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PURPOSE/OBJECTIVES: To determine what spiritual care practices oncology nurses use. DESIGN: Descriptive, cross-sectional survey. SETTING: Variety of oncology clinical settings from all regions of the United States. SAMPLE: Stratified, random sampling of Oncology Nursing Society members who identified themselves as clinicians; 181 out of 700 completed the questionnaires; respondents typically were Christian, caucasian, female, adult inpatient oncology staff nurses. METHODS: Oncology Nurse Spiritual Care Perspectives Survey and a demographic form were delivered and returned through mailing; questionnaires required up to two hours for completion; respondents were given one month to complete the questionnaires. MAIN RESEARCH VARIABLES: Spiritual care practices/interventions (types and frequency) and indicators of spiritual need. FINDINGS: Frequent practices included praying with patients, referring them to chaplains or clergy, providing them with religious materials, serving as a therapeutic presence, and listening and talking to them. Frequency of traditional spiritual care practices differed by variables such as self-reported spirituality, religious service attendance, ethnicity, and education. Identified indicators of spiritual need included anxiety, depression, patient requests, death issues, hopelessness, and withdrawal. CONCLUSIONS: Oncology nurses provide spiritual care in a variety of ways that often are personal and private, yet they do so infrequently and with some discomfort. Research examining relationships between spiritual care practices and demographic variables is needed. IMPLICATIONS FOR NURSING PRACTICE: Spiritual care education and resources for clinicians are needed. Data provide examples of interventions for and indicators of spiritual need.