caregivers are required to embrace positive self-care strategies as a crucial step towards making full recovery. Also, caregivers are advised to develop healthy rituals. Caregivers are also encouraged to adopt new approaches to self-care. Examples include yoga classes and mediation. Health care providers should also set aside space for a relaxation center where caregivers can have a rest briefly in a comfortable and quiet setting.
Health care providers should also consider implementing programs like the Schwartz rounds where caregivers get a rare chance to open up and share their experiences with traumatized patients. This strategy has been proved to be psychotherapeutic (Thompson, 2012).
Conclusion
Caregivers often have to work under an environment characterized by heart wrenching and highly emotional situations daily. In addition, increased demand for time, productivity, energy, and workloads causes a rise in the caregivers’ stress levels. This is likely to trigger compassion fatigue. To deal with compassion fatigue, caregivers should learn the importance of satisfying their emotional, physical and spiritual needs. Acknowledging the symptoms of compassion fatigue is the first step towards recovery. Additionally, caregivers should adopt positive self-strategies like getting sufficient sleep, nutrition, and hydration. Other strategies include meditation and massage.
References List
Anewalt, P. (2009). Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthcare Nurse, 27(10), 591-597.
Collins, S., & Long, A. (2003). Too tired to care? The psychological effects of working with trauma. Journal of Psychiatric and Mental Health Nursing, 10(3), 17-27.
Figley, C. R. (2003). Compassion Fatigue: An Introduction, Gift From Within. Web.
Florida Center for Public Health Preparedness. (2004). Understanding compassion fatigue: helping public health professionals and other front-line responders combat the occupational stressors and psychological injuries of bioterrorism defense for a strengthened public health Response. Web.
Joinson, C. (1992). Coping with compassion fatigue. Nursing, 22(4), 118-20.
Showalter, S. (2010). Compassion fatigue: what is it? Why does it matter? Recognising the symptoms, acknowledging the impact, developing the tools to prevent compassion fatigue, and strengthen the professional already suffering from the effects. American Journal of Hospice & Palliative Medicine, 27(4), 239-242.
Slocum-Gori, D.H., Chan, W., Carson, A., & Kazanjian, A. (2011). Understanding Compassion Satisfaction, Compassion Fatigue and Burnout: A Survey of the hospice palliative care workforce. Palliative Medicine, 27(2), 172-178.
Thompson, A. (2013). How Schwartz rounds can be used to combat compassion fatigue. Nursing Management, 20(4), 16-20.
Yang, L. C., Lin, T.R., Yu, Y.L., Yang, L.C., Tsai, S.H., & Hung, C.H. (2012). Compassion fatigue and coping strategies for hospital nurses. Compassion Fatigue symptoms, 59(3), 93-9.
This paper provides a summary of a spiritual assessment conducted on a Muslim patient. The spiritual assessment tool will be used to evaluate the spiritual beliefs of the patient through direct interviews. Observations recorded from the assessment will be recorded as significant discoveries. Further, the paper will examine the effectiveness of the tool and recommend possible solutions in the future. Lastly, the paper will expound on the spiritual experiences learned from the patient’s assessment.
Summary of Assessment
The interview yielded results that demonstrated purity and prayers are integral parts of a Muslim’s life.
Significant Discoveries Made
Muslims must pray five times a day facing the direction of Mecca. Their faith also prohibits them from praying before they purify themselves. Purification requires people to wash their hands and feet with clean water in preparation for prayers. They also use a unique mat or a clean piece of clothing for kneeling.
In a hospital setting, most Muslim patients desire to observe their prayer life by praying five times a day. Healthcare providers should make sure that they offer the desired assistance, especially to bedridden patients. Water and a clean piece of bed sheet should be provided when necessary. Health care providers must also see to it that they recognize the direction of Mecca to aid the patient in preparing for prayers.
According to the Muslim culture, God entrusts human beings with bodies to be used appropriately for the achievement of salvation. Muslims consider that agony is a trial from God portrayed through suffering, sickness, and calamities. The Muslim religion does not allow its believers to eat any foods containing alcohol, pork, or animal meat with stock.
They believe that Christians, Jews, or Muslims should remove blood from meat when slaughtering. They also consider that apart from death and aging, all illnesses are curable even if medical applications do not invent cures. The Muslim faith believes in medical science and prayers for healing. Health care workers are highly looked upon as God’s instruments of healing. According to the Muslim faith, healing can only come from God since it starts with him.
Muslims accept death as a natural phase in life, which occurs at any time. This explains why Muslims do not believe in grieving the dead, but rather accepting death as God’s will and destiny for all human organisms. Medical procedures are performed on patients if there are prospects for a cure. On the contrary, extended ineffective medical procedures and suffering are not guaranteed.
The Muslim culture does not preserve the bodies of the dead in mortuaries but conducts burials immediately. Muslims heavily respect human bodies and stress the importance and necessities of the rituals observed before burials. People are also supposed to observe purity when dealing with the dead. Washing hands before and after handling the dead is very important in the Muslim culture. Bodies are handled gently, covered, and washed by people of the same sex.
Gender is a very significant aspect of Muslim society, especially in instances where both males and females came into contact. These beliefs are guided by cultural and religious guidelines regarding the purity of the body.
As regards these beliefs, Muslim patients highly value privacy, especially in cases where healthcare providers are of a different gender. In most cases, healthcare providers of the same gender as the patient are preferred, especially for women. All the same, in cases that health maintenance providers of the opposite gender enter patients’ rooms, they should give notifications so that individuals could put together their clothing.
Strengths
The patient provided information without any hesitations. The choice of an elderly patient exposed and familiar with the Islam religion ensured the accuracy of recorded information. Communication during the interview was satisfactory, and we did not take in any destruction whatsoever. The ability of the patient to speak in English also helped in yielding the desired results.
Future Changes
In the future, I would generate information from different clusters of patients in terms of age and gender. This would ensure that gender and age distinctions are made especially in the contemporary culture where cultural and religious beliefs are changing.
Barriers and Challenges
In applying this assessment tool, I felt that the questions were rather too general and single-sided. The tool guided me to gather up the patient’s thoughts and opinions about life and their beliefs but was not specific to their perspective on health care and alterations that could make them satisfied. To address this challenge in the future, I would include questions that aim at getting views on how to improve health care.
Spiritual Experience
My spiritual experience with the patient did not only withdraw my attention close to the Muslim faith but also about how to be a prayerful spirit. I was interested in the prayer life of the Muslim religion. Their beliefs of facing towards the direction of Mecca fascinated me.
I also recognized the importance of prayers for spiritual support and healing. Their respect and ways of treating the dead also made me aware of the importance of human life on land. This instrument has enabled me to understand the ethnic and religious backgrounds of Muslim patients. This will help me know what to do when offering health care.
There is a growing relationship between medicine and spirituality. Recent studies suggest that in the care of the terminally ill patients, the spiritual connection is as important as their psychological, existential, and social support. Spiritual assessment, hence, is a vital component of a holistic treatment and, in order to ensure a complete body, soul and mind restoration should be factored in all health institutions.
The study utilizes the Faith, Importance, Community and Address (FICA) model of study that works to assess the patient’s faith and beliefs, importance and community as well as address points of concern as listed by the patient (Hodge, 2013).
The study analyses the results of a questionnaire as a spiritual needs assessment tool. It constitutes the result of a family member with an incurable disease and his take on spirituality especially when, and after the diagnosis was done. The study clearly shows the dire need to incorporate the aspect of spirituality in such patients. The study showed how much the inclusion of spirituality during the treatment hastened the healing process and uplifted the patient’s self-esteem.
Through the process the patient has now firmly established himself as a believer and serves to call other patients to the same belief, in addition to this, the study clearly shows that the impact of the study has influenced his family’s beliefs as they all now accept spirituality.
Revelations about the Patient, what went well
The patient under study is Fred, a father of five who fell ill in January 2010. After various attempts to manage the prevailing signs and symptoms of what started as a subtle thing, he had to go and get a prostate cancer test. The test turned out to be positive. This was a true time of test for the entire family since the wife was negative.
Prior to his illness, Fred was not so much into spirituality. Even though he is now a great admirer of the spirituality and meditates quite often, it took a lot to turn his thoughts into religion and spirituality. When he fell ill and the diagnosis came out as prostate cancer, he felt like it was a death sentence and nothing was going to change that. After days of hospitalization, I, being the family doctor, came up with the idea of building up his self-esteem, hope, and faith and soon he was back on his feet.
I encouraged him to focus on living right and pray daily. Even though he is still under medication, he is far much healthy and living positively. During the interview, all went well in that the interview took place as scheduled and he shared intimately about his life.
What I would do differently in Future
In future, what I would do differently is prepare the patient in prior for our meeting, since the one analyzed was kind of an ambush. Again, the atmosphere of the work place does not seem to favor such a discussion because of its interference with the other patients.
Barriers experienced, and how to address them in future
One of the barriers that hindered my ability to implement the assessment tool was the distance between us. Since the patient regained his normal functions, he went back to work in a different town and was later transferred to a much convenient location near his home and schools where he does his inspirational talks. This made it hard to set up a physical meeting.
Even though the choice tool for data collection was a questionnaire, I filled it up with the recorded telephone conversation we had. Secondly, because of his busy schedule and nature of work, the conversation was limited to a certain fixed time and was frequently interrupted whenever he was needed to answer a query on the other side. To avoid this challenges next time, I would strive to travel if need be in order to have proper time and feedback from the patient.
Physical presence also makes it easy to interact with the patients also allows the interviewer to participate emotionally with the patient analysis the real experience as is being shared. Dameron (2005) suggests that an earlier arrangement of a meeting gives one an edge in setting up his schedule, and as such next time a properly scheduled interview would be done to avoid interruptions of any kind.
The spiritual experience
The spiritual experience during the interview was deep and emotional. It was evident that as much as the doctors did the best in their field, a huge part of the of the patients healing and recovery process was through the impact of his spiritual belief, the belief that there was a supreme being who could do anything for him and actually did and still does.
It is a overwhelmingly convincing thought and belief and seeing the photos of the patient during treatment and what he is now, one is convinced of the existence of God, and his ability to restore as well as heal to health. It also brings to light the fact that some illnesses are more psychological than physical and a single belief can work it out for you.
How the tool helps in meeting patient’s needs
This tool enables the caregivers and those around the patient a way to attend to some of the patients’ needs. A patient whose faith and spiritual belief has helped him or her recover from a disease is easy to manage as compared to one with no spiritual inclination (Draper, 2012) In addition to this those with spiritual mentors; those who urge them on whenever they are giving up also make quick recoveries.
Conclusion
In conclusion, though at times uncomfortable, spiritual needs assessment is seemingly a required remedy to patients. Questionnaires with easy to answer questions can be used by nurses and other caregivers to determine the patients spiritual beliefs and faith. The questions should be open-ended and should not impose any religion or belief on the patient. This is because not all believe in the spiritual world and happenings.
References
Draper, P. (2012). An integrative review of spiritual assessment: implications for nursing management.Journal Of Nursing Management, 20(8), 970-980.
Hodge, D. R. (2013). Implicit Spiritual Assessment: An Alternative Approach for Assessing Client Spirituality. Social Work, 58(3), 223-230.
Questionaire
Patient’s name (optional)
Do you have any spiritual beliefs?
Is there anything you believe in that gives meaning to life?
Has your illness affected your beliefs and practices?
Are you affiliated to any faith-based organization? Do you have a spiritual mentor?
What kind of support can I give towards nourishing your beliefs?