The clinical assessment tool I developed in the evaluationof the patient included the following questions what is your faith?Are you religious or spiritual? Is the religion important to you? Howdoes it influence you in taking care ofyourself? How does it help you in regaining good health? Are youassociated with any religious community? Does it support you? Howwould you want me to address your spiritual issues as your nurse?(Borneman, & Puchalski, 2010, p.406) Usingthese questions, I interviewed a client,and an analysis of that interview is to beexplored here. Below is the content of theinterview I hadwith the client.
What is your faith? I am a Christian who goes to CatholicChurch every Sunday.
Are you religious or spiritual? Yes, I am a religious person,praying daily and sometimes I do fast.
Is the religion important to you? Yes, it is important to mebecause I get to lead a straightforwardlife through its teachings. More so, it helps me understand JesusChrist. Again, I read about things that I have never experiencedbefore.
How does it influence you in takingcare of yourself? I live by its provisions I know that there aremundane ways of handling issues but theChristian teachings demand that prayer is paramount. So I usuallypray before any other intervention is exercised.
How does it help you in regaining good health? I believe thateverything happens for a reason, even sickness come because God hasplanned. But sometimes it gets overwhelming that I deem it apunishment for not being so spiritual and faithful to my religion.
Are you associated with any religious community? Currently, Iam not. Two years ago, I was a member of the church choir and aprayer group. But when personal commitments became intense, I slowlyquit. But sometimes they contact me and ask me to have a session atleast once.
Does it support you? Yes, my religion supportsme, I do not engage in any other worldly issues,and I believe it has helped me get out of trouble with many people.
How would you want me to address your spiritual issues as yournurse? I can see you practice Sikhism, but I would like you tounderstand that religion has one mission, and that is for theprogress of humanity. So I need you torespect my religious views. If I deny something, respect that,please. Christianity is dear to me.
Mrs. J.A is a 65-year old female who hadcome with complaints of having insomnia because of horriblenightmares. She was involved in an accident and was the onlysurvivor therefore, she was diagnosed withpost-traumatic stress disorder (PTSD). She is a Latino American whopractices Christianity under Catholicism. I conducted a spiritualassessment on her using the tool questions mentioned above.
It was a successful process in that I managed to secure the areasthat I felt there were gaps and out of that, I devised the bestremedy for the client. I realized that shehas no spiritual community despite being an active member of thechurch. It was hard for her to share the problems she had with thefamily because it constitutes young and inexperienced children. So,the spiritual help could be necessary.Moreover, I realized she is a religiousperson but quickly gives up when there ismuch pressure this was the case when shecould not divert her attention to other issues after the accidentthat she survived. She was only thinking about those who perished asshe witnessed.
In developing the tool of assessment, there were challengesespecially the integration of all the details aboutthe spiritual life of the client.The tool did not capture much information as directed by theFaith/Belief, Importance/Influence, Community, and Address (FICA)framework (Borneman, & Puchalski, 2010,p.407). For instance, it did not capture how the client’sbelief has influenced her health issues. Considering this challenge,I will develop a more comprehensive tool in the future.
The tool helps in prioritizinginterventions because it identifies which spiritual needs the clientneed first. In this case, I realized thatshe has no religiousattachment with other church members, and so, she could not sharemuch of her problems with them. Again, the tool issystematic, and as the interview progresses, the interviewer capturesthe nitty gritty information that could not be available if a generalassessment was done (Paul,2016). For instance, I could capturethe mindset of the client about her illness. Thatshe has considered herself weak and given in to the stress after thetraumatic experience. This was thereason she had insomnia and nightmares. Moreover, the tool, in itselfis a healing process because it demands that the interviewer becomesdiscreet and empathetic to the interviewee so that they can open up.The interviewer can visit the inner life ofthe client and identify areas that are notcaptured well. For this reasons, the tool was sufficientenough to help me prioritize theinterventions that I would do to my patient (Paul,2016).
I realized that the client’s traumaticexperience had increased her need for spiritual interventions. Shecould narrate that she sees the child who died next to her in herdreams and the child instructs her tocommit suicide. Moreover, she says her faith in God has diminishedbecause He has let her endure all these tribulations after theaccident. She says that God could just have left her to die as well.This was severe stress that she had begunliving a life of blame and bargaining as stipulated in the stages ofgrieving (Usherwood, 2012, p. 2923). Moreso, the church and religious friends played a less role in helpingher after the accident. The tool was instrumental in devising thebest interventions for the client.
The tool I used for spiritual assessment borrowed some key detailsfrom different sources. There were challenges in developing it, whichincluded the inability to capture alldetails and brevity. However, the tool helped me uncover the unknownworld of the interviewee and ultimately prioritizedthe care. Again, the client’s spiritual needs were to be handledfirst because her condition was more inclined to this area.
Borneman, T., & Puchalski, C.(2010). Assessment of FICA SpiritualAssessment Tool (501). Journalof the Pain and the Symptom Management,39(2),406-407. doi: 10.1016/j.jpainsymman.2009.11.149
Paul, R. (2016). The MIRS: An Instrument forFaculty, Students and Standardized Patients to Use for Teaching andEvaluation. (n.d.). Retrieved November 01,2016, from https://www.mededportal.org/icollaborative/resource/835
Usherwood, T. (2012, July 21). Personaland behavioral appraisal of the instructing of patient interviewskills. MedicalEducation, 27(1),41-47. doi:10.1111/j.1365-2923. 1993.tb00227.x