[CARE NURSE AT REFRACTORY SPIRITUAL SUFFERING USING TAXONOMY NANDA-NOC-NIC]

This paper introduces the concept of refractory spiritual suffering in the terminal patient, the factors that influence it, the possibility of their assessment and care approach emphasizing the role of nurse care to despair for identification and relief through the use of taxonomy NANDA-NOC-NIC (NNN). We conclude that it is necessary to incorporate into the care routine screening of spiritual suffering, assessment, prevention and interdisciplinary care. When direct care nursing developed aimed at improving levels of hope that the patient achieves his spiritual suffering terminal decline. In refractory spiritual suffering is necessary to consider the option of palliative sedation in which nurses have a crucial role both in their valuation for the indication and in the administration and evaluation of its therapeutic effects.