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This article reports the results of a study to determine the extent to which nurses assessed patients' spiritual needs, indicators of spirituality used in the assessments, data collection methods used, and nurses' demographic information related to assessment and methods of data collection. Boutell's Inventory for Identifying Nurses' Assessment of Patients' Spiritual Needs was developed. Test-retest indicated an acceptable level of reliability. The Inventory was sent to a random sample of 817 nurses eligible to practice nursing in Oklahoma, yielding 238 (29%) usable questionnaires. Criteria for inclusion in the study were that the nurses needed to be employed and giving direct care to patients 18 years of age or older. Findings indicate that the majority of nurses assessed their patients' spiritual needs from a moderate to considerable extent. They most frequently assessed for fears, sources of strength, and feelings of hope. Least frequently assessed were integration, giving love to God, meaning in suffering, and transcendence. Moreover, nurses ages 50 to 59 and psychiatric nurses were more likely than other nurses to assess the spiritual realm. Availability of time and patient acuity were major factors that influenced assessment. Data were most frequently obtained through observation of patients and discussions with patients rather than from secondary sources, such as clergy or patient records. Also, the nurses' basic educational preparation was not found to influence assessment. Suggestions for continuing education and programs are made.