In many countries today, the practice of health care has become a complicated system of services. The notion of health prevalent in this system is that of catering to physical needs and functions. The role of healthcare professionals becomes a function of this system. This runs against the experience and the worldview of many that professional systems and practices can never be morally and existentially neutral. Traditionally, health care and in particular nursing care have been understood as an element of fostering human flourishing. The question arises: what is lost when health care is no longer thus understood? In this article, the ‘raison d’etre’ of nursing care is explored by highlighting the Judeo-Christian notions of health and care as elements of shalom. The meaning of this concept is illuminated by recent nursing literature. Furthermore, Alasdair MacIntyre’s analysis of ‘social practices’ explains how such a concept runs deep in the capillaries of health care practices like nursing care. It is argued how shalom permeates nursing’s professional values (what nurses aim for), norms (how nurses ought to act), and virtues (who nurses ought to be). This ‘DNA’ of nursing care can combine professional clinical language with religious-moral language, enriching its understandings of health, care, and professional identity.

Abstract Background Nurses have a critical role in providing spiritual care that improves the well-being of patients. Competencies for spiritual care are well described by the Enhancing Nurses’ and Midwives’ Competence in Providing Spiritual Care through Innovative Education and Compassionate Care (EPICC) network. Development of these competencies needs to be addressed by nursing education but how is yet to be explored. Objective Explore how the implementation of the EPICC Spiritual Care Competency Self- Assessment Tool in a bachelor nursing program contributes to the development of spiritual care competencies in nursing students. Design Qualitative study to explore experiences of nursing students regarding their development of spiritual care competency. Setting(s) Bachelor nursing education in the Netherlands. Participants 20 undergraduate nursing students. Methods Individual interviews, Reflexive Thematic Analysis. Results The students described developing spiritual care competency as a process influenced by student factors, the support from significant others, and the design and content of the curriculum. Students reported the use of the EPICC Tool as enhancing this learning process by providing reflection, support and knowledge about spiritual care. The EPICC Tool is mentioned as support to overcome barriers to start providing spiritual care. In this process, students opened up for spiritual care and recognised ‘the other’ as a human being. By building relationships they reported incentives to repeatedly provide spiritual care. By doing so, they built up competency and became intrinsically motivated for spiritual care. The mandatory use of the EPICC Tool is described as supportive. Conclusions Developing spiritual care competency is a process influenced by many factors. This research shows that students experienced that the use of the mandatory EPICC Tool enhances this learning process. Educators should consider the use of mandatory assignments and threading spiritual care content throughout their curriculum to support the process of learning. Trial registration clinical trial number: not applicable.

Abstract It seems remarkable that several philosophers in the Reformed tradition have recently interacted with social practice theory without interacting with each other. This gave rise to the question as to whether they interact differently or similarly with social practice theory and to what extent Reformed philosophy might benefit from such an interaction. In this article, therefore, we aim to clear the way by addressing three strands in Reformed philosophy, namely, Nicholas Wolterstorff, the normative practice approach, and James K. A. Smith. We explore why they use social practice theory, what they do with it, and how they make it their own. Finally, we highlight what unites them and what divides them, and conclude with suggestions as to how they might benefit from each other’s work in social practice theory.

This study aims at exploring the perspectives of patients with cardiovascular disease (CVD) on the existential meaning of lifestyle change as an evidence base for spiritual care by nurses and other health professionals. This study has been carried out within the paradigm of phenomenological caring sciences. The sample of 18 participants was purposively selected. Data consisted of in-depth interviews among adults with an episode of CVD. Data analysis of transcribed audio recordings was done using the method of Reflective Lifeworld Approach. For patients with CVD, changing one's lifestyle is an experience of transition in self-image. This transition has a twofold dynamic. On the one hand, it entails alternating phases in what is meaningful for the patient: letting go (loss of the normal, of health, of bodily functions) and holding on (desire to be healthy and to be normal). On the other hand, through the vulnerability and loneliness patients often experience, patients report a need to be encouraged by and connected to others/the Other. Making brave choices and connecting to the patients' spiritual resources of inner strength are crucial for successful lifestyle changes and meaningful transition to a new lifestyle. Lifestyle change is not only a physical and psychological process for the patient with CVD but also an existential transition that involves fundamental views and values of being human. It is an experience that is in part socially influenced, that is, by encouragement from meaningful others. For the health care worker, knowledge of this experience may help provide spiritual care after CVD.

Abstract Aim: To explore how mental health professionals address spiritual care for outpatients in weekly multidisciplinary care meetings (MDM), and to explore the barriers and facilitators in the ways health professionals address spiritual care in those meetings. Method: Two teams of mental health professionals providing care for psychiatric outpatients are included. Qualitative data were collected from audio recordings of multidisciplinary meetings and from focus-group interviews afterwards. Data were analysed using ‘open coding’. Results: Spiritual care was not frequently addressed mostly due to the requirements of the health insurance reimbursement system. Aspects of spirituality addressed in these meetings pertained mainly to meaningful daily activities. Addressing spiritual care was facilitated, on the other hand, by a holistic focus on health and recovery-oriented care. Conclusion: In ambulatory mental healthcare spirituality is sparsely addressed and, when addressed, few aspects of spirituality come into view. Facilitating healthcare professionals’ awareness of their clinical perspective is an essential step to improve spiritual care for psychiatric outpatients.

This study aims at exploring the perspectives of patients with cardiovascular disease (CVD) on the existential meaning of lifestyle change as an evidence base for spiritual care by nurses and other health professionals. This study has been carried out within the paradigm of phenomenological caring sciences. The sample of 18 participants was purposively selected. Data consisted of in-depth interviews among adults with an episode of CVD. Data analysis of transcribed audio recordings was done using the method of Reflective Lifeworld Approach. For patients with CVD, changing one's lifestyle is an experience of transition in self-image. This transition has a twofold dynamic. On the one hand, it entails alternating phases in what is meaningful for the patient: letting go (loss of the normal, of health, of bodily functions) and holding on (desire to be healthy and to be normal). On the other hand, through the vulnerability and loneliness patients often experience, patients report a need to be encouraged by and connected to others/the Other. Making brave choices and connecting to the patients' spiritual resources of inner strength are crucial for successful lifestyle changes and meaningful transition to a new lifestyle. Lifestyle change is not only a physical and psychological process for the patient with CVD but also an existential transition that involves fundamental views and values of being human. It is an experience that is in part socially influenced, that is, by encouragement from meaningful others. For the health care worker, knowledge of this experience may help provide spiritual care after CVD.

Professionals function in what can be called “social practices.” Norms in the practice set professionals’ responsibilities and rights and classify what is seen as morally proper and improper. Tensions arise when norms emerge that are not coherent with the nature of the practice. For example, when a hospital is assessed on the basis of economic criteria only, staff will feel uncomfortable and nd difficulty in functioning properly in that practice.

Background: spiritual care by nurses may be omitted from clinical practice when not structurally embedded in daily professional care routines. Method: a mixed method study was designed to measure qualitative and quantitative outcomes of a “link nurse” as a spiritual care resource (LNSC). Data were gathered from nurses (n = 123–86), link nurses (n = 15–18) and patients (n = 131–122) before and after an implementation and education project among (link) nurses. Results: findings show a self-reported increase of competency in providing spiritual care, especially assessment, counseling and referral in nurses, and referral in link nurses. In interviews afterwards, link nurses (n = 10) and nurses (n = 8) indicated more confidence in providing spiritual care. Patients reported high satisfaction with spiritual care by nurses, although differences in satisfaction between measurements before and after the project could not be demonstrated. Referral frequency to chaplaincy increased during the project. Conclusion(s): nurses may be willing to include spiritual care and collaboration as part of their professional role when support is provided by the hospital leadership. Education and practice development in spiritual care are supported by the implementation of link nurses, while the hospital’s leadership needs to take its responsibility to provide preconditions. Intervention evaluation suggested that the wider context of professional practice, collaboration, and organization needs to be addressed as well.

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Verpleegkundigen komen in de praktijk steeds meer zorgtechnologie tegen. Zo zijn er ‘sociale robots’ (sprekende en programmeerbare agenda’s) die zorgvragers herinneren aan afspraken, contacten met de buitenwereld en bezigheden. Maar voor welke zorgvragers zijn ze geschikt? Wanneer dragen ze bij aan goede zorg? Dat zijn ethische vragen. De zorgethiek kan helpen te zien wat de zin en onzin is van sociale robots: helpen ze zorgzaamheid gestalte geven? Neem de ondersteuning van mensen met beginnende dementie die thuis wonen. Zorgrobots helpen in de ene fase beter zorgzaam te zijn dan in de andere, zo blijkt. Het begint met aandacht: oog hebben voor de zorgbehoefte. Een sociale robot is niet geschikt om vast te stellen wat de zorgbehoefte is van iemand met dementie. Wel helpt het gebruik ervan zorgverleners extra te letten op die zorgbehoefte waar de robot wel voor ingezet kan worden. Het draait vervolgens om verantwoordelijkheid: inzet voor iemand die dat nodig heeft. Een mens kan daartoe besluiten, maar een robot niet. Een sociale robot kan alleen in een bestaande zorgrelatie de verantwoordelijkheid van een zorgverlener ondersteunen. Goede zorg vereist voorts bekwaamheid: ingaan op een zorgbehoefte vraagt kundig handelen. Als een sociale robot is ingesteld kan hij iets uitvoeren in het zorgproces. Dat is het voordeel van een robot: als hij werkt dan werkt hij, onvermoeibaar. Het betekent tot slot responsiviteit: komt de geboden zorg goed aan? Een sociale robot kan dit niet controleren. De omgeving moet nagaan of inzet van een sociale robot bij iemand met beginnende dementie zorgzaam is. Kortom, zorgtechnologie kan gebruikt worden bij mensen met beginnende dementie die thuis wonen. Maar dit moet passen in een bestaande zorgrelatie bij een persoon met een specifieke aandoening in een veranderlijke context.