1. Taylor, Elizabeth Johnston PhD, RN, Associate Professor

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Evangeline was a middle-aged, Baptist, baccalaureate-prepared nurse who had worked in several health care facilities since immigrating from the Philippines. When I told her how the Joint Commission mandated spiritual assessment and support, she opened a floodgate for secret stories. Evangeline took me to where we couldn't be overheard as she proceeded to tell me about how she had prayed for patients. She said that previous employers told her not to pray with patients. If found praying with a patient, she believed she would be terminated. Because of her personal spiritual beliefs, she felt compelled to pray for patients sometimes-typically, during extremis. Although I silently questioned the ethics of some of her prayer "interventions," I was nevertheless impressed with her courageous compassion.


Evangeline's story prompts the question: Should nurses pray with patients? For many nurses the personal answer is yes. Some major nursing texts agree. 1-6 In 1997, nearly 150 empirical studies obtained statistically significant results to demonstrate that prayer effected physical change or healing. 7 Meta-analyses of research investigating the curative outcomes of intercessory prayer have yielded inconclusive results, not enough to guide clinical practice. 8-10 Findings from more recent clinical trials have also showed inconsistency as to whether there are medical benefits from receiving intercessory prayer. 11-15


The notion that prayer can be empirically studied is fascinating. It reflects the human desire to manipulate and control outcomes, fix problems, and cure illness. Although these human tendencies aren't bad, they are misapplied when researchers mechanically apply and test prayer as curative therapy. 16,17 For theists, prayer is about encountering God, not controlling God via prayer. Because of the nature of prayer, it isn't surprising that these experiments testing the medical outcomes of prayer are inconsistent and inconclusive.


Although experimental evidence of prayer's curative effect is inconclusive, research about psychological health correlates prayer with sense of purpose, mental health, self-esteem, and decreased psychological distress, anxiety, and depression. 18-21 Many studies have documented that persons perceive prayer as an effective coping strategy for dealing with illness, medical procedures, and symptoms of aging. 5


Even when assuming that prayer can be appropriate in nursing practice, many questions arise: How and when should nurses pray with patients? When would prayer be unethical or not therapeutic? If a nurse doesn't believe in prayer, should he or she pray with a patient? What qualifies a nurse to pray with a client? Should nurses develop guidelines for how to pray?


We need to open a discussion about the use of prayer in nursing practice. Rather than continue to have nurses like Evangeline covertly and perhaps unethically pray with patients-or fearfully avoid praying with patients, an open discussion can lead to informed, therapeutic, and compassionate nursing care that includes prayer.




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