The Hole in Holistic Patient Care

Throughout its history, the nursing profession has claimed to provide holistic patient care, which is defined as bio-psycho-socio-spiritual care. Today, however, many nurses do not feel comfortable with the “spiritual” element of care and are uncertain about their professional role in the assessment and delivery of spiritual care. Discomfort and avoidance of attending to the spiritual needs of human beings creates “a hole” in holistic patient care. Contributing factors to the “hole in holistic patient care” include: 1) blurring of boundaries in the language and definitions of “spirituality” and “religion”, 2) insufficient attention to definitions of spirituality and spiritual distress; 3) confusion and role conflict with professional identity among disciplines related to responsibility for spiritual care; 4) insufficient education and skill development for nurses and other healthcare professionals in the assessment, intervention and appropriate referral of patients experiencing spiritual distress. The purpose of this article is to explore the history of holistic nursing as it pertains to the human dimension of spirituality and conclude with practice models for spiritual assessment and spiritual care that can “fill” the hole in holistic nursing care.