Purpose: The purpose of this research is to examine nursing practices in which nurses experienced a realization of spirituality and their thoughts at that time. Methods: A questionnaire was administered to nurses in four hospitals and one palliative care unit. Results: A total of 835 participants completed the questionnaire. Nearly 20% of nurses reported having spiritual experiences associated with their work, including realizations of the value of human life and patients' strength in facing death or living with illness. In addition, nurses achieved a sense of spirituality through transcendent occurrences related to life and death, such as premonitions. Nurses pondered providing care that transcends both mind and body after encountering difficulty in providing nursing care. Conclusion: Nurses' sensitivity to human life and death and transcendent occurrences may be a reflection of the unique features of Japanese spirituality. In order to enhance Japanese nurses' perceptions of spirituality, it is necessary to offer nursing education in spirituality related to each nurse's own experiences. Palliat Care Res 2011; 6(1): 216-221