Spiritual care has been recognized as integral to nursing care for centuries, as described by Florence Nightingale, and has been studied in both medicine and sociology. Health care institutions, particularly faith-based health systems, also have recognized the importance of spiritual care. Both qualitative and quantitative research support the importance of spirituality in patient health. Although the profession, health care institutions, and research support spiritual care, there is no empirically derived theoretical framework to guide research in spiritual assessment and spiritual care. We used focus group data from registered nurses who care for the chronically ill (n = 25) in a large Midwestern academic health center to generate a grounded theory of spiritual care in nursing practice. What emerged from this study was a beginning theoretical framework to guide future spiritual care research.