The ambiguities of nurses and prayer

We are interviewing nurses, doctors, and social workers (along with spiritual health practitioners) as part of our project, “Prayer as Transgression?” (See about project).  I’ve been intrigued with the responses of nurses because of my own identity as a nurse and nurse educator.  I am aware that there are great variations in what nurses (and other health professionals) are taught about spirituality, spiritual care-giving, and prayer.  I am also intrigued as a researcher, given the public cases in Britain of nurses who were disciplined on account of praying with patients.  In the 2009 case, a community nurse asked an elderly patient during a home visit if she wanted her to say a prayer for her.  The patient complained and the nurse was suspended without pay for several weeks, although she was welcomed back to work shortly thereafter.  The case received widespread public attention, with some concerned that the employer overreacted, and others voicing discomfort with the thought of bringing religion into the workplace, particularly at a time when people are ill and vulnerable.  More recently, in November of 2016, a nurse was fired after offering to pray with patients ahead of surgery.  This case is currently under review.  At the same time as these 2 cases demonstrate the sensitivity around prayer in healthcare settings, the NHS is suggesting that nurses and doctors must not be afraid to ask the dying about their spiritual, cultural, religious and social preferences.

Where then do the lines fall in regard to prayer in healthcare settings?  When is prayer transgressive of professional boundaries? 

There is, by my reading, some variation in the nursing literature in regards to prayer and spiritual care, depending on the source country.  In the U.S., recent studies suggest that prayer may be acceptable as a healthcare intervention by nurses (Hubbartt et al., 2012, Pfeiffer et al., 2014).  These U.S.-based authors include guidance for the nurse in opening a conversation about prayer.  In contrast, British scholars take a more restrained approach.  In French and Narayanasamy’s (University of Nottingham) 2011 article, “To pray or not to pray”, they conclude that until more is known about the side effects and implications of prayer, nurses must be cautious about not abusing the authority placed in them, promoting their own religious causes, or using self-disclosure in an insensitive way.  In other words, the ethics of prayer must be uppermost for the nurse.  Similarly, Dr. Janice Clarke (University of Worcester), in her 2013 book “Spiritual care in everyday nursing practice”, suggests that praying with patients would usually only happen if it is suggested by the patient themselves.

When considering whether to pray with a patient, the nurse is guided by—at minimum—a concern for patient-centredness in following the preferences of the patient, a caution not to be impositional in promoting their own spiritual views (regardless of whether these are grounded in religious tradition or not), and a high degree of self-reflexivity about their motivations and knowledge.  Our research is revealing how contextually-specific prayer encounters can be, and as nurses we do well to develop a well-honed sense of the ambiguities and subtleties at play.

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Clarke, J. (2013). Spiritual care in everyday nursing practice: A new approach. Palgrave Macmillan.

French, C., & Narayanasamy, A. (2011). To pray or not to pray: a question of ethics. British Journal of Nursing, 20(18).

Hubbartt, B., Corey, D., & Kautz, D.D. (2012). Prayer at the bedside. International Journal for Human Caring, 16(1), 42-47.

Pfeiffer, J. B., Gober, C., & Taylor, E. J. (2014). How Christian nurses converse with patients about spirituality. Journal of Clinical Nursing23(19-20), 2886-2895.

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