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Sacred Care

November 2, 2011

I have been thinking a great deal about exactly what it is I am meant to be doing at the nursing school.  My queries to the doctors have elicited only vague statements, something along the line of, “We want you to help us.”   The Lord has not made things any clearer up until now.  But perhaps He is giving me a hint.

For some time now in my life I have recognized a basic truth.  I am not sure if it is universal, but I know it is true for me.  When I question something sincerely, from my heart, God provides answers.  Those answers often come from unexpected places, often places I didn’t know existed when I began to question.  So it has been with my pondering what God would have me do in the school.  It has come in part through the discovery of a thin book I found quite by chance (or by God’s design, depending on your perspective), The Nature of Suffering and the Goals of Nursing by Betty Ferrell and Nessa Coyle, which in turn led me to a couple of remarkable papers, Diagnosing Suffering by Eric J. Cassell, and Giving Comfort and Inflicting Pain by Irena Madjar.   The ideas expressed in these works were not new to me; instead, as I read I again and again experienced “Yes!” moments.  Consequently I will borrow heavily from the authors in writing this post.  The answer to my question is not crystal clear as yet, so as I often do, I will work it through by writing.  Somehow the transformation of my thoughts to print brings clarity.

Perhaps what I am meant to do is not so much to teach nursing techniques, although undoubtedly that will be part of what I will do, but to impress upon the students what their calling, and nursing definitely is a calling, constitutes.  While one of the principal precepts of medical ethics that doctors embrace calls for them to do no harm, for nurses, in my opinion, the call is more impelling.  I believe nurses have a sacred mandate and therefore an obligation to minimize and relieve human suffering.  This obligation goes well beyond pain relief.  As Eric Cassell wrote in his seminal paper on the subject, suffering includes but is not limited to pain.  It is “experienced by persons, not merely by bodies, and has its source in challenges that threaten the intactness of the person as a complex social and psychological entity.”  Suffering involves not only threats to survival but also threats to the wholeness of the person.

It has become very difficult to live out a nurse’s mandate.  Advances in medical technology hurtle forward at breathtaking speed; trying to keep up with them is a daunting task.  These advances have shifted the focus of modern medicine; it has become very task oriented, technical and often depersonalized.  Financial considerations often trump individual needs.  The result is that often there is a disconnect from transcendence—the meaning of human life.  But it is only in recognizing the meaning of human life that nurses can truly provide the sacred care to which they are called.

Nurses often experience a dissonance and moral disquiet when prescribed treatments involve actually inflicting pain.  I saw this most acutely in neonatal care.  Often the “rightness” of such procedures is weighed according to their outcomes.  Personally, inflicting pain sometimes leaves distressing memories etched into my psyche.

I hope to encourage the doctors with whom I work to have our students work with end-of-life patients to learn about pain management and communicating with the dying and their families.  The students also need opportunities to learn first hand how providing care that will not result in what many would consider good outcomes will affect them personally.  It is extremely important that nurses come to terms with suffering and death themselves, as witnessing suffering will be their daily work, and they will become well acquainted with death in the course of their careers.  It need not be traumatic.  Personally I always found caring for the dying an incredible privilege, an experience of the grace of God.

There is an absolute necessity for nurses to have personal awareness of their own attitudes and feelings about the meaning of life and death.  They need to be prepared to deal with the pain, anxiety, spiritual crisis, hopeless and fear of their patients, of their patients’ families, and quite possibly, of some of their colleagues.  They need to discover how to deal with their own intense emotional responses, the personal crises and the debilitating stress their work may elicit.  In order to sustain effectively caring for others, nurses need to learn to take care of themselves.

Although nursing is unquestionably a profession of technical proficiency, that proficiency must always be couched in human kindness and compassion.  Nursing care is first and foremost a human relationship between a caring nurse and a patient in need of support.  It involves the profoundly complex gift of presence, “being with” the patient in their time of suffering.  It always respects the dignity of the human being.   At its best it restores the sense of the sacred to health care.  It recognizes the disease and the suffering together.  It melds the objectivity of science with the subjectivity of God’s healing will.  It is where the finitude of the moment and the infinity of a life lived in the service of love meet.


Perhaps this is more than a hint.








One Comment leave one →
  1. November 3, 2011 9:56 am

    Good thoughts, and definitely a need here. I often wonder at the gruffness that I see in clinics and hospitals from staff and wonder what the root is. Is it a demonstration of education, putting oneself above others? Is it a disconnect so that the suffering that is so present here all the time doesn’t enter in too far? I don’t know, but it’s a curious thing. I know when I was working at the clinic at Canaan there were times where I was fighting tears because of what was in front of me while the Haitian nurses were so clinical and “turned off”. As I was reading and agreeing with you, I was thinking that it would be an interesting exercise for you to just go to certain places where care is given, and just observe. Ask to just sit in the waiting area to watch how patients are admitted. Ask to sit in the lab (I’m thinking Pierre Payen) and ask to watch how they work with patients taking samples, letting them know that you’ll be training nurses and you’re just getting a feel for how things are done here. Maybe Judy can connect you with some nurses or doctors at the hospital too that will let you observe how they work. Then take that and see what ways you can teach so that your students can connect with their patients in ways that you might see lacking. You’re a people person who speaks with his heart, and I know this is an area of strength for you, that you can speak into others. Just some thoughts to ponder.

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