How can nurses find time to do spiritual care when they are already maxed out caring for eight to ten patients, when more and more is being expected of them? There always seems to be a shortage of time. Even with all the technology, there seems to be less and less time.

Does it really take a lot of time to provide spiritual care? Often nurses give spiritual care simply by being who they are and being present with patients. I recently heard a story about a physician who made rounds with his patients every day and spent only one minute with each of them. However, he did not stand in the room, but took the time to sit at each patient's bedside. Later, when the patients were questioned if he had come to see them, they almost always said "yes," and stated that he had stayed "quite a while," at least seven to eight minutes.

This shows that it isn't necessarily the quantity but the quality of time spent that makes a difference. It may be that spiritual care does not need to take a lot of time.

Here are ideas that do not require much time, but can improve spiritual care:

* Be present. The concept of presence means a self-giving to the other person at the moment. It means being available for that time. Presencing also involves listening in a meaningful way and "being there."1 Being where you are in both mind and body also may bring a presence of calmness and peace to the situation.

* Be watchful. Scripture talks about "being watchful" and on guard for Christ's return (Mk 13:32-27). I think this also applies to spiritual care. Although it may be unrealistic to do a thirty-minute spiritual assessment or life review, although these are very helpful tools, we can be alert for cues from our patients. Often, spiritual needs are not planned for, but come as a surprise, and we can be watching for them.

* Enlist help. Prayer support is a big part of our lives as nurses. Ask Christian groups to which you belong to pray for you and your patients. The extra grace can help with setting priorities and making work days flow better. Hands-on help, when needed, can come from the pastoral care department. Although we shouldn't always call on pastoral care, pastors usually have more time to talk with patients.

* Be informed. In Patricia Benner's book, The Primacy of Caring, she shares a case study of a nurse who was doing interviews with select rheumatoid arthritis patients for a clinical trial for the National Institutes of Health. The interview questions showed empathy for what it meant to have this disease. She asked key questions that cut to the core of what the patient was feeling because she had knowledge about the disease, how the disease progressed and what it was like to live with the disease. One woman interviewed for the study went away from her interview with hope because she had been understood.2 In this short encounter, a spiritual need was met.

* Smile. Mother Teresa often reminded her sisters to show their joy. She said, "A joyful heart is the normal result of a heart burning with love. We may never know all the good a simple smile can do, but we show our love by a smile."3 Mother Teresa encouraged her sisters never to let anything so fill you with sorrow as to make you forget the joy of Christ risen!!