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.

This research focuses on spiritual well-being in the workplace and its relation to work performance. Extant empirical studies have mostly focused on demonstrating statistical links between these two concepts to the exclusion of qualitative studies that can better explain what spiritual well-being may be and how the experience is possibly related to work performance. Especially under-researched is the ground-level employees’ perspectives and the possible incompatibility of spiritual and organisational goals. This research thus examined the experiences of spiritual well-being among successful healthcare sales representatives in Malaysia, particularly on how their spiritual inclinations or their inclination for meaningfulness interfaced with the need to meet work targets. This qualitative research is exploratory and is framed within a constructionist epistemological stance. It used narrative inquiry as its methodology. Its primary data were stories successful healthcare sales representatives in Malaysia told about their work. These were collected and analysed using narrative interviews and narrative analysis respectively. What the research found was that the relation between spiritual well-being and work performance was depicted to be diverse, fragile and transitory. This was predicated on the ground-level employees’ experience of the interface between their spiritual inclinations and the need to meet work targets, which was diverse and changeable. What the research also found was that spiritual well-being resembled an experience that was constructed as employees engaged with their work. Spiritual well-being is thus neither merely found at work nor merely brought to work but constructed in the interplay between the employees’ spiritual inclinations and what they do at work. The research contributes to theoretical development in the area by advancing an expanded understanding of spirituality in the workplace. It demonstrates that spiritual well-being is contingent upon the work employees do, and the extent to which the work may be amenable for the construction of the experience. Thus, the relation between spiritual well-being and work performance ought to be understood from the way individual employees construct and individualise their experience of work. The research also foregrounds the importance of using models of organisation that accommodate the constructed, interactive and evolving nature of spiritual well-being in the workplace.