Exploring spiritual care in nurse education: is phenomenology the right tool for the job?

Spiritual care is considered important as part of holistic practice within nursing (Cooper et al 2013). The Nursing and Midwifery Council Standards for Pre-registration Nursing Education (2010) states that nurses need to assess spiritual aspects. However, the reality is that spiritual care is poorly addressed in education leaving nursing students feeling unprepared to deal with issues (Bennett & Thompson 2015). This paper will argue that Van Manens’ ‘Phenomenology of Practice’ (2014) has a philosophical and methodological perspective that can reveal the complexity of spiritual care when exploring student nurses experiences.

Western society is seen as pluralistic and diverse in spiritual matters (MacLaren 2004) but there is debate around whether spiritual expression should be a private or public concern. Within a secularised society, spirituality has generally been seen as a private issue but whether it is possible to detach personal beliefs from public function is contested. Consequently, there is discussion about whether spiritual care is part of the nurses’ role in a secular healthcare setting and this can lead to confusion in practice (Bennett & Thompson 2015). Phenomenology focuses on the individual lifeworld and meaning attached to lived experience (Heinonen 2015) and involves reduction, description and searching for essences (Finlay 2009) which is a suitable approach for this subject area.

Dowling (2007) notes differing methodological approaches to phenomenology as descriptive, interpretative or hermeneutic, which are blurred leading to contradictions in its use. Van Manen emphasises the process of interpreting, reflecting and writing as a way to understand the phenomena. This paper will consider aspects, such as epoché and reduction, to discover openness, concreteness, wonder and meaning within phenomenological work.

The subjective and pluralistic area of spiritual care means that phenomenology enables an in-depth consideration of the phenomena to offer insights that can be applied to nurse education.

References

Bennett, V. & Thompson, M.L. (2015) ‘Teaching spirituality to nursing students’. Journal of Nursing Education and Practice. 5 (2): 26-33

Cooper, K.L.; Chang, E.; Sheehan, A.; Johnson, A. (2013) ‘The impact of spiritual care education upon preparing undergraduate nursing students to provide spiritual care’. Nurse Education Today. 33. 1057-1061

Dowling, M. (2007) ‘From Husserl to van Manen. A review of different phenomenological approaches’. International Journal of Nursing Studies 44 (2007) 131–142 doi:10.1016/j.ijnurstu.2005.11.026

Finlay, L. (2009) ‘Debating Phenomenological Research Methods’. Phenomenology & Practice. 3 (1): 6-25

Heinonen K (2015) van Manen’s method and reduction in a phenomenological hermeneutic study. Nurse Researcher. 22, 4, 35-41.

MacLaren, J. (2004) ‘A kaleidoscope of understandings: spiritual nursing in a multi-faith society.’ Journal of Advanced Nursing. 45 (5): 457-46

Nursing and Midwifery Council (2010) ‘Standards for Pre-registration Nursing Education’. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-pre-registration-nursing-education.pdf (accessed 21st March 2017)

Van Manen, M. (2014) ‘Phenomenology of Practice’. California: Left Coast Press