Changes in worldviews have brought changes to nursing and health care. The Christian
worldview perceives nursing as “a ministry of compassionate care for the whole person, in
response to God’s grace, which aims to foster optimum health and bring comfort in suffering and
death” (Shelly & Miller, 2006, p. 68). The nursing metaparadigm starts with God as the creator
of world (environment), creator of humans (person), and the purpose to live in shalom (health)
(Shelly & Miller, 2006). “Through him all things are made”, (John 1:3, New International
Version). The associations with nursing and God as a fatherly affiliation are prominent. In
nursing, we serve God who cares for us and our patients. Nursing purpose fluctuates with needs,
circumstances, and resources but Christian nursing is always a result of God’s gift of salvation
(Shelly & Miller, 2006).
My own nursing environment involves spiritual caregiving. Beliefs play an important role
in nursing as a career choice. Spiritual nurturing can serve as a channel for attaining personal and
professional understanding (Gilliat-Ray, 2003). Research suggests nurses who see their job as
work versus those who identify their role as a calling are more engaged with patient care (Gilliat-
Ray, 2003). Nurses have a role in holistic patient care and should be able to identify spiritual
needs of patients and respond. Providing spiritual care is contingent on personal characteristics
and abilities of nurses and it is possible some nurses may feel uncomfortable with provision of
spiritual care or believe it to be emotionally draining (Gilliat-Ray, 2003).
Healthcare is a competitive field and like other industries consumers have choices.
Information about the performance of hospitals and health care facilities are now published to the
public. The data dictates the development and distribution of standardized reports on quality care
and enables evaluation of performance compared to distinct standards of practice (Marshall, M.,
Shekelle, P., Leatherman, S., & Brook, R., 2000). The execution of public reporting of quality-
of-care data has promoted transparency and accountability. These reports are aimed to incite
active participation by consumers to make choices regarding their healthcare providers (Faber,
Bosch, Wollersheim, Leatherman, & Grol, 2009). These reports are thought to encourage
consumers to choose high-quality healthcare providers, yet they are utilized by the organizations
as well. At the organization level there is emphasis on ensuring accountability and improving
care (Marshall et al., 2000).
Healthcare organizations that are secular in position can create obstacles for nurses with
deep religious faith. Nursing is a 24/7 job, which can require one to work on Sundays and
holidays. A study of nursing students presented the conflict with the organizations and working
Sundays. Though none of the students in the study refused to work on Sundays, the nurses in the
study felt missing services on Sunday meant missing support and community sense received
from attending church (Timmons & Narayanasamy, 2011). Interviews of the nursing students in
the study also indicated that nurses believed it was difficult to practice spiritual beliefs in the
workplace. The nurses interviewed stated they were cautious about how they portrayed
themselves related to being Christian or religious. They did not divulge their beliefs and were
careful to not inflict them. (Timmons & Narayanasamy, 2011).
References
Faber, M., Bosch, M., Wollersheim, H., Leatherman, S., & Grol, R. (2009). Public reporting in
health care: how do consumers use quality-of-care information? A systematic review.
Medical Care, 47(1), 1-8. Retrieved from www.jstor.org/stable/40221830
Gilliat-Ray, S. (2003). Nursing, professionalism, and spirituality. Journal of Contemporary
Religion, 18(3: 335-349). doi: 10.1080/13537900310001601695
Marshall, M., Shekelle, P., Leatherman, S., & Brook, R. (2000). The public release of
performance data: what do we expect to gain? A review of the evidence. Journal of the
American Medical Association, 283(14), 1866-1874. doi:10.1001/jama.283.14.1866
Shelly, J. A., & Miller, A. B. (2006). Called to Care. Downers Grove, IL: InterVarsity Press.
Timmons, S., & Narayanasamy, A. (2011). How do religious people navigate a secular
organisation? Religious nursing students in the British National Health Service. Journal
of Contemporary Religion, 26(3), 451-465. doi: 10.1080/13537903.2011.616040
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