ABSTRACT
Openness' as a particular style of communication is facilitated by experiential learning. Morse et al. used autobiographical and biographical accounts of caregiver and patient interaction to illustrate their model of communication, which describes nurses' responses to patients who are suffering. A potential coping strategy used in situations of loss is the use of everyday 'chatter' to escape the real life and death issues that these circumstances tend to throw up. Nurses' understanding of the use of metaphor and sensitivity to others' use of metaphor is a valuable asset in spiritual care and worthy of some exploration in educational forums. Deep presence is achieved through active listening, watching for visual clues and setting the emotional tone of conversation with patients. Clinically based reflection groups to raise spiritual awareness are another means of promoting competence in spiritual care. An exploration and understanding of the use of metaphor where language falls short in expressing spiritual and existential concerns may be of value.
