This study identified the internal and external factor that affect the role of nurse leaders in the provision of spiritual care for hospitalized ,medical-surgical patients. The findings revealed the ill-prepared nature of 10 nurse leaders in similar roles. Lack of understanding, and education were all contributing factors to their lack of role engagement pertaining to spiritual care provided in their department . This study was limited by a small size, homogeneity of population, and geographic location. To validate the finding of this study, data collection could be expanded to include a larger sample size, more hospitals, different patient population, and other geographical location.