Archives For Nursing

Misplaced Trust

October 16, 2014 — 8 Comments

trustingWhy do some nurses kill? Most people attracted to the nursing profession possess deep reservoirs of compassion for others. And yet, every once in a while we read about a nurse intentionally taking the life of a patient.

Today’s case comes from Italy, where a forty-two year old nurse is under investigation for thirty-eight possible cases of murder. And we are not talking about the ending of a life that some would term euthanasia.

Poggiali did not overdose them to end their suffering. She did it simply because they irritated her. She, or their relatives, bothered her.

One troubling aspect of the case could only happen today. Authorities have actually found a photograph on her phone where she is standing beside a deceased patient giving a “thumbs up” sign. (The article didn’t indicate whether this was a sickening “selfie,” or if there is another person at the hospital with a similarly demented sense of humor.

When people we implicitly trust violate our faith in them, it is jarring. We struggle to comprehend things when . . .

Medical professionals intentionally cause injury . . .

Clergy behave immorally, particularly when they attempt to justify it from the pulpit . . .

Police victimize rather than protect . . .

Teachers care more about themselves than their students . . .

Soldiers display cowardice rather than courage . . .

There is some good news here. It is precisely because these breaches of our expectations are the rare exception, that we are shocked by them. For the most part, people entrusted by the public with authority or power honor that trust.

(Let’s exclude, for our discussion here, the case of politicians, where that supposition would be hotly debated. As Lewis in his essay “Equality” wrote, “Mankind is so fallen that no man can be trusted with unchecked power over his fellows.”)

Our trust in people who occupy special positions goes so far as to be illogical. For example, we tend to think of actors or actresses as possessing the traits of various characters they have portrayed.

We laugh at the joke, “I’m not a doctor, but I play one on TV.” Yet, we’re still tempted to ask the person how we can best deal with our persistent cough or chronic rash.

We think of television cops as believing in law and order, but if we seriously considered the matter, we would recognize just how foolish that is. They are no more, or less, likely than anyone else in Hollywood to be law abiding.

An ongoing scandal reveals just how disorienting it can be to have our illusions shattered. It is the case of Stephen Collins. In the popular Seventh Heaven series, he played the ideal father. A pastor, no less. We mourn for the lives he has injured, and we subconsciously grieve our own disillusionment.

The solution to the problem is not in ceasing to trust others. Life from that perch would result in paranoia and alienation.

No, I think that it still makes sense to trust—within limits. I am willing to extend my trust to someone in a respected profession who I have just met. That is based on the profession’s self-policing of standards.* Most require minimal education and competence standards, and have mechanisms for decertifying those who violate professional ethics.

Still, when time allows, the best advice is probably to “trust and verify.” The time I take to verify whether the person’s credentials or claims are true corresponds to the importance of what I’m entrusting to them. I would leave my car with a mechanic far sooner than I would entrust my child to a babysitter.

Returning to the case with which we began, we assume that a hospital is one of the safest places to be. And, even in light of the latest tragedy, this remains true.

For every one nurse tempted to end a complainer’s life early, there are a hundred thousand** who are striving to prolong the lives of their charges.

Trusting should not only be viewed as something we extend to others. Each of us would do well to ponder for a few moments just how trustworthy we are. This is especially true for those of us in privileged or respected professions. However, it is no exaggeration to say that the measure of any woman or man is determined by the degree to which they have earned the trust of others.

Lewis writes about the nature of trust, as it relates to friendship. It doesn’t relate to trust imbued in societal roles, but rather in the trust that exists where a relationship is already present. Still, he expertly describes the interplay between mind and heart, when it comes to trust. And this explains, in part, why the betrayal of our trust causes us so much anguish, in mind and soul.

To love involves trusting the beloved beyond the evidence, even against much evidence. No man is our friend who believes in our good intentions only when they are proved. No man is our friend who will not be very slow to accept evidence against them. Such confidence, between one man and another, is in fact almost universally praised as a moral beauty, not blamed as a logical error. And the suspicious man is blamed for a meanness of character, not admired for the excellence of his logic. (“On Obstinacy in Belief”).


* The fact that some “professions” don’t have any mandatory requirements or standards, means that I remain wary when I meet people sporting those titles. For example, in America it’s possible to “ordain” oneself (or buy a meaningless diploma or certificate online). Thus, when someone tells me they are a minister, I am eager to learn more (about their education, congregation, accountability, etc.). There are far too many hucksters out there to take a person’s word for it that they are a genuine minister of God.

** Perhaps a slight exaggeration, but I’d like to continue believing that the ratio is something wonderful like that, 1:100,000. Then again, if I think of it literally, in terms of how many are “tempted” to expedite the passing of an inconsiderate and ungrateful patient, I imagine the numbers might be rather less encouraging.

Compassionate Care

August 11, 2012 — 17 Comments

In my last column I shared how I had been drafted into service as my wife’s nurse.

The duties are not onerous, in part because she’s become quite ambulatory with her crutches . . . but even more, due to the fact that I truly love her. To care for those you love is a natural thing, and it would be the opposite path—to ignore the suffering of those about whom you care—that would be contrary to human nature.

This is why we are also so deeply stunned when we see spouses doing harm to one another, or (far worse) injuring children in their care. These are inhuman acts contrary even to that universal Natural Law which governs even those who take no notice of religious codes.

But, returning to my nursing experience . . . I am not a total stranger to such matters. My first assignment as an Air Force chaplain was in a “Contingency Hospital” which was part of the Reserve. As part of my active duty tours I frequently included hospital visitation and service.

In fact, years ago during a five week Joint military exercise in Thailand, I served for a season as the chaplain of a Mobile Army Surgical Hospital. (Yes, I was an honest to goodness M*A*S*H chaplain!)

Returning to my initial point, caring for my wife is not burdensome. I readily confess I would hardly bring the same enthusiasm and selflessness to caring for a stranger.

But that’s not the man, the disciple of Jesus, I desire to be. And so, I pray for greater compassion, exercise and “stretch” my concern for others, seek forgiveness for my failings . . . and repeat the cycle.

C.S. Lewis writes brilliantly about the great significance of each and every human life. In The Weight of Glory he reminds us that we have the potential to influence their lives either positively or negatively, and assisting them to follow the path to “glory” is central to our reason for being.

It is hardly possible for [us] to think too often or too deeply about [the future destiny] of [our] neighbor. The load, or weight, or burden of my neighbour’s glory should be laid on my back, a load so heavy that only humility can carry it, and the backs of the proud will be broken. . . .

All day long we are, in some degree, helping each other to one or the other of these destinations [glorified resurrection in the presence of our Creator or eternal corruption apart from God].  It is in the light of these overwhelming possibilities, it is with the awe and the circumspection proper to them, that we should conduct all our dealings with one another, all friendships, all loves, all play, all politics. There are no ordinary people. You have never met a mere mortal. Nations, cultures, arts, civilizations—these are mortal, and their life is to ours as the life of a gnat.  But it is immortals whom we joke with, work with, marry, snub, and exploit—immortal horrors or everlasting splendours.

One of my favorite books was written by Calvin Miller. He’s the author of numerous classics, and I most recently enjoyed his The Path of Celtic Prayer. However, because of my interest in the early church, and my affection for keenly wielded wit, it is The Philippian Fragment which ranks in my personal “top ten.” (And, great news, despite being out of print for some time, it’s now available in a Kindle edition!)

The following quotation is from one of the epistles gathered in pseudepigraphical Philippian Fragment. The letters are written by a pastor named Eusebius of Philippi to another shepherd, “Clement, pastor of Coos.” It illustrates precisely the spirit we should have within us. If we were all like Eusebius, this world would be a far more wonderful place.

I am not sure that I can survive the new hostility I have engendered by missing church merely to pray for a dying man. I was foolish to assume that the church would see the glory of my ministry to Publius and excuse the absence of my sermon. Through pain I have learned that it is still wrong to heal on the sabbath—at least during the eleventh hour. . . . Is the yet-paralyzed Publius worth the cancellation of my morning sermon? I have betrayed a tradition to furnish forth a single act of compassion. Oh, the institutional cankers that do fester when traditions are unserved! . . . It is time for the evening vigil now, and I have just received word that one of the lepers is at death’s door and has called for me to come. Shall I go to tend the dying, or shall I go to church and keep my place?

I had planned to talk tonight about how we must minister to our world before we seek each other’s consolations. I am still unforgiven by most for healing the paralytic. Now I must go to the leper and seal my fate. 26. Grief is seldom convenient to our scheduled worship.

I had a dear mentor, Constantinus, who was shepherd of the congregation in Antioch. His church’s meeting house was near a busy road. One day, five minutes before his well-packed service was to begin, a Roman chariot ran over a beggar and left him dying before the church house. How grieved was the pastor that most of his members stepped over the bleeding man to carry their prayer scrolls on into the sanctuary. Constantinus was a gentle pastor and full of the love of Christ. He scooped up the emaciated old man and carried him to his grieving widow.

In the process of his ministry to this victim of Roman traffic, his hands and togas were fouled with blood. There was no time to go home and change clothes, so he entered his pulpit besmirched by the gore of his own compassion. 31. Clement, many in that congregation never forgave Constantinus his bloody toga. Ministry must ever be willing to face tradition. Somewhere a leper is dying. Tonight I shall act out a sermon. I can preach next week when human suffering is more remote. (Calvin Miller, The Philippian Fragment).

Nursing Those We Love

August 1, 2012 — 13 Comments

This week I became a nurse. No, I didn’t complete a degreed or certificated program, I simply assumed the duties of being my wife’s post-surgical caregiver.

She had very serious knee surgery, which will require her to place no weight at all on her right leg for at least a month and a half. This first week she’s required an escort and assistance for virtually everything. And I’ve offered this service gladly, and lovingly . . . even when it’s interrupted my sleep apnea crippled rest.

Obviously, over three and a half decades of marriage, she has needed modest nursing in the past. But this is more serious. It is sustained. She has seen me through a number of serious illnesses and surgeries, but then she (like so many other women I’ve been privileged to know) is a natural nurse and caregiver.

C.S. Lewis was a man not vastly different from me. He was not terribly comfortable when placed in such a role . . . yet he too discovered great meaning in caring for the needs of his wife during her illness. His precious Joy was dying, so the intensity of his labors, and their corresponding emotional investment dwarf my own. And yet the “framework” of our circumstances bears a marked similarity.

In his wonderful book Lenten Lands, Lewis’ son Douglas Gresham relates how Lewis and his brother Warnie provided exceptional care to his mother during her illness. He writes:

[Lewis] spent most of each day with [Joy] at the hospital, but they both agreed Mother should be brought home to The Kilns to die—in Jack’s home—her husband’s home—with him at her side. The “common room” was converted to a hospital ward, complete with a system of bells by which Mother would summon a nurse, or later Jack, if she needed help, as she often did.

I’ll make a confession. Although most men can adequately perform familial nursing duties when there is no alternative caregiver, most of us are quite content to step aside and let our wives or sisters attend to whatever nursing procedures are called for. Actually, I was quite gifted at removing slivers, but when it comes to bodily discharges, I’m no sexist to admit I and most of my gender display a serious weakness.

And yet, even in these cases, when changing the soiled diaper of an infant (or someone old enough to feel shame for having such needs) . . . even such unpleasant acts are possible for us to do for those we love. So the key to being able to care for others is not to pinch our nose and do it as quickly as humanly possible. The key, instead, is to learn to love those placed in our care.

In our grandparents day, it wasn’t uncommon for an elderly great-grandparent to reside with the family of one of their children. My father, for example, grew up with his blind grandfather as a member of their household. Similarly, my mother enjoyed the daily presence of her grandmother in her own home throughout her life. Not only was it expected that children would “take in” their elderly parents, it was natural. After all, they were family.

But, how does one transfer this familial affection to the stranger? After all, as Jesus said, “If you love those who love you, what benefit is that to you? For even sinners love those who love them. And if you do good to those who do good to you, what benefit is that to you? For even sinners do the same” (John 6).

Mother Teresa and the many thousands of saints throughout history who have cared for the leper, the outcasts, and the dying know this truth. They do everything as though they were caring for the Lord himself, just as he asked his disciples to do. Medicines are not their only balms—nor their most important. Their compassionate touch and tender encouragements are often far more healing.

When I compare myself to these caregivers, I realize just how inadequate a nurse I am. As a pastor, a core aspect of my vocation has been to bind the injuries of the sheep entrusted to my care. But I do this in a “spiritual” manner, and it has been rare to ever help one of them replace a bloodied bandage. Spiritual, emotional and social wounds are those that most pastors feel comfortable treating. Providing for the “baser” physical needs of the diseased is quite another matter.

And this brings us to the end of today’s reflection. When next I write, I’ll carry this final thought a bit farther forward.