The nursing ideal is to give total patient care-meeting physical, psychosocial and spiritual needs. But in reality, we must set priorities.

When I worked in coronary care, prayer was my key to giving spiritual care. I prayed to be filled with God's strength and love, to set right priorities and to recognize patients' concerns. I also prayed that God would ultimately meet patients' spiritual needs and that if I was to be part of the process, I would know it and respond.

As nurses, our role as Christ's witnesses differs from other Christians' roles: We are present in times of illness, crisis and vulnerability, when people can be more open to God than when they are healthy. When we have opportunities, we talk about our faith. But sharing the gospel is only part of our role, not all of it.

Also we should remember that God works through us in giving spiritual care. The same principles that guide us in giving good nursing care should guide us in proclaiming the gospel to patients. When we give physical and emotional care, we observe and interpret data before we plan and carry out interventions. We should use that same process for spiritual care.

The story of Philip and an Ethiopian official in Acts 8:26-40 illustrates how to assess and respond to spiritual needs. As he was going along the road from Jerusalem to Gaza, Philip came upon another traveler. The Spirit prompted Philip, "Go up and join this chariot."

Philip observed the man in the chariot reading Isaiah and asked, "Do you understand what you are reading?" Note, he did not ask, "Do you know Jesus as your Savior?" Rather, Philip encountered the man in a natural way with an appropriate assessment question based on his observation.

"How can I, unless someone explains it to me?" the Ethiopian official asked. Then he invited Philip to join him. With his question and invitation, the man gave Philip permission to interpret the Scripture to him.

God was working in the Ethiopian man to create spiritual interest. When the man expressed that interest, Philip intervened by explaining the Isaiah passage. When the man asked about whom the passage spoke, Philip told him the good news of Jesus.

Then the official asked to be baptized. Philip didn't force him. It was the man's choice to believe. Philip's part, in response to the Holy Spirit, was to observe, assess and intervene appropriately with the gospel.

Like Philip, we are coworkers with God. His Holy Spirit works in patients as well as in us.

While passing medications, Sara, a friend of mine, saw a man in a hospital gown pacing up and down the hallway. She stopped him, commented that she had seen him pacing, and asked if something was wrong. He spilled forth details of his surgery scheduled for the next day and said he was afraid of dying since he was not ready to meet God.

Sara explained how he could have a relationship with God through believing in Jesus. That night the man slept peacefully and came through surgery fine.

Just as Philip did, Sara observed a behavior, asked a question, assessed a need, then intervened appropriately with the Word of God. We need to use the nursing process while being sensitive to God's leading. We will not talk to all patients about God, but we will to some.

I know nurses like Deborah who feel great pressure to share their faith with dying patients like Jerry. These nurses think they are the patients' last chance to hear about God and feel guilty if they don't share their faith.

We cannot avoid our responsibility as Christ's witnesses. On the other hand, God desires a relationship with our patients. The Holy Spirit pursues patients long before we care for them. And they make many choices before they are ready to die.

Jerry shrugged off Deborah's earlier attempts to discuss spiritual concerns. Now she needs to continue praying for Jerry and for creative opportunities to share the gospel based on his need.

We can't force patients to accept God. Some people even turned Jesus down when they met him face to face. When the skeptical Nicodemus questioned Jesus about spiritual rebirth, Jesus knew the depth of his resistance. "If I have told you earthly things and you do not believe," Jesus said, "how can you believe if I tell you heavenly things?" (John 3:12). Jesus accepted Nicodemus's choice not to believe.

Knowing our patients' spiritual concerns guides us in knowing how to share the gospel. Nevertheless, some Christians teach a specific method of leading others to Christ. Many, including nurses, find security in knowing a 1-2-3 method of evangelism.

Yet nurses often face dying patients who are unreceptive to lock-step methods, to the gospel or to both. Then, if the nurses don't witness in the prescribed way, they feel guilty. This is their dilemma: They may proceed with the 1-2-3 method, relieving their guilt but possibly offending the patient. Or they may choose not to witness with their familiar method, and risk leaving patients' needs unmet.

Instead of predetermined methods, we should tailor our approach to each patient's specific needs. If patients are concerned about life after death and interested, you can describe how Jesus gives eternal life (1 John 5:11-12). If patients feel guilt ridden, you can help them explore seeking forgiveness-from others as needed and if they are open, from God.

Fear of pain and of being alone in the dying process requires a different, sensitive approach to spiritual care. Jesus also experienced pain, suffering and death. Frequently, patients can identify with Jesus' humanity, then receive his promise of comfort and endurance, and his presence in the midst of trials.

Psalms can be helpful for patients who feel fearful or alone. Partly because it is so familiar, Psalm 23 can be especially comforting. "Even though I walk through the valley of the shadow of death, I fear no evil; for thou art with me; thy rod and thy staff, they comfort me" (Psalm 23:4, KJV).

God is not limited to one evangelistic approach. The Holy Spirit will guide us in meeting dying patients' needs. Being Christ's servant is an adventure: Pray for God's guidance and see how creatively he uses you, with your knowledge of him and of the nursing process, to meet the needs of dying patients.