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While mass casualty disasters may pose seemingly overwhelming physical and/or psychological challenges, many people find strength and comfort in their spiritual beliefs. Some individuals can accept that a disaster may be beyond human understanding but accept the event as a test of faith in Gods plan; prayer, meditative practices and faith communities can provide strength and support. A disaster victims or a responders spiritual needs may involve a desire for personal prayer or prayer with a clergy person; a loving hug or words of support from a relative, friend, or a caregiver; formal religious rituals in cases of death or critical wounding of loved ones; and myriad other kinds of spiritual or religious support. Much will have to do with the nature of the disaster, the role of the individual in the disaster and the personal spiritual or religious orientation of the victim or responder. However, admit that the question of why begins to be articulated as initial stressors fade and long-term coping begins. A victims or survivor request for an answer to the why of evil or suffering is perhaps the most difficult issue for a spiritual caregiver to address, quite simply because there is no clear answer. The question of why is become even more sensitive when a disaster or trauma affects the very young.


The most important thing that a nurse caring for a disaster victim can do, in terms of spiritual care, is to reinforce the fact that the trauma a patient has experienced was not caused by God, or brought about by any behavior on the victims part. This can free a victim from possible feelings of guilt, help restore his or her faith in God, and allow the individual to, as Rabbi Kushner suggests, turn to God for help in overcoming the suffering caused by the disaster. Before attempting to provide more specific spiritual care such as praying with a patient or clergy referral, a nurse can do a on-thespot spiritual assessment by asking a few simple questions related to a disaster victims spiritual or religious tradition, such as finding out what kind of pastoral care or prayer life they have been used to and what might support them both immediately and in future coping with the disaster. Family members, if available, can provide much of this information. Also, variety of volunteer clergy members are usually present at disaster sites; their intervention may be very helpful in assisting the nurse with both assessment and planning for a patients future, especially if the victim is to be hospitalized. It can also be helpful for a disaster nurse to provide clergy referral to less seriously injured victims for future spiritual care and counseling. It is very important to refer patients to pastors who are willing and able to listen to sometimes graphic and gruestone reports of a disaster scene in a nonjudgmental and practical way but with a sensitivity to the theological implications for the victim.

Nurses also are natural crisis counselor and natural providers of spiritual care because they are often the people most closely involved with a victim immediately after a disaster.