Correspondence: Frans Cilliers, Department of Industrial and Organisational Psychology, PO Box 392, UNISA 0003, South Africa.Correspondence: Frans Cilliers, Department of Industrial and Organisational Psychology, PO Box 392, UNISA 0003, South Africa. Tel: � 27.83.709.8776. Fax: � 27.12.429.8368. E-mail: cillifvn@unisa.ac.za

Correspondence: Frans Cilliers, Department of Industrial and Organisational Psychology, PO Box 392, UNISA 0003, South Africa.Correspondence: Frans Cilliers, Department of Industrial and Organisational Psychology, PO Box 392, UNISA 0003, South Africa. Tel: � 27.83.709.8776. Fax: � 27.12.429.8368. E-mail: cillifvn@unisa.ac.za

The role of spirituality in coping with the demands of the hospital culture amongst fourth-year nursing students

FRANS CILLIERS 1 & LANDA TERBLANCHE 2

1 Department of Industrial and Organisational Psychology, University of South Africa, Pretoria, South Africa, and 2 School of Nursing, Trinity Western University, Langley, Canada

Abstract The aim of this research was to describe the role of spirituality in coping with the demands of the hospital culture amongst fourth-year nursing students. Qualitative, descriptive, hermeneutic interpretive research was done. A case study of 14 female Canadian nursing students was asked to write an essay on their experiences of the demands of the hospital culture. Con- tent analysis was used and positive psychology served as the interpretive lens. Trustworthiness and ethicality were ensured. The fi ndings indicated that although the nursing students expressed themselves in religious and spiritual words, they did not signifi cantly illustrate the theoretically associated intra-, interpersonal and sacred behaviours to be referred to as being spiritual in their experience as a care giver in the hospital culture. They also did not illustrate behaviours linked to other positive psychology constructs such as sense of coherence, resilience, engagement or emotional intelligence. Rather, the nursing students experienced identity crises. Recommendations for the inclusion of mentoring in the curriculum of nursing students were formulated.

Introduction

Organizational culture can be defi ned as the customs, ways, rituals, rules and regulations implemented by a system to preserve its identity (Robbins et al., 2009). As institutions, hospitals are seen as different from most other types of orga- nizations because of their unique primary task of attending to illness, pain, dying and death (Katz & Kahn, 1978). This has resulted in a worldwide hos- pital culture of strict hierarchy and control in order to preserve order in reporting lines, obedience to methodology and technique, and cleanliness and sterility for the survival of patients, their families, communities and hospital staff. Menzies ’ (1993) research on hospital organizational dynamics found that hospitals as systems compensate for manifest- ing institutionalized survival anxieties (amongst patients) and performance anxieties (amongst staff) by enforcing strict personnel and procedural con- trol mechanisms.

It is generally accepted in the nursing fraternity that student nurses experience emotional diffi culty upon entering the hospital culture (Lanzette, 2010). As little information is available on their spiritual experiences, this study investigated how they cope from a spiritual perspective.

Literature review

Nursing science views and studies nurses as whole people, and it is believed that their professional and work performance depends on the level of inte- gration of their physical, psychological (including cognitive, emotional, motivational), social, cultural, environmental and spiritual functioning (Duke, 2013; Lanzette, 2010; Meier et al., 2005; Reimer- Kirkham et al., 2012; Young & Koopsen, 2005). Of these domains, research on spirituality is limited and controversial (Wissing & Fourie, 2000) due to the multidimensionality of spirituality, its confusion with religiosity or religious activities, as well as the diverse research methodologies being applied.

Spirituality input has been studied amongst vari- ous patient groups (Bauer & Barron, 1995; Brillhart, 2005; Hampton & Weinert, 2006; Lovanio & Wallace, 2007; Meraviglia, 2004; Reynolds, 2006; Tuck et al., 2001). Although the results are inconsistent, it has been shown to facilitate patients in coping with pain, hopelessness and despair. Research on the spiritual- ity of nursing students showed that the women especially regard themselves as having high levels of spirituality characterized by religious activities (discussions, church attendance) and experiencing meaning in life (Shores, 2010). Spiritual sensitivity

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