Eighteen participants in a rural Appalachian community were interviewed to learn about their mystical experiences in the context of health care. Semistructured interviews addressed factors initiating mystical experience and essential qualities of mystical experience. Nursing process and the nurse's response were examined. Data were analyzed using the immersion/crystallization method and concept mapping. Mystical experience was conceptualized as a process incorporating initiation, occurrence, maturation, and integration of mystical experience. Essential qualities included sensory-motor perception, interaction with the supernatural, interaction with family members, conviction of reality, cognition, dynamic tension and emotional intensity. Nursing interventions included listening and support. Subjective nursing responses included tension, intimacy and empathy, sense of awe, autonomic responses, and appreciation of the mystical in everyday life. Various stressors are associated with mystical experience. Patients having mystical experiences may benefit from nursing support.