Personal account: spiritual issues When visiting a nursing home recently I read a notice on front hall which said, 'the nurses aim to care for all the patients' needs, mind, body, emotion, and spirit'. When I asked the matron what she meant by caring for the patient's spirit she replied that when a patient was dying she called the chaplain! This confusion between spirituality and religion is common. Equally, a common belief is that spiritual- ity only applies when a patient is beyond a cure.

The word religion means an affiliation to a com- munity of people with similar beliefs. They express their beliefs through certain rites and rituals. They have their own symbols, special places, books, objects and leaders. Being a member of a religion may serve to deepen the understanding of spiritual questions, but in turn may detract from individual searching. One can be religious, but not necessary spiritual, and one can be spiritual without being a member of any religious organization.

I work in a busy NHS general practice and so have an opportunity to see patients with a broad range of problems, of all ages and from various backgrounds. I have had an interest over the years in the question, 'What is the spiritual dimension in health care?'. To help me focus on the spiritual com- ponent I have had a spiritual healer sitting in one of my morning surgeries each week over the last ten years. In these surgeries I carry out my normal medi- cal approach and sometimes invite the healer to con- tribute. When the patient has left we discuss the spiritual dimension of their condition and what addi- tional ways we could be helpful to them. As a result we have been able to identify four areas of spiritual- ity in health care that gives a basis for further study.

�9 Meaning. The 'Why me?' and 'Why now?' ques- tions that patients often ask, especially when faced with serious illness. I would contend that every illness has a meaning, and helping patients explore and understand the meaning of their ill- ness will bring some purpose to their life.

�9 Values. The positive qualities of an individual or a group can form the foundation on which to build their lives. In the context of illness, using positive qualities can aid recovery. Simply the physician being compassionate, and drawing out such qualities as patience, acceptance, tolerance and kindness are beneficial to the patient and carer alike.

�9 Awareness of spirit. The view that there is more than mind and body and that we are spiritual beings is common to all cultures yet is rarely addressed in medical care. We are souls in a body and that soul survives physical death. What is more, as that realization deepens we may begin to experience a connection to a collective soul. This experience of a peaceful loving being is what some people call God.

�9 Peacefulness. The goal of healing is not cure, but peace. Our natural soul state is one of peace and our journey through life is towards peace. Not only does that give meaning to our work, but one can use practical interventions, such as medita- tion and visualization, to benefit our patients and ourselves.

Craig Brown President, National Federation of Spiritual Healers

Complementary Therapies in Nursing & Midwifery (I 998) 4, 105 �9 1998 Harcourt Brace & Co. Ltd