Angelite Nurses: Spiritual Distress

Spiritual Distress

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Pain (_) Trauma (_) Loss of body part/function (_) Terminal illness (_) Death of s/o (_) Unable to practice religious rituals (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	(_) Experiences a disturbance in belief system.
Minor: (May be present)	(_) Questions credibility of belief system. (_) Demonstrates discouragement or despair. (_) Is unable to practice usual religious rituals. (_) Has ambivalent feelings (doubts) about beliefs. (_) Expresses that he/she has no reason for living. (_) Feels a sense of spiritual emptiness. (_) Shows emotional detachment from self and others. (_) Expresses concern, anger, resentment, fear - over the meaning of life, suffering, death. (_) Requests spiritual assistance for a disturbance in belief system.

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Continue spiritual practices not detrimental to health.

(_) Express decreasing feelings of guilt and anxiety.

(_) Express satisfaction with spiritual condition.

(_) Other:

(_) Assess current level of spiritual state: Comfort, distress, desire for minister, priest, rabbi to visit, desire to practice religious rituals.

(_) Implement patient requests regarding spiritual needs.

(_) Contact spiritual/religious advisor of patients choice.

(_) Discuss impact of stress on challenging one's spiritual beliefs.

(_) As patient desires, allow opportunity to discuss belief system, the meaning of illness/suffering within this system.

(_) Other:________________
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Patient/Significant other signature

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RN signature

Angelite Nurses