Spiritual care is currently an important issue within hospice and palliative care. There is a need to explore the indigenous nature of spiritual care in Taiwan. There is also an ongoing discussion on whether spiritual care should be a scientific process or artistic process. The purpose of this study was to explore the recognition of spiritual care among a group of hospice nurses. A qualitative approach using in-depth interviews was used to collect the data. It was found that the overall guideline for spiritual care is an increase in harmony among self, others, the environment, and with God. Under this framework, spiritual care was divided into the physical, psycho-social and religious endeavors. In addition, through the application of life reviews, the work of hospice nurses with patients was explored to obtain their life meanings. The most important aspect of spiritual care is the presence of the nurses' deep involvement with patients who are engaged in the dying process. The nurses learn to release their medical expertise and mind-set. They also take up a new role as the peer disciple of the patient. Together they learn from the dying and the death. It was this "presence" experience that most facilitates the recognition of nurses and their experience in spiritual care.