Caring for a Patient in Spiritual Distress Spiritual distress may be caused by chronic or terminal illness; but often, other factors are contributing to it, such as: lack of family contact or family conflicts, social alienation, loneliness, depression, permanency of disfigurement, loss of job or housing, or inability to pay bills. Although the nurse is not a member of the Pastoral Care Team, attending to the patient for long periods of time allows the nurse to observe the patient spiritually and identify signs of spiritual distress. • Expresses hopelessness, anxiety, despair, lack of inner peace, unable to pray. • Verbalizes fear about the seriousness of the injury, disfigurement/permanency of disability, loss of independence, becoming a burden or feeling abandoned. • Expresses fear of dying. Depressed over loss of a child, family member, trauma or terminal illness. • Does not accept terminal illness or suffering. • Views illness or injury as punishment by God for past sins or wrongful deeds, feels s/he cannot be forgiven. • Cannot forgive, or is angry with God, self or others. • Feels abandoned by God, • Experiences guilt/anxiety. • Unable to participate in religious practices/services. • Asks for priest, minister or rabbi or other faith leader. • Worriedly asks for prayer, spiritual help or confession. • Repeatedly calls the name of God, Jesus or Mary. Clings anxiously to a Cross, religious medal, or holy card. • Lacks purpose and meaning of life. • Suicidal ideation/attempt. • Overwhelmed with grief. • Shows no interest/refuses contact with Pastoral Care, family members, or others. • Experiences internal conflict over ethical/moral decisions. • Medical condition is critical, exhibits anxious or restless behavior.14 Signs of Patient’s Spiritual Distress 59
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