Student Feature: Terri Styles -MacKinnon | Arts-based Spiritual Support in Nursing Education and Practice

Written by Terri Styles-MacKinnon, who is in her last year of the MSN program at Trinity Western University and has been working on a knowledge translation project through a studentship with Dr. Kendra Rieger, focusing on arts-based spiritual support in nursing (ABSS).

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Introducing Terri

Terri has been a nurse for over 30 years, with a variety of public health roles in Nova Scotia, PEI, New Brunswick, and Saskatchewan. In May 2023, she embarked on a new journey by starting the TWU Masters of Science and Nursing (MSN) program and working in Nunavut as a fly-in, fly-out Public Health/Tuberculosis nurse. Working with Inuit patients, families, coworkers and communities has taught her about resilience, joy, the strength of community, the connection between health, spirituality and the land, and the importance of cultural humility, safety, and truth and reconciliation. She is thrilled to work on this KT project as her spiritual beliefs and love for the arts have always been integral to life and nursing, but she has never integrated all of them together.

Spirituality in Nursing

The concept of spirituality in holistic nursing has existed for many years, yet there has not been consensus on how to incorporate it into practice. Research shows that art in nursing education, practice, as a workplace wellness tool, and in nurses’ lives is a powerful tool providing deeper learning, increased empathy, and psychosocial health and wellbeing. There has been recent interest in exploring arts-based spiritual care in healthcare more broadly, but there remains a knowledge gap regarding the intersection of art, spirituality, and nursing specifically.

Reviewing Current Literature

To address this gap, a knowledge synthesis of 11 articles was conducted to answer the question: What is known about art-based spiritual support in nursing? The knowledge synthesis showed that using art in nursing education and practice can provide an equitable and non-threatening means of providing spiritual support in a diverse, pluralistic healthcare setting as it can transcend cultural, religious, and hierarchical barriers. Art-based pedagogy can enhance and deepen nurses’/nursing students’ understanding of spirituality. Art is a door to the spirit and can bring diverse patients, families, nurses and communities out of a dark place, providing a way to express difficult emotions and feelings that words cannot. ABSS promotes holistic healing and spiritual wellbeing, facilitates caring and connection between patients and nurses and humanizes the healthcare setting.

Knowledge Translation Framework and Stakeholder Engagement

The Knowledge as Action KT framework [1], developed by Dr. Sheryl Reimer-Kirkham (an Arts for Equity co-lead investigator) and colleagues, was used in this project and its dimensions of knowledge, context, people, processes, values, lifts, and currents are important concepts to consider.

To further understand the context and gain experiential knowledge regarding arts-based spirituality:

• I connected with my KT facilitator, Evy Klassen, a member of the Arts for Equity research team, who uses art-based learning in a spirituality and nursing course. Working with her provided firsthand knowledge of the connection between art and spirituality and how powerful it can be in nursing education and other aspects of life.

• I spent 2 days shadowing staff from the Healing Arts & Spiritual Care team at St. Paul’s Hospital in Saskatoon. I shadowed one of the music therapists as she visited dialysis patients, talking, playing guitar, and singing songs from a variety of genres one-on-one with different patients. In those 3 hours, I witnessed the power of music to heal through tears, laughter, guided imagery, and therapeutic conversations.

• In the afternoon, I joined the Artist-in-Residence with 4 medical students who were doing a module on holistic health, for an interactive art activity where patients, families, visitors, and staff came together to paint small stones to put in the Miyo-ohpikitowin Garden, which means "a good place for growing together knowledge and health" in Cree, given by Indigenous knowledge keepers.

One of the music therapists played the guitar and sang while the activity was going on, creating a relaxing environment. It was a transformative experience to be part of and as the medical students, art therapist, myself, and other staff mingled and painted rocks while chatting with patients and families. The professional hierarchies dissolved and people laughed and shared stories. After the event, we gathered, debriefed, and placed the stones in the garden.

• On the second day, I met with the Writer-in-Residence to hear about how he works with patients to tell their stories. As they speak about what is on their hearts, it is recorded, transcribed, and compiled as a manuscript for them to keep for themselves and their families or to attempt to publish if they desire. The act of having someone listen while telling deeply personal memories can be very healing.

• I spent the afternoon with one of the spiritual care practitioners visiting patients and witnessed the power of being present with and able to encourage and offer hope to patients at a vulnerable time in their lives.

  
  

Through connecting with Evy and spending time with the healing arts/spiritual care experts, as well as attending the Arts for Equity Community of Practice art-based spirituality monthly sessions, I felt more equipped to facilitate an arts-based spirituality experience. I gathered with staff from a local long-term care facility (St. Mary's Villa, in Humboldt) and share the results of my knowledge synthesis with them. The participants expressed interest in the topic and evaluations showed that they felt it was a relaxing experience and important to learn more about art and spirituality in nursing.

Other KT strategies used in this project include creating an infographic (see below), writing this blog post for the Arts for Equity Community of Practice, meeting with the Healing Arts/Spiritual Care team at St. Paul’s Hospital to present my KT project findings, and having an engagement session with the Arts for Equity research team.

Future Hope

This has been a very meaningful learning opportunity, and I hope that my KT project has helped in a small way to continue the Arts for Equity research team’s knowledge development regarding arts-based spiritual care in nursing, and that we will see more interest in bringing arts into nursing as a way of enhancing spiritual support for patients, families and communities with diverse religious/spiritual/secular backgrounds. I look forward to seeing where the ongoing Arts for Equity research projects and knowledge translation projects lead!

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[1]Reimer-Kirkham S, Doane GH, Antifeau E, Pesut B, Porterfield P, Roberts D, Stajduhar K, Wikjord N. Translational Scholarship and a Palliative Approach: Enlisting the Knowledge-As-Action Framework. ANS Adv Nurs Sci. 2015 Jul-Sep;38(3):187-202. doi: 10.1097/ANS.0000000000000077. PMID: 26244476.