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Laura,
a junior nursing student, began her day of clinical
experience with a bad case of anxiety. She just
knew she was going to do something dumb and kill
somebody. However, her assignment looked pretty
simple, so she gathered her courage and went to
introduce herself to her patient, Bob Norris.
A muscular thirty-five-year-old construction worker,
Bob was one day post-op from a splenectomy following
an automobile accident. He’d had no fractures, only
some abdominal bleeding from a ruptured spleen.
However, today Bob seemed restless and pale. His
skin felt clammy. Laura took his vital signs, feeling
a thready pulse of 120. She couldn’t hear his blood
pressure, but she did not worry about it. She still
hadn’t mastered listening through a stethoscope.
She reassured Bob that he was fine and went to look
for her instructor to help with the blood pressure
reading.
Of
course, the instructor quickly recognized that Bob
was in shock. Within twenty minutes, he was back
in the operating room. Laura’s anxiety had clouded
her ability to think. The signs of shock
were the farthest thing from her mind as she tried
to master basic skills and remember the tasks she
was supposed to perform.
No
one would question the necessity of clear thinking
in concrete, life-and-death situations in nursing.
Laura would soon learn the assessment skills she
needed to be a good nurse. However, when it came
to abstract, philosophical thinking, Laura, along
with most other nurses, would resist. That kind
of thinking doesn’t seem important when we are surrounded
by the demands of acutely ill people with too few
staff to care for them adequately. When terms like
philosophies of nursing, nursing theories
or conceptual models enter a conversation,
I’ve often seen eyes roll and heard comments such
as, “I’ll leave that kind of thinking to the academics;
I don’t have time for such heady stuff!”
However,
God doesn’t let us off the hook. He created human
beings with the unique ability to consider the reasons
for our existence and the consequences of our actions.
It is not good enough for nurses to know what
to do; we must also know why we are doing
it. Otherwise, we may end up doing more harm than
good.
Paul
challenged the Philippian church to think when he
wrote to them: “Finally, beloved, whatever is true,
whatever is honorable, whatever is just, whatever
is pure, whatever is pleasing, whatever is commendable,
if there is any excellence and if there is anything
worthy of praise, think about these things” (Phil
4:8). His exhortation stands worthy of our attention
today.
First,
we are to consider what is true. Nursing
has been hard at work in the past three decades
determining what is true for us as a profession.
Theorists and nursing faculties have labored over
defining the concepts in the nursing metaparadigm.
Why? Because the way you define person, environment,
health and nursing determines the kind
of care you deliver. For example, if you believe
that a person is created in the image of
God, you will approach that person with much more
respect than you would if you thought that person
were only a bundle of chemicals with no eternal
significance. That distinction has serious consequences
when the person in question is an HIV-infected drug
dealer or a ninety-two-year-old woman with a fractured
hip or an inconvenient unborn baby.
Similarly,
we need to think about the environment. The
Bible tells us that God created it good and then
gave it to humankind to subdue and nurture. However,
human sin brought the environment under God’s curse.
We are neither to worship it nor exploit it. This
understanding of a good environment, tainted with
evil, has far-reaching ramifications. It explains
why bodies usually heal, why fresh air and sunshine
invigorate us and why eating a balanced diet makes
strong bodies grow. However, it also explains why
we constantly face accidents and natural disasters,
why families become dysfunctional, why drugs have
side effects, why cells become malignant and why
we die.
Furthermore,
we need to think about the true understanding of
health. If health is the goal of nursing,
then we’d better know where we’re headed. Some contemporary
understandings see health as merely killing germs
and surgically removing tumors (the much maligned
medical model). Others see only the spiritual
or mental dimension, discounting the need for physical
care (some alternative therapies). On the other
hand, the Bible describes health as shalom—an
all-encompassing, whole-person wellness.
Now
back to Paul’s list. Paul challenges us to think
about what is honorable, just and pure.
God calls us to account for our ethical standards
and moral behavior. Being honorable means
doing what is right, even when it may bring dire
consequences. It might include reporting medication
errors, refusing to participate in collusion or
cover-ups, crossing a picket line or volunteering
to take difficult assignments. Being just
requires us to open our eyes to things we would
rather not see and then to take appropriate action.
That action might include serving on a hospital
ethics committee, confronting discrimination, reporting
abuse, educating colleagues about important ethical
issues, taking risks to serve the underserved or
becoming involved in politics. It is never easy.
Remaining pure in our motives and behavior
results from deep introspection and serious pursuit
of God’s will. That involves prayerfully studying
the Scriptures and consistently applying them to
our lives.
Finally,
we are to think about what is pleasing, commendable,
excellent and worthy of praise. Thinking
Christianly about nursing shouldn’t just make us
an annoying thorn in the flesh of our colleagues.
As we look at the lives of the nurse mentors described
in this issue, we see people who struggled—often
for their faith—but their colleagues recognized
the excellence of their work. Ultimately, if we
think carefully about the meaning of nursing, seeking
to glorify God in what we do, the world will be
drawn to the truth of Jesus Christ reflected in
our nursing care.
Jesus
said, “Let your light shine before others, so that
they may see your good works and give glory to your
Father in heaven” (Mt 5:16). We should strive for
excellence in nursing. The recognition the world
gives to excellence provides an open door to share
the basis for our actions. However, excellence begins
with the hard work of thinking about what
is true and right. I challenge you to read the thoughtful
articles in this issue and think on these things.—JAS
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