This chapter opens with the challenge Nightingale and her close colleagues faced in establishing nursing as a profession when the ethical standards of the existing (secular) nurses were (generally) so low. The ethical issues she had to deal with in her own school, soon after it opened, are discussed three thorny problems with appointments. Anyone reading Nightingale’s writing on nursing will be struck by how often and how forcefully she insisted on high ethical standards. The reason for the emphasis on ethical standards is obvious enough in the task Nightingale faced in raising the new profession from its disreputable past. The International Council on Nursing (ICN) established its Code of Ethics in 1953, again based on Nightingale principles. It identified four responsibilities: to promote health, to prevent illness, to restore health, and to alleviate suffering. The code asks nurses not only to act ethically themselves, but to challenge unethical practices.

The caring nature striven for is that which has the potential to “gently shake the world”, as Gandhi said, and to move healthcare toward the whole-person, whole-planet healing that Nightingale. This work continues to be an invitation to pause, intentionally create space for reflection and intention, and move into the world with a refined sense of purpose, presence, and authentic power. Caring Science is not the property of a particular profession or system; it does not belong to the annals of nursing any more than the halls of medicine, finance, or law. Nurses have simply been granted the privilege of ushering the texture of its message into the stratosphere; a nursing lens has been the kaleidoscope of sacred human interaction chosen for this tender phase of its being and becoming.

This chapter reviews research and theory linking religion and health. It presents number of reasons why nurses should appreciate the role of religion as they provide health care. Social scientists describe facets of religion with typologies. The growing body of evidence linking religious belief with health care decision making describes the influence of beliefs on varied decisions, from those related to pregnancy and genetic testing to cancer and HIV treatment. Furthermore, a health-related event may have religious implications. Nurses have many reasons for recognizing patient religiosity. These include the fact that religion is prevalent, that some religious practices have health-related implications, and that some health-related events have religious implications for adherents of some religions, and professional mandates. Religion serves many functions, from social cohesion to intrapsychic comfort. When religion lacks personal spirituality, it becomes harmful.

Faith community nurses (FCNs) establish connections with parishioners, colleagues, other faith communities, agencies, universities, and other organizations. Collaboration is one of the core competencies of advanced practice nursing. Nurses and other health care providers who are members of the faith community can also create barriers to collaboration if they do not clearly understand the FCN’s role. FCNs provide counseling, expert guidance, and coaching to parishioners about a broad range of health- and illness-related issues. Health counseling was defined as spiritual and psychosocial support. Prior to consulting with others, a FCN is required by both professional standards and the Health Insurance and Portability and Accountability Act (HIPAA) to have the patient’s permission. The key connection for the FCN is the local or regional health department. Home health care services may be provided by the health department and/or nonprofit visiting nurses associations, and by proprietary home care agencies.

Like many Protestant Christians, Baptists believe in a Trinitarian God who is customarily known as Father, Son, and Holy Spirit. Baptists vary greatly in their understanding of the meaning one can attribute to disease and illness. Because of Baptist roots in Calvinist teachings, there is a doctrinal thread that views suffering as an inevitable consequence of the adverse effect of human sinful behavior on the natural world over the centuries. Occasionally, Baptist families of a patient receiving artificial life support measures will ask hospital staff to prolong those treatments to allow God the time to create such a miracle. Baptist rituals after death can involve a memorial service, a funeral, a graveside service, or any combination of these options. Nurses and other clinicians should feel free to consult the chaplain or the pastor from a local Baptist church if spiritual needs arise.

Paganism or Neo-Paganism refers to a grouping of disparate religions that share some common attributes. Modern Paganism is largely theistic in nature, although it would be incorrect to say that all Pagans are theistic. Some Pagans view Western medicine and particularly modern pharmaceuticals with suspicion and prefer to avoid taking medications when possible if herbal remedies are available. Although there are no prescribed or proscribed lifestyle practices, individual Pagans may engage in variety of health-promoting practices based on their personal understanding of their spiritual path. Some of these include vegetarianism or veganism, meditation, yoga, Reiki, and dietary supplementation. While some hospital chaplains may try to support Pagan patients, most Pagans are extremely uncomfortable working with clergy of mainstream religions. Nurses could be able to provide spiritual support when needed and requested if they identify various Pagan groups in their locality who might be willing to be on-call for Pagan patients.

Roman Catholicism is the continuation of Christianity practiced in Western Europe from the first through the sixteenth centuries. Catholics experience God chiefly through prayer, sacramental worship, reading of the Bible or other spiritual texts, meditation, and charitable deeds. Community worship is an important aspect of living the Catholic faith. Roman Catholics believe that mind, body, and spirit comprise a unity. Thus, ‘health’ exists when the different facets of the self are in balance and harmony. Physical and psychological health, as they are understood by modern medicine, are important elements in this harmony. Most parishes provide training programs for lay persons who are specially commissioned to visit and minister to the sick, especially by bringing them Holy Communion. Nurses can plan patients’ schedules not only to allow time for Holy Communion but also time to meditate in silence for a brief time afterward.

This chapter describes the various roles and functions of the treatment program or clinical management staff in the residential facility. It characterizes the roles of support staff and agency personnel. Teachers, physicians, nurses, psychologists, social workers, lawyers, and accountants in the TC ply their professions in the usual way. The relationship between staff and peer roles is rooted in the evolution of the Therapeutic Community (TC). In the TC approach, the role of staff is complex and can be contrasted with that of mental health and human service providers in other settings. An array of staff activities underscores the distinctively humanistic focus of the TC. The chapter describes how primary clinical staff in the treatment program supervise the daily activities of the peer community through their interrelated roles of facilitator, counselor, community manager, and rational authority. Other staff provide educational, vocational, legal, medical, and facility support services.

This chapter examines basic medications that are important for all students to know and reviews medication terminology and accompanying abbreviations. It explains about medication “rights” and dosage calculations, and also offers medication administration guide. Students should be encouraged to learn the characteristics of a variety of medications. The chapter provides medication list that contains the most common drugs used and students must learn their uses, the typical dosage of each, side effects, and so forth. Nurses must possess a wide range of knowledge about the vast number of drugs currently available, including their classification, actions and indications, routes of administration, appropriate dosages, side effects and adverse reactions, and antidotes. Analgesics are drugs used to provide relief from pain. Anticoagulants are drugs that prevent the clotting of blood. Vitamin and mineral supplements are used to treat various conditions caused by nutritional deficiencies.

Simulation and reflection in nursing education provide a foundation for knowledge, skill performance, collaboration, clinical reasoning, and development of self-confidence. In this simulation scenario, communication with an elderly client, students have the opportunity to reinforce previously learned content and explore principles used in communication with the older adult. Nurses of the 21st century use critical thinking when communicating with elders the most rapidly expanding group of the population. Development of expert skills in communication facilitates efficient client-centered care, resolution of illness, and promotion of health. This scenario focuses on communication with an elderly client in the hospital. The scenario can be used in an introduction-to-nursing or gerontologic nursing course or as a tutoring tool for students who desire reinforcement of learning to support clinical practice. This scenario builds on previous learning, using the principles of scaffolding while focusing on achievement of new outcomes.