1. Taylor, Elizabeth Johnston

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Over the past few decades, the percentage of atheists, agnostics, and those not affiliating with any religion has increased substantially in the United States. These "nones" (which also include "dones"-individuals done with religion) are now 29% of the American population (Smith, 2021). A few years ago, 3.1% of a large, nationally representative sample reported as atheist (Pew Research Center [PRC], n.d.).

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You may wonder: Do atheists especially need spiritual care? Or, if I am to avoid religion, how can I support their spiritual well-being? The religious abyss between you and the patient may not only create a desire to support them spiritually, it may also create concern within you. Here are suggestions to help nurses offer spiritual support.


Understand the atheist's perspective. Research findings document what atheists believe and why they are not religious. A 2017 survey identified common reasons for atheism as questioning a lot of religious teachings (77%), viewing religion as irrelevant (63%), and not liking the positions religions take on sociopolitical issues (54%) (PRC, 2018). Of note, only 89% confirmed not believing in God. Similarly, Bradley et al. (2018) identified several categories of reasons for nonbelief. The most prevalent included science, logic, or intellectual beliefs that counter religious belief, belief that religion is bad for society, intuition that prevents belief in God "on a gut level," and previous negative interactions with religious people or institutions.


This evidence suggests that atheists do not carelessly or naively avoid religion; rather, they may give considerable thought to it and experience the ethical choice as nonbelief. Furthermore, atheists who reject religion because they have been hurt by it may perceive they need to protect themselves from religion's harm. Indeed, persons who reject religion for relational reasons tend to have characteristics that leave them vulnerable to perceiving rejection (i.e., insecure adult attachment styles, entitlement, and trait anger) (Bradley et al., 2017). This evidence underscores the importance of spiritual care that is nonjudgmental, accepting, and dignifying of the atheist.


Remember what spiritual nursing care really is. Pesut and Sawatzky (2006) elegantly described this as


an intuitive, interpersonal, altruistic, and integrative expression that is contingent on the nurse's awareness of the transcendent dimension of life but that reflects the client's reality. . . . Spiritual nursing care begins from a perspective of being with the client in love and dialogue but may emerge into therapeutically oriented interventions that take direction from the client's religious or spiritual reality [-or lack thereof]. (p. 23)


A nurse can do much to spiritually support a patient without interjecting overt religion. For example, a nurse can listen deeply to an atheist's yearning to make sense of personal chaos, to forgive self or others, to create beauty or leave a legacy. Therapeutic responses will allow the patient to experience belovedness and peace, and gain insight.


Consider the source of your inner concern. Sometimes differing beliefs of others push our buttons. Pushed buttons often indicate projections that invite us to explore our "shadows" (hidden, unconscious thoughts or feelings). As challenging as it may be to accept, the anxiety of being around an atheist is a gift. Explore within what may prompt it (e.g., insecurity with one's own religion, fear of differences, etc.).


"I have other sheep, too," said Jesus (John 10:16, NLT). Indeed, we are fellow "sheep" with atheists; we are all welcome in the fold.


Bradley D. F., Exline J. J., Uzdavines A. (2017). Relational reasons for nonbelief in the existence of gods: An important adjunct to intellectual nonbelief. Psychology of Religion and Spirituality, 9(4), 319-327.[Context Link]


Bradley D. F., Exline J. J., Uzdavines A., Stauner N., Grubbs J. B. (2018). The reasons of atheists and agnostics for nonbelief in god's existence scale: Development and initial validation. Psychology of Religion and Spirituality, 10(3), 263-275.[Context Link]


Pesut B., Sawatzky R. (2006). To describe or prescribe: Assumptions underlying a prescriptive nursing process approach to spiritual care. Nursing Inquiry, 13(2), 127-134.[Context Link]


Pew Research Center. (2018). Why America's nones don't identify with a religion.[Context Link]


Pew Research Center. (n.d.). Religious landscape study.


Smith G. (2021). About three-in-ten U. S. adults are now religiously unaffiliated. Pew Research Center.[Context Link]