Nursing the spirit: the Framework of Systemic Organization.
OBJECTIVE
To elucidate the concept of spirituality as an essential and integrated dimension of the functioning of individuals and families through the Framework of Systemic Organization (Friedemann 1995) and to demonstrate with a case example, how a nurse can integrate spirituality in the care of a terminally ill patient.


BACKGROUND
Spirituality is the focus of discussion in nursing and other health professions in the United States of America, but whether or not it should be generally included in patient care is heavily debated. Also unanswered is the question about how spirituality should be addressed. The Framework of Systemic Organization (Friedemann 1995) is introduced here as an organizing structure to guide nurses in caring for the spiritual needs of patients. IMPLEMENTATION OF THE THEORETICAL FRAMEWORK: Spirituality is defined as connecting to systems such as God, nature or other people, and thus finding meaning through relationships. Key to spiritual care is the establishment of a balance between control and spirituality that is tailored to an individual patient's history, values and needs. A case example is used to show how a nurse intervenes with a patient who faces death.


RESULTS
The example shows that control remains important in a patient's life process until death arrives. Nevertheless, a dying patient benefits from an increasing focus on spirituality to gain self-acceptance, reconciliation with the family and restoration of emotional health. Nurses are instrumental in finding the balance between control and spirituality that a patient desires.


CONCLUSIONS
Nurses who have explored and reconciled their own spiritual beliefs can learn to address their patients' unique needs within the broad context of family and environment. Nursing the spirit by using the Framework of Systemic Organization is a client-directed and intimate process that leads to growth of both patient and nurse.
Friedemann
Marie-Luise
ML
Shool of Nursing, Florida International University, North Miami 33181, USA. friedemm@fiu.edu
Mouch
Judith
J
Racey
Teri
T
D000368:Aged; D018939:Holistic Nursing; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*