BackgroundSpirituality in nurses is considered an important aspect of nursing care today. Often, the palliative care ward environment teaches nurses the philosophies of life of dying patients but can leave them feeling powerless from the impact of facing death, which can place them in a state of crisis. However, there are no existing studies that have examined the relationship between the factors of spirituality and self-esteem in nurses working in palliative care wards. This study thus aimed to investigate the relationship between spirituality and self-esteem and to identify the factors of spirituality in nurses working in a palliative care ward.MethodsA survey was conducted on 300 nurses working in a palliative care ward in the Chugoku Region[1]. This study is a cross-sectional study using an anonymous self-administered questionnaire. Higa’s spirituality rating scale A (SRS-A) and a self-esteem scale was used. Data were analyzed using the Mann–Whitney U test and Spearman’s rank correlation. ResultsThe nurses surveyed and analyzed had long experience as nurses and all demonstrated motivation in palliative care and were highly interested in spirituality. Among SRS-A subscales, they scored highest for “motivation (M = 9.41 ± 2.04),” and they were strongly affected by items “I want to fulfill my dreams and wishes” about self-realization and “I can choose the way I live.” There were significant differences in transfer to the palliative care ward (self-requested or ordered) (p < 0.01) and whether they had training (p < 0.05). Moreover, there was a positive correlation between spiritual and self-esteem (r = .518, p < 0.01).ConclusionsThe survey outcomes suggested that the important factors of spirituality intrinsic to nurses working in palliative care wards were a sense of purpose and will to envision self-realization; motivation, which is the source of energy; self-esteem, which increases self-affirmation and self-acceptance; and “educational support,” which translates “experience” into experiential knowledge. Nurses working in palliative care words possess the viewpoints on mortality and life developed through a wealth of experiences in palliative care. Educational support should aim to allow nurses to integrate their experiential knowledge with theoretical knowledge. [1] Chugoku Region: a region of Japan located in the western part of Honshu with area ‎31,921.87 km2, population = ‎7,251,351, and 30 facilities with palliative care wards (as of June 1, 2020).