In Margaret Edson's Pulitizer Prizewinning play and film "Wit," the main character, Vivian Bearing, is a no-nonsense and unlovable literature professor diagnosed with end-stage ovarian cancer. She is given a fullcourse regimen of chemotherapy, despite her grim prognosis.

As Bearing's treatment progresses, she descends into pain, loneliness and eventually death, reflecting on her life's decisions with humor, remorse and sadness. She has few visitors except for a research-hungry resident and her clinical-results-oriented physician.

Both doctors seemingly are bent on seeing how much chemo she can take, and view her as more of a vessel of their research than as a person. A busy nurse provides a modicum of compassion to Bearing and, in the end, is her only protector.

The film often seems to be a caricature of mechanized institutional care, but it's the first lesson Kennesaw State University's Lois Robley uses in her palliative care nursing course. It's the cold clinical setting and lack of spiritual solace for the dying woman that often moves Robley's students - many who are already involved in ICU or hospice care - to tears.

The audience knows the woman is dying, but it's the way she dies that makes the impact.

Whether or not a patient is "terminal" or dealing with a chronic illness, her health and spirituality are intrinsically linked. The medical community has begun to see this relationship as valuable - either as an aide in speeding recovery or in helping patients become at peace with their illnesses.

Nursing by its very nature has recognized this value - a dimension, or spirit, in every human being that goes beyond religious affiliation. But a way to approach this in a clinical setting can be awkward. In this month's Pulse, writer Judi Kanne looks at ways to bridge that awkwardness and recognize a patient's spiritual needs.

Just how is spirituality defined? Spirituality is not necessarily religion, but it does provide a link to a meaning and purpose, even for those who don't believe in a higher power. It can be recognizing that the patient in front of you, who has just learned he will no longer walk, needs to talk about unfulfilled hopes and dreams; or that the candles and special religious items that are placed around a comatose patient are important to the patient's family.

"Remember that patients are in crisis when they come into an acute care setting," said Sharon Stanton, who directs Saint Joseph Hospital's Center for Health Ministries. "They need to be understood from a physical, emotional, intellectual and spiritual perspective. But physical seems to get all of the attention. We need to look at the person as a whole."

If patients and families must grapple with end-of-life and other difficult decisions, so must the nurses and physicians who care for them. As a health care worker, it's important to take care of your spiritual needs.

Sometimes, the need occurs not after hours but during the job. Whether it is praying with a family when asked, rejoicing over good news, or being able to cry with fellow workers over the loss of a beloved patient, recognizing these special times is important to your health.

Here's to a healthy New Year. Blessings upon all of you who give your hearts - and share your spirit - with those you care for.