"Nursing care comes in many forms. Sometimes it is the ability to make someone feel physically comfortable by various means. Other times, it is the ability to improve the body's ability to achieve or maintain health. But often it is an uncanny yet, well honed knack to see beyond the obvious and address, in some way, the deeper needs of the human soul." ~ Donna Wilk Cardillo, A Daybook for Beginning Nurses The essence of nursing as a profession is the willingness and the ability to heal the sick and the needy. Now, the thing to be noticed is that unlike commonly perceived, healing is not only confined to just physical care. Which means that nursing is not just about making sure if the patient has been given his/her medicines on time, or if the bed sheets have been changed, and the food has been eaten. When a patient is unwell, or is suffering from a terminal illness, he or she goes through a series of trauma which affects the physical, emotional, as well as the spiritual health. Therefore, to be efficient in nursing, one needs to be efficient in identifying and catering to all these needs, especially the spiritual needs, which most of the time, are left unnoticed and unattended. What Does One Mean by Spirituality? In order to identify the need of spirituality as a fundamental essence of nursing , it is important for one to understand as to what exactly is meant by the term 'spirituality'. Now, many people associate spirituality with religion, however, spirituality and religion are two different things. You can be spiritual but not religious. On the other hand, religion can give you a way to connect with your spiritual self. So, even though the two terms are different, they can be considered complementary. Spirituality is your existence on this earth beyond the physical or material aspects. It is the connection of your inner self with the energy that flows in the universe. Spirituality is when you feel that you are not confined to a mere body, but your spirit has a higher purpose on this planet. Spirituality helps one focus on his purpose on this planet, justify a cause behind his sufferings, show a hope beyond the sufferings endured, and ensure an ultimate journey to inner peace and fulfillment. According to the Robert C. Fuller's modern secular definition, "Spirituality exists wherever we struggle with the issues of how our lives fit into the greater scheme of things. This is true when our questions never give way to specific answers or give rise to specific practices such as prayer or meditation. We encounter spiritual issues every time we wonder where the universe comes from, why we are here, or what happens when we die. We also become spiritual when we become moved by values such as beauty, love, or creativity that seem to reveal a meaning or power beyond our visible world. An idea or practice is "spiritual" when it reveals our personal desire to establish a felt-relationship with the powers governing life." Importance of Spirituality in Nursing Care Now, after understanding the meaning of spirituality, do you realize as to why it should be an essential part of nursing care? When we speak about patients who are dealing with any form of physical or emotional illness, spiritual distress follows. Even though the focus of nursing care primarily lies in healing the body and mind, one fails to realize that unless the spiritual side is not at ease, the body and mind would also not be at peace. When a patient is suffering from a terminal illness, many questions like, "Why is this happening to me?", "What did I do to deserve this?", "Has God forbidden me?", etc., arise in their minds. During this time, they are not bothered about taking their medicines on time, there focus is not on the tangible things anymore, rather they are focusing on something that is extremely spiritual and intangible. They try to connect with their higher self and wish to know, how their sufferings are an integral part of the higher plan that the universe has for them. The 'whats' and the 'whys' arising in their minds are nothing, but their self questioning their spiritual existence. In situations like these, it is not the physical inputs, neither the emotional inputs that will help the patient find peace. Therefore, it becomes very important for a nurse to cater to the spiritual needs of the patient. And a nurse is the most appropriate person to do so as they are the ones that spend most of the time with the patient. Therefore, during the times of spiritual distress, it is only a nurse that can comfort the patient by bonding with the patient on a spiritual level. This bonding and connection enables the patient to spiritually confide in the nurse. On the other hand, the nurse too, goes through the spiritual journey with the patient, as he or she can see what the patient is going through. Doing simple things like listening to what the patient has to say, conversing with the patient and responding to what he or she expresses, acknowledging the patient's thoughts and ideologies, and making sure that you help the patient find peace of mind through your presence, is what is required to comfort the spiritual distress that the patient is suffering from. Let me give you an example of spiritual nursing care. We all are aware of the fact that when a person is suffering from grief because of the fatal illness that one is dealing with, many patients claim to see a white light. Now, when the patient expresses this experience to others, most of them just listen quietly without any response. However, you need to understand that the patient is in the state of spiritual dilemma and is seeking for a response that clears this confusion. Therefore, fulfilling your duty as a spiritual healer, you are expected to listen and respond to the patient's spiritual experience. You can ask them questions like, "What could the white light signify?", or, "Where do you think the light leads one to?" Starting a conversation like this will build a spiritual bonding between the nurse and the patient which can actually help the patient achieve spiritual satisfaction and healing, which is the prime purpose behind the whole concept of catering to the spiritual needs. Teaching Spirituality in Nursing "The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest...." ~ William Osler Indeed, a trained nurse who is efficient enough to provide holistic care to the patient, as well as cater to the spiritual needs, is someone who takes place beside a priest and a physician. In fact, I would say that a nurse is more than that, she is a caretaker, a listener, a comforter, a friend, and a confidante. The woman who laid the foundation of the first secular nursing school in the world, Florence Nightingale, herself embraced the role of spirituality in the nursing profession. However, the point to be noted is that not all nursing professionals come with an inbuilt sense of spirituality and compassion. Therefore, it is of prime importance that spiritual assessment and healing is introduced in the nursing training curricula. Another challenge that this issue faces is when the nurses highlight concerns about their own understanding of religion and spirituality as a subject. Again, as I mentioned earlier, spirituality has got nothing to do with religion, it is a concept beyond religious beliefs which doesn't require a deity. It just evolves through one's curiosity related to life, existence, and the connection of the spirit with the higher power, which needn't be a deity. Human beings are referred to as the biopsychosocial-spiritual-cultural individuals. This term is a part of the holistic caring approach that all nurses adhere to. This means that a holistic approach includes a spiritual diagnosis as well. Speaking of spiritual assessment and care, nurses should be taught how to develop their own spirituality first, so that they can identify the spiritual needs of their patients. This can be done through conducting various educational courses about the need of spiritual knowledge in this profession. Conducting workshops, meditation camps, providing reading materials about spirituality, open discussions with seniors and colleagues about this aspect, discussing one's personal spiritual experiences with patients or otherwise, and being more open about the concept of spirituality on a whole is required to be able to cater to the spiritual needs of a being. The curricula should be designed keeping in mind the legal, professional, ethical, and humanitarian implications of-course. Spirituality in nursing is not only a way to identify the patient's spiritual concerns, but it also gives you an opportunity to identify your own spiritual needs and values. It helps you identify that life is more than what we see, it is beyond the needs of the body, it is beyond the needs of the mind, it is a spiritual experience which makes us what we are. The spirit needs love, the spirit needs attachment, and a sense of belonging; the need of which is the most when one suffers from an illness, especially a fatal one! A nurse is the one who is responsible to take care of these people, to comfort and soothe their troubled spirits and heavy hearts. Small and simple things, like praying with them, holding their hand, listening to their theories, sharing your positive vibes, etc., is all that takes to soothe a heavy heart and a troubled spirit. Do you still think that spiritual caring should be neglected the way it has been so far? To conclude, I would like to use the following prayer to remind you all about the essence of the nursing care that is expected from you, the care which caters to the tangible body as well as the intangible spirit. "I pray I do my part to lift each downcast spirit, and to soothe each heavy heart. May my touch being reassurance, may my voice be soothing too. May my gentle care remind them of the love they have in you." ~ A Nurse's Prayer, Author Unknown.