The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when attempting to integrate spirituality within their practice. This study used a phenomenological approach to explore the infusion of spirituality in nursing practice and the hospice nurses perceptions of assessing spiritual distress needs of terminally ill patients. Frankl's existential theory and Kubler- Ross's stages of grief theory framed the study. Participants included 8 hospice nurses working in a Pacific Northwestern state. Face-to-face interviews were conducted to explore the essence of the experience of integrating spirituality as well as their views and concerns regarding assessment instruments used to assess spiritual distress. Data was analyzed for content themes. The study found that spiritual courses were merged into hospice nursing as a teaching unity making it difficult for hospice nurses in a Pacific Northwestern State to fully grasp the concept of spirituality. Further findings suggested that only a handful of schools had spiritual nursing as an independent course. The study may impact social change by informing the advancement of hospice nurses and hospice administrators in the practice of including spirituality within healthcare and integrating extensive existential support training within nurses' curriculum.