• Mary E Minton, Mary J Isaacson, Brandon Michael Varilek, Jessica L Stadick, and Shannon O'Connell-Persaud.
• South Dakota State University College of Nursing, Brookings, SD, USA.
• J Clin Nurs. 2018 Jan 1; 27 (1-2): 173-181.

Aims And ObjectivesTo describe rural and urban palliative/hospice care nurses' communication strategies while providing spiritual care for patients and families at end of life.BackgroundNurses aim to provide holistic care consisting of physical, psychological and spiritual components. However, it is well documented that spiritual care is largely missing from nursing care. Internationally, spiritual care is a growing topic of interest, yet many nurses feel unprepared to deliver spiritual care.DesignThis qualitative study used Braun and Clarke's thematic analysis method.MethodsAs part of a larger multimethod study, this study shares the narrative descriptions from 10 experienced palliative/hospice care nurses. Individual, face-to-face interviews were conducted and lasted 45-60 minutes. Each interview started with the same lead-in questions, was audio-recorded and was transcribed verbatim. The research team used an inductive analysis approach and met several times reviewing and analysing the detected themes until reaching consensus.ResultsThe primary theme, sentience includes the capacity to act, a willingness to enter into the unknown and the ability to have deep meaningful conversations with patients regardless of the path it may yield. Subthemes include: (i) Willingness to Go There, (ii) Being in "A" Moment and (iii) Sagacious Insight.ConclusionNurses are integral in the provision of spiritual care for patients/families across the lifespan and at end of life. Nurses must feel confident and competent before they are willing to enter uncomfortable spaces with patients/families. Nursing curriculum must include purposeful engagement and focused debriefing in spiritual assessment and care.Relevance To Clinical PracticeThere is a dire need to prepare undergraduate and graduate students to assess and support a patient's spiritual needs. Addressing spiritual care content as a clinical and educational priority will promote a patient-centred approach for spiritual care and can further shape nursing curricula, policies, guidelines and assessment tools.© 2017 John Wiley & Sons Ltd.

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