PURPOSE/OBJECTIVES: To determine what patients with cancer and primary family caregivers expect from nurses with regard to having their spiritual needs addressed. RESEARCH APPROACH: Descriptive, cross-sectional, qualitative study using Miles and Huberman s approach to data reduction. SETTING: Outpatient and inpatient settings in a county hospital and a comprehensive cancer center, both located in a large, southwestern, metropolitan area. PARTICIPANTS: 28 African American and Euro-American adult patients with cancer and primary family caregivers were purposively selected to provide variation of experiences (e.g., religious backgrounds). METHODOLOGIC APPROACH: In-depth, semistructured, tape-recorded interviews conducted by the investigator. Analysis of transcribed interviews concurrently with data collection followed a process of data concentration, data display, and conclusion drawing. MAIN RESEARCH VARIABLES: Spiritual needs, spiritual care. FINDINGS: Informants identified nursing approaches for spiritual needs, including kindness and respect; talking and listening; prayer; connecting with symmetry, authenticity, and physical presence; quality temporal nursing care; and mobilizing religious or spiritual resources. To provide spiritual care, nurses must possess requisites of a personal, relational, or professional nature. CONCLUSIONS: Although some patients or caregivers do not want overt forms of spiritual care, others are eager for them. Many recognize nonreligious actions or attitudes that nurses can practice to care for spiritual needs. INTERPRETATION: Nurses must consider how they can address patient preconceptions and requisites for spiritual caregiving. Nurses may need to educate the public regarding their role as holistic and spiritual healthcare providers.