AIM: This paper reports a study describing nurses' conceptions of how the spiritual dimension is addressed in psychiatric patient-nurse relationships. BACKGROUND: In psychiatric care, it is essential that patient-nurse relationships be built on a holistic view. In this context, nursing research shows that there is a lack of integration of the spiritual dimension. METHOD: Twelve strategically selected psychiatric nurses were interviewed and analysed using a phenomenographic approach. The data were collected in 2003. FINDINGS: The main findings were three descriptive categories: being a good carer, recognizing the spiritual dimension, and regarding the spiritual dimension as difficult to capture in patient-nurse relationships. The first descriptive category shows that nurses deal with spirituality by behaving as good carers. Those included in the second descriptive category reveal nurses who are aware of patients' spiritual needs and who deal with these needs in different ways. The third descriptive category consists of conceptions revealing lack of knowledge of patients' spiritual needs, both in abstract and real terms. CONCLUSIONS: Further research is needed to explore how patients describe their own spiritual needs, and how nursing staff can learn to be aware of and understand their own spirituality, thus enabling them to detect, discuss, clarify and deal with the concept of spirituality in patient-nurse relationships.