"THE WALL!"
THE TROUBLE WITH STUDENTS & THE THEORY-PRACTICE GAP!
In the article entitled "Now and Then - the trouble with students, in the June 2008 issue of Paediatric Nursing (20,5,12), the author discussed the enduring problem of 'the theory-practice gap' and reflected, helpfully, on the history of the clinical nurse teacher role, which has long since vanished. The article implies that Nursing blundered into the theory-practice gap haplessly, rather than it being a considered decision, taken consciously by the movers and shakers of the nursing profession at the time.
I recall one of my RGN tutors in the early 1980's at St James' University Hospital in Leeds lamenting the fact that the school of nursing was set back from the hospital and not an integral part of the building.
When I returned to "Jimmy's" in the late 1980's to do my paediatric course, our tutor took the opposite view. She thought that a physical gap was essential to create good practice. In fact, she advocated building a wall between the school and the hospital and having a separate entrance.
This tutor was instrumental in setting up up the paediatric branch of what was then known as 'Project 2000'. She, and presumably her generation of nurse leaders, were determined to recreate the Nursing profession along an entirely new model. Any suggestion we made were treated with with scorn despite the fact that we were already qualified nurses with several years' clinical experience. The attitude was that our clinical experience would 'contaminate' the new students with bad practices. In her view it was essential to break that cycle.
Nurse education was not perfect prior to 'Project 2000' , but student nurses were valued members of the clinical team; today's students do not have that sense of belonging and lose out in terms of clinical practice which is actually where theory and reality meet. When I completed my third year I was ready to be in charge of a surgical ward on nights as my first job as a staff nurse; today's students do not have that confidence.
The 'theory-practice gap' did not come about by the law of unintended consequences, it was the ideologically driven rejection of clinical experience that created that rift.
Showing posts with label Nursing. Show all posts
Showing posts with label Nursing. Show all posts
Saturday, February 13, 2010
Friday, December 18, 2009
A Father's Anger, Health Care Administration and the Philosophy of Science.
It is not unusual for parents of children in 'intensive care' to vent their anger and frustration on staff members. One accepts that people under stress can display the recognised signs of grief; "denial", "bargaining", "anger" and "acceptance". These signs are not confined to the bereaved but can also be manifested in those who grieve for their child's suffering. Thank God that the vast majority of kids on our unit do get better! Our mortality rate is about 4% which compares favourably with comparable units.
Of course, understanably, such statistics cut little ice with parents, for them a death is not a fraction it is the loss of a loved one and that is 100%. Even when seriously ill children recover it should not be inferred that the parents are unscathed psychologically; they still had the fear of loss to contend with. They may also be grieving for the 'loss of innocence' - not their child's neccesarily - but their own! People can have a rather 'Pollyannish' view of life which a visit to PICU rudely contradicts, it isn't surprising then that parents feel a deep sense of anger at society for having sold them a lie - that 'all is for the best in the best of all possible worlds'!
Recently one father had a 'go at me'. He could not comprehend 'how in this day and age' medical science had no clear cut answer to an issue he raised. He was quite angry about it and I listened - I hope with good grace - to his frustrations. Of course I had no answer to his technical question although I could have replied "do you really want to discuss The Philosophy of Science?" I suspected he did not. His frustration arose out of a misconception about science; in his worldview "science" was about concrete facts, settled knowledge which can be looked up in a text book. But the reality is "science" does not deal in such certainties, what Mankind "knows" is only ever provisional - we must constantly re-evaluate our knowledge and revise our practice in the light of new information. Medical science is no exception, especially when one is dealing with complex and dynamic disease processes.
Another naive idea which came to grief was his view, of what I will term, his "entitlement" within the UK's National Health Service. I suppose, again, I could have asked "do you really want to talk about 'Social Policy and Health Administration'?" I suspected he did not. He clearly felt that having paid more than his fair share in taxes he was entitled to more than he felt he was getting. I listened - again I hope with good grace - to his frustrations. The answer I could have given would have been inappropriate; 'however much you have paid in tax it is no where near enough! And I bet at the last election you didn't vote for higher taxation did you?!' The demand for all health care services way outstrips the supply and the electorate needs to wake up to that reality. The government is not some rich uncle who can dig ever deeper into his infinite pockets, it is the tax payer who funds the health service and in a world with 'third party payment' we can always be very generous with other people's money can't we? But we live in a democracy where politicians will promise more and more while the electorate is prepared to pay less and less. This irreconcilable conflict is taken out on the people who have to break the bad news to a naive public that the State cannot always provide what they demand and that is usually the same people who are haplessly trying to make the system work!
Western society has produced a generation with a profound sense of what life owes to them. People feel some sort of entitlement from life which is bolstered by our concepts of 'rights' - as if our 'rights' are absolute and written as immutable laws into the very fabric of the cosmos rather than relative and subject to the vagaries of humanity.
But, of course, I didn't say any of this. This father was grieving, but not for his child, who was ultimately discharged from our unit alive and well - he was grieving for the death of his naive worldview!
It is not unusual for parents of children in 'intensive care' to vent their anger and frustration on staff members. One accepts that people under stress can display the recognised signs of grief; "denial", "bargaining", "anger" and "acceptance". These signs are not confined to the bereaved but can also be manifested in those who grieve for their child's suffering. Thank God that the vast majority of kids on our unit do get better! Our mortality rate is about 4% which compares favourably with comparable units.
Of course, understanably, such statistics cut little ice with parents, for them a death is not a fraction it is the loss of a loved one and that is 100%. Even when seriously ill children recover it should not be inferred that the parents are unscathed psychologically; they still had the fear of loss to contend with. They may also be grieving for the 'loss of innocence' - not their child's neccesarily - but their own! People can have a rather 'Pollyannish' view of life which a visit to PICU rudely contradicts, it isn't surprising then that parents feel a deep sense of anger at society for having sold them a lie - that 'all is for the best in the best of all possible worlds'!
Recently one father had a 'go at me'. He could not comprehend 'how in this day and age' medical science had no clear cut answer to an issue he raised. He was quite angry about it and I listened - I hope with good grace - to his frustrations. Of course I had no answer to his technical question although I could have replied "do you really want to discuss The Philosophy of Science?" I suspected he did not. His frustration arose out of a misconception about science; in his worldview "science" was about concrete facts, settled knowledge which can be looked up in a text book. But the reality is "science" does not deal in such certainties, what Mankind "knows" is only ever provisional - we must constantly re-evaluate our knowledge and revise our practice in the light of new information. Medical science is no exception, especially when one is dealing with complex and dynamic disease processes.
Another naive idea which came to grief was his view, of what I will term, his "entitlement" within the UK's National Health Service. I suppose, again, I could have asked "do you really want to talk about 'Social Policy and Health Administration'?" I suspected he did not. He clearly felt that having paid more than his fair share in taxes he was entitled to more than he felt he was getting. I listened - again I hope with good grace - to his frustrations. The answer I could have given would have been inappropriate; 'however much you have paid in tax it is no where near enough! And I bet at the last election you didn't vote for higher taxation did you?!' The demand for all health care services way outstrips the supply and the electorate needs to wake up to that reality. The government is not some rich uncle who can dig ever deeper into his infinite pockets, it is the tax payer who funds the health service and in a world with 'third party payment' we can always be very generous with other people's money can't we? But we live in a democracy where politicians will promise more and more while the electorate is prepared to pay less and less. This irreconcilable conflict is taken out on the people who have to break the bad news to a naive public that the State cannot always provide what they demand and that is usually the same people who are haplessly trying to make the system work!
Western society has produced a generation with a profound sense of what life owes to them. People feel some sort of entitlement from life which is bolstered by our concepts of 'rights' - as if our 'rights' are absolute and written as immutable laws into the very fabric of the cosmos rather than relative and subject to the vagaries of humanity.
But, of course, I didn't say any of this. This father was grieving, but not for his child, who was ultimately discharged from our unit alive and well - he was grieving for the death of his naive worldview!
Monday, April 20, 2009
RCN Consultation onAssisted Suicide.
The Royal College of Nursing in the UK is presently carrying out a consultation among it members to see what the consensus of professional opinion is about 'assisted suicide'. So if you are a member and have an opinion on this topic you have until 22 May 2009 to send your views into the RCN.
One of the worrying aspects of this so-called "debate" is how the pro-euthanasia lobby frequently misrepresent the issues in the media and not infrequently caricature people who object to euthanasia as motivated by ill-will or sheer ignorance.
For example; the case is often put forward that it is accepted 'custom & practice' for patients to die in pain and that they are subjected to unwanted medical interventions. These commonly accepted fallacies are repeated so often and so authoritatively that the innocent public are unduly influenced by them. It is no surprise that public opinion is moving towards euthanasia but the fact is they are faced with the phoney "false choice" argument ie 'do you want your loved ones to die in agony, yes or no?' Who in their right minds would say anything but 'no!' given that proposition?
I have worked in children's and adult's critical care for more years than I care to remember and I can honestly say that I do not recognise the caricature of our profession.
First up, it is NOT acceptable practice for patients to be in pain - that is not acceptable and there is no excuse for it. If the disease process is such that pain control foreshortens life then so be it - that is not euthanasia or assisted suicide - that is effective pain management. This is exactly the same legal situation as someone dying as a consequence of any other medical treatment aimed at controlling the disease process.
Secondly, everyone has a right to refuse medical treatment. All interventions require informed consent. No one has any intervention "forced" on them - indeed to do so is a criminal offence! (There are some legal exceptions of course - when the mental capacity of the patient may be in doubt - in which case there are legal procedures to be followed). In my experience it is more often the case that family members insist on medical interventions when the professional consensus is that further treatment is futile.
Thirdly, the withdrawal of treatment is not euthanasia or assisted suicide. The purpose of medical treatment is to enable the patient to make a recovery. If the consensus of opinion is that no such recovery is possible then active treatment may be withdrawn and the disease process allowed to take its course.
None of the above are the cause of any ethical or professional dilemma! Okay? Clearly the truth does not suit the pro-euthanasia lobby's arguments which is why they resort to caricature.
When the pro-euthanasia lobby stress the 'pain' people are suffering we must of course exclude physical pain because that can and should be adequately treated. I suspect the 'pain' they refer to is existential pain - the pain we will all have to face at some time in our lives as human beings living in a fractured world. How far do you really want to push the limits of state sanctioned suicide as a cure for this? It is no surprise to me to hear that people who are physically healthy but feeling depressed are being offered suicide at a Swiss clinic. Given everything I have said above about the reality of pain control and informed consent and withdrawal of treatment I do not see where the pro-euthanasia lobby is attempting to take society except down the same route.
Oh! And no I am not motivated by ill-will!!!
ps there is a video about this RCN consultation at http://www.policyreview.tv/embed239/882
Monday, December 17, 2007
NURSING - IN SEARCH OF IDENTITY.
Imagine the scene. It is a busy ward in a large teaching hospital. A patient has collapsed, is unresponsive, there is no pulse. A "Crash Call" goes out. The nurses start cardiac massage. The 'resus' trolley is wheeled up, the de-fib fetched. The 'Crash Team' come running up the corridor. Cannula inserted, nervous fingers snap open ampoules. Adrenaline, Calcium, DC shock. No output. As the drama unfolds a nurse steps forward and commences massage - not cardiac massage but foot massage.
In the ensuing exchange of conversation with the Senior Registrar, the nurse asserts that as a practitioner in Reflexology she alone is treating the patient's underlying disease, all the rest were merely treating symptoms. Sounds far-fetched? I'm reliably informed that this very scenario was played out in a London hospital recently. It invites the question, "What's going on in society in general and nursing in particular?"
There is a sea change at work in our culture. For three centuries or more the prevailing philosophy within western culture has been modernism. This emphasised the human intellect and the scientific, technological, rational approach to life. It is a materialist philosophy, rejecting any notion of the spiritual. Such a world-view questions the existence of a Creator and asserts that everything can be explained in secular and reductionistic terms.
Most of us will have had contact with some institution of higher education. Within these academic circles, modernism is the over-arching belief system. Until recently this has been the influence that has helped shape Medicine and Nursing as we know them, particularly as they move away from their earlier Christian roots. But now we are witnessing a sea-change. So while once-upon-a-time the general public showed great respect and deference to scientific experts, now attitudes are changing. People are more likely to question, probe and doubt the words of scientists. Indeed, whereas once science was viewed as mankind's hope for a better future, now people are more likely to blame it and the technology it has spawned for causing more problems than it has solved. The belief in inevitable progress is defunct.
This tendency occurring in society as a whole is magnified with nursing. Nursing as a profession is currently seeking to discover an identity of it's own, one that will make it distinctive from Medicine. In my view nurses will inevitably turn to alternative forms of medicine simply because they are alternative. The emerging 'post-modernist' nurse will emphasise the emotional, the intuitive and the holistic, as opposed to the rational, objective, quantifiable and material. As a thorough-going pluralist, the new nurse will accept that there are many different points of view about everything, all of which are equally valid. Indeed any "truth claim" is by definition coercive and domineering, aimed at forcing others to conform to someone else's version of the truth. In this context it is not surprising that an article in the Nursing Times last year urges nurses to avoid making moral judgements if one is asked to obtain the services of a prostitute for a client.
Although Christians have never felt entirely comfortable within modernist professions which denied the spiritual, Christians could at least work within Nursing and Medicine, appreciating the benefits of science but recognising that it did not present a complete picture of what it is to be human. Now, however, we are increasingly being faced not with a denial of spirituality, but with alternative spiritualities often dressed up as complementary therapy. It is easy to feel threatened and overwhelmed by the challenge that faces us at the start of the twenty-first century. I suspect that within Nursing, we will continue to see an on-going tussle between two opposing schools of thought, the post-modernist and a reactive modernist rear-guard action.
These are not easy times for Christians. And yet this situation presents Christians with an opportunity. "Spirituality" is on the agenda, and as Christian nurses we will need to prayerfully consider how best to use these new opportunities. Like the modernist, we too believe in objective truth and that it is knowable. But at the same time we appreciate the limitations of human knowledge and that to be human cannot be fully explained in purely material terms. The spirituality we would profess is one of dependence upon God, rather than one which depends on us manipulating real or supposed spiritual forces.
This article was first published in the Spring 2001 issue of "TRIPLE HELIX" and is reproduced here with the kind permission of the Christian Medical Fellowship.
Imagine the scene. It is a busy ward in a large teaching hospital. A patient has collapsed, is unresponsive, there is no pulse. A "Crash Call" goes out. The nurses start cardiac massage. The 'resus' trolley is wheeled up, the de-fib fetched. The 'Crash Team' come running up the corridor. Cannula inserted, nervous fingers snap open ampoules. Adrenaline, Calcium, DC shock. No output. As the drama unfolds a nurse steps forward and commences massage - not cardiac massage but foot massage.
In the ensuing exchange of conversation with the Senior Registrar, the nurse asserts that as a practitioner in Reflexology she alone is treating the patient's underlying disease, all the rest were merely treating symptoms. Sounds far-fetched? I'm reliably informed that this very scenario was played out in a London hospital recently. It invites the question, "What's going on in society in general and nursing in particular?"
There is a sea change at work in our culture. For three centuries or more the prevailing philosophy within western culture has been modernism. This emphasised the human intellect and the scientific, technological, rational approach to life. It is a materialist philosophy, rejecting any notion of the spiritual. Such a world-view questions the existence of a Creator and asserts that everything can be explained in secular and reductionistic terms.
Most of us will have had contact with some institution of higher education. Within these academic circles, modernism is the over-arching belief system. Until recently this has been the influence that has helped shape Medicine and Nursing as we know them, particularly as they move away from their earlier Christian roots. But now we are witnessing a sea-change. So while once-upon-a-time the general public showed great respect and deference to scientific experts, now attitudes are changing. People are more likely to question, probe and doubt the words of scientists. Indeed, whereas once science was viewed as mankind's hope for a better future, now people are more likely to blame it and the technology it has spawned for causing more problems than it has solved. The belief in inevitable progress is defunct.
This tendency occurring in society as a whole is magnified with nursing. Nursing as a profession is currently seeking to discover an identity of it's own, one that will make it distinctive from Medicine. In my view nurses will inevitably turn to alternative forms of medicine simply because they are alternative. The emerging 'post-modernist' nurse will emphasise the emotional, the intuitive and the holistic, as opposed to the rational, objective, quantifiable and material. As a thorough-going pluralist, the new nurse will accept that there are many different points of view about everything, all of which are equally valid. Indeed any "truth claim" is by definition coercive and domineering, aimed at forcing others to conform to someone else's version of the truth. In this context it is not surprising that an article in the Nursing Times last year urges nurses to avoid making moral judgements if one is asked to obtain the services of a prostitute for a client.
Although Christians have never felt entirely comfortable within modernist professions which denied the spiritual, Christians could at least work within Nursing and Medicine, appreciating the benefits of science but recognising that it did not present a complete picture of what it is to be human. Now, however, we are increasingly being faced not with a denial of spirituality, but with alternative spiritualities often dressed up as complementary therapy. It is easy to feel threatened and overwhelmed by the challenge that faces us at the start of the twenty-first century. I suspect that within Nursing, we will continue to see an on-going tussle between two opposing schools of thought, the post-modernist and a reactive modernist rear-guard action.
These are not easy times for Christians. And yet this situation presents Christians with an opportunity. "Spirituality" is on the agenda, and as Christian nurses we will need to prayerfully consider how best to use these new opportunities. Like the modernist, we too believe in objective truth and that it is knowable. But at the same time we appreciate the limitations of human knowledge and that to be human cannot be fully explained in purely material terms. The spirituality we would profess is one of dependence upon God, rather than one which depends on us manipulating real or supposed spiritual forces.
This article was first published in the Spring 2001 issue of "TRIPLE HELIX" and is reproduced here with the kind permission of the Christian Medical Fellowship.
Monday, October 29, 2007
THE NIGHT OF THE LONG SKIVES!
British Summer Time ended yesterday night when the clocks went back. Give a thought for those of us nurses and doctors and physios & etc etc etc who were working on the night shift when we had the extra hour! When I volunteered to cover this shift on PICU at the SNC Hospital I hadn't appreciated that daylight saving time was due to change! So while the rest of you got an extra hour in bed we had a very very VERY long shift! The only thing that made it remotely tolerable was the fact that we could take a bit longer over our breaks. In fairness I should add that I worked the short night last spring when the clocks went forward so I guess it all evens out in the end.
British Summer Time ended yesterday night when the clocks went back. Give a thought for those of us nurses and doctors and physios & etc etc etc who were working on the night shift when we had the extra hour! When I volunteered to cover this shift on PICU at the SNC Hospital I hadn't appreciated that daylight saving time was due to change! So while the rest of you got an extra hour in bed we had a very very VERY long shift! The only thing that made it remotely tolerable was the fact that we could take a bit longer over our breaks. In fairness I should add that I worked the short night last spring when the clocks went forward so I guess it all evens out in the end.
Just for the record; we had a 1am BST followed an hour later by 1am Greenwich Mean Time.
On the whole I enjoy working shifts - I like the variety in the work pattern. I also enjoy having time off midweek: you can go places when it's quiet rather than follow the herd working 9-5 and being off when everyone else is!
I even enjoy night shifts: you can actually focus on caring for patients without all the other extraneous hassle which the NHS seems to generate. The only drawback to night duty being that my body clock always wakes me up by midday when I'm trying to sleep, like it's saying 'hey, it's day time you should be up!' But I get by on 3-4 hours sleep. By the end of four night shifts though I usually feel wiped out... I finish four nights on Tuesday morning.
The thing is as I get older I'm not so sure that I can keep up working crazy nurse's shifts but I don't know what else I'd do!
Friday, October 05, 2007
Euthanasia and the Arguments
of Straw Men!
From time to time one hears supporters of euthanasia pressing their case in the national media. To judge from the "debate" one would probably conclude that it is the 'accepted custom and practice' for patients to be allowed to die in pain and that health care professionals are solely concerned with employing every conceivable technology to prolong every individuals life to the last uttermost second regardless of the pain involved and the patient's (or their family's) wishes.
I have to tell you in all candour I have NEVER witnessed this scenario in over the twenty five years of my nursing career - the bulk of which has been in critical care. Funny that.
Funny that the commonly accepted "truth'"is that only those who are in favour of euthanasia are motivated by compassion and the rest of us are motivated soley by professional arrogance. There is not a little humbug attached to the argument of the euthanasia lobby.
I qualified as a registered nurse twenty five years ago. I went on to do my paediatric course and subsequently worked on a childrens cancer ward before making a move into Paediatric Intensive Care. I feel that I have earned the right to speak on the subject of euthanasia.
Advocates of euthanasia generally set up a phoney scenario of a patient dying in agony when compassion would demand that we put them out of their misery. As someone who has worked extensively in a variety of critical care settings I can tell you that I find such allegations utterly repugnant and a slur on my
profession. If someone does die in pain that is a matter of professional incompetence not (as euthanasia advocates would have it) accepted 'custom and practice'. And frankly I cannot help but feel that the public is being hoodwinked by their spurious arguments.
There is no excuse for anyone to die in pain. None whatsoever. This is a 'no brainer' as issues go. Period. If you find yourself witnessing such a scenario then I would say that that is clinical mismanagment.There is no excuse for it.
I will give as much pain relief as is required to prevent pain - if their disease process is such that that required analgesia actually foreshortens their life - then so be it. That is NOT euthanasia, that is pain control. As a Christian and a nurse I have no issue with this.... it is a none issue! (It is exactly the same situation as giving any drug with a known side-effect in such circumstances).
Perhaps it is a dated term but no-one seems to mention the principle of "double effect". This is where one carries out one action i.e. to control pain, but which secondarily foreshortens life.
Euthanasia (which is Greek literally meaning 'good death') actually means intentionally terminating a life as the primary purpose.
Now some one will say that this is splitting hairs but I will reply that speaking as someone at the coal-face of these ethical dilemmas this distinction is crystal clear... there is no ambiguity. Killing someone is murder, dying as a consequence of a pathological disorder which professional people are trying but failing to arrest is an entirely different matter.
The real question is why are the advocates of euthanasia pushing a "false choice" argument? Presumably it's simply because the truth will not do.
Another 'straw man' is the implication that patients are having medical treatment "forced" upon them. But the reality is that everyone has the right to refuse treatment, to compel someone to undergo procedures they have declined is assault. (There are some rare instances where perhaps a patients mental state causes medical staff to follow through a legal process to compel a patient (or the parent of a sick child) to have treatment....but that is not the issue in view here). Sadly it is my experience that such legal proceedings that do occur are more often when a parent refuses to let go of a loved child - and insist on futile attempts at resuscitation.... it is heart breaking for all concerned. The purpose of medical treatment is to support a patient through an acute episode of illness to a point where they have recovered sufficiently not to require such support. If the consensus of opinion is that no such recovery is possible, then in my view, the removal of this life support causes no ethical problems - we are merely allowing the pathological process to takes its course. I have been involved in countless such discussions and contrary to the arguments put forward by the pro-euthanasia lobby there are no legal ambiguities about it.
Another 'straw man' is that somehow people like me are in some sort of legal limbo and therefore society should sanction euthanasia. That is yet more codswallop! If I sound irritated - I am. I detest being used as bait to manipulate an unsuspecting public.
The REAL question is this; when so many 'straw men' are being marshalled to emotionally intimidate the innocent onlooker into sanctioning the demise of our fellow human beings where do you think the REAL end point of this argument is?
If anyone wants to take issue with me the comments box is open as always.
of Straw Men!
From time to time one hears supporters of euthanasia pressing their case in the national media. To judge from the "debate" one would probably conclude that it is the 'accepted custom and practice' for patients to be allowed to die in pain and that health care professionals are solely concerned with employing every conceivable technology to prolong every individuals life to the last uttermost second regardless of the pain involved and the patient's (or their family's) wishes.
I have to tell you in all candour I have NEVER witnessed this scenario in over the twenty five years of my nursing career - the bulk of which has been in critical care. Funny that.
Funny that the commonly accepted "truth'"is that only those who are in favour of euthanasia are motivated by compassion and the rest of us are motivated soley by professional arrogance. There is not a little humbug attached to the argument of the euthanasia lobby.
I qualified as a registered nurse twenty five years ago. I went on to do my paediatric course and subsequently worked on a childrens cancer ward before making a move into Paediatric Intensive Care. I feel that I have earned the right to speak on the subject of euthanasia.
Advocates of euthanasia generally set up a phoney scenario of a patient dying in agony when compassion would demand that we put them out of their misery. As someone who has worked extensively in a variety of critical care settings I can tell you that I find such allegations utterly repugnant and a slur on my
profession. If someone does die in pain that is a matter of professional incompetence not (as euthanasia advocates would have it) accepted 'custom and practice'. And frankly I cannot help but feel that the public is being hoodwinked by their spurious arguments.
There is no excuse for anyone to die in pain. None whatsoever. This is a 'no brainer' as issues go. Period. If you find yourself witnessing such a scenario then I would say that that is clinical mismanagment.There is no excuse for it.
I will give as much pain relief as is required to prevent pain - if their disease process is such that that required analgesia actually foreshortens their life - then so be it. That is NOT euthanasia, that is pain control. As a Christian and a nurse I have no issue with this.... it is a none issue! (It is exactly the same situation as giving any drug with a known side-effect in such circumstances).
Perhaps it is a dated term but no-one seems to mention the principle of "double effect". This is where one carries out one action i.e. to control pain, but which secondarily foreshortens life.
Euthanasia (which is Greek literally meaning 'good death') actually means intentionally terminating a life as the primary purpose.
Now some one will say that this is splitting hairs but I will reply that speaking as someone at the coal-face of these ethical dilemmas this distinction is crystal clear... there is no ambiguity. Killing someone is murder, dying as a consequence of a pathological disorder which professional people are trying but failing to arrest is an entirely different matter.
The real question is why are the advocates of euthanasia pushing a "false choice" argument? Presumably it's simply because the truth will not do.
Another 'straw man' is the implication that patients are having medical treatment "forced" upon them. But the reality is that everyone has the right to refuse treatment, to compel someone to undergo procedures they have declined is assault. (There are some rare instances where perhaps a patients mental state causes medical staff to follow through a legal process to compel a patient (or the parent of a sick child) to have treatment....but that is not the issue in view here). Sadly it is my experience that such legal proceedings that do occur are more often when a parent refuses to let go of a loved child - and insist on futile attempts at resuscitation.... it is heart breaking for all concerned. The purpose of medical treatment is to support a patient through an acute episode of illness to a point where they have recovered sufficiently not to require such support. If the consensus of opinion is that no such recovery is possible, then in my view, the removal of this life support causes no ethical problems - we are merely allowing the pathological process to takes its course. I have been involved in countless such discussions and contrary to the arguments put forward by the pro-euthanasia lobby there are no legal ambiguities about it.
Another 'straw man' is that somehow people like me are in some sort of legal limbo and therefore society should sanction euthanasia. That is yet more codswallop! If I sound irritated - I am. I detest being used as bait to manipulate an unsuspecting public.
The REAL question is this; when so many 'straw men' are being marshalled to emotionally intimidate the innocent onlooker into sanctioning the demise of our fellow human beings where do you think the REAL end point of this argument is?
If anyone wants to take issue with me the comments box is open as always.
Wednesday, August 01, 2007
STATE RUSH VOMIT HEALER
SERVICE!
As a specialist centre the Paediatric Intensive
Care Unit at the 'Saline Nerve Child Hospital'
operates a "retrieval service"; which means
that when a critically ill child is admitted to
a District General Hospital a team is sent out
from SNC to stabilise the patient and transfer
them safely back to our unit. To this end we now
have a dedicated ambulance with a specialist
driver and a senior doctor and nurse on standby.
This is not how things were 15 years ago when
"paediatric intensive care" was a novel concept
in this country; and the idea of a "retrieval
service" was totally alien.... the accepted
practice at the time was that the referring
hospital would transfer the patient to our unit
for specialist care.
In the early days when we pioneered this service
I remember that our team would go out in a taxi
with as much gear as we could carry between us.
We would stabilise the patient and then arrange
a transfer back to SNC with a regular ambulance.
In order to train up doctors and nurses in these
skills we might take along a junior to shadow us.
As a senior nurse in children's intensive care
I would often go "out on retrieval"! On one
particular occasion I went out on a call with
Gavin M who was one of our senior medical
team (he is now a consultant paediatric
intensivist at St Elsewhere in the Midlands)
and a nurse called "Caz" who was learning
the ropes.
On this particular call we had to get from
central London to Worthing on the south coast
of England. In those days we did not have a
specialist ambulance but by this time we had
just enough kudos to blag a ride on a "Rapid
Response Unit" vehicle belonging to the London
Ambulance Service. We stowed our gear
and piled in to the Renault Espace and took off
to Worthing.
Now the crucial thing to bear in mind is that
there are two ways to get to get to Worthing
after leaving the motorway from London;
continue on the 'A'road to Brighton and then
follow the south coast road or cut across
country. On this trip the driver went across
country.
Travelling under blue lights I generally find
exciting - cutting through red lights and
shooting down the wrong side of the road...
no problem. What I had a problem with on
this trip were the sudden accelerations and
decelerations! And the journey to Worthing
is a long one - and felt interminable as I
started to feel queasy. I wound down the
window and took some sips of water, but
as the relentless stopping and starting took
its toll on my stomach I knew that I wouldn't
be able to hold onto the contents much
longer. As soon as I admitted that thought
I started chucking up.
Cramped in the back of the vehicle I just
managed to grab a 'sharps bin' in the nick
of time to receive my stomach contents.
And the journey went on and on and on....
with me heaving into this receptacle the
rest of the way. Eventually I had nothing
left to vomit but I was still retching.
After an eternity we pulled up at the
hospital in Worthing and got out of the
car. As soon as I stood up my legs buckled
under me and I felt faint and clammy.
"Pete, are you alright?"
"I'll be fine. I'm okay", I said wanly as I slumped
back into the car.
"You look awful!"
"I'm okay, I'm okay", I said bravely.
"Well you don't look it - go lie down somewhere
and join us when you feel better."
"Okay."
Then Gavin and Caz continued on their 'mercy
dash' while I stumbled into the Accident &
Emergency Department of Worthing Hospital.
I found some chairs and lay down on them among
all the drunks and other casualties of 'chucking
out time'; it was around midnight by now.
I lay there for some time and realised that
the nausea wasn't going to go away, so
I hobbled over to casualty reception and booked
myself in!
The staff took pity on me - I was in uniform
remember - I got seen quickly and was
prescribled an anti-emetic... which I had as an
injection in my bum!
Eventually Gavin & Caz retrieved me from
A&E and we made the journey back to
London. They kindly sat me in the front
of the ambulance so I never even saw
the patient we had gone for until we
arrived back at SNC; for all the use I
was on this retrieval I needn't have gone!
Fortunately the child Gavin & Caz collected
was absolutely fine without my ministrations
- which only goes to prove that none of us
are indispensable!
SERVICE!
As a specialist centre the Paediatric Intensive
Care Unit at the 'Saline Nerve Child Hospital'
operates a "retrieval service"; which means
that when a critically ill child is admitted to
a District General Hospital a team is sent out
from SNC to stabilise the patient and transfer
them safely back to our unit. To this end we now
have a dedicated ambulance with a specialist
driver and a senior doctor and nurse on standby.
This is not how things were 15 years ago when
"paediatric intensive care" was a novel concept
in this country; and the idea of a "retrieval
service" was totally alien.... the accepted
practice at the time was that the referring
hospital would transfer the patient to our unit
for specialist care.
In the early days when we pioneered this service
I remember that our team would go out in a taxi
with as much gear as we could carry between us.
We would stabilise the patient and then arrange
a transfer back to SNC with a regular ambulance.
In order to train up doctors and nurses in these
skills we might take along a junior to shadow us.
As a senior nurse in children's intensive care
I would often go "out on retrieval"! On one
particular occasion I went out on a call with
Gavin M who was one of our senior medical
team (he is now a consultant paediatric
intensivist at St Elsewhere in the Midlands)
and a nurse called "Caz" who was learning
the ropes.
On this particular call we had to get from
central London to Worthing on the south coast
of England. In those days we did not have a
specialist ambulance but by this time we had
just enough kudos to blag a ride on a "Rapid
Response Unit" vehicle belonging to the London
Ambulance Service. We stowed our gear
and piled in to the Renault Espace and took off
to Worthing.
Now the crucial thing to bear in mind is that
there are two ways to get to get to Worthing
after leaving the motorway from London;
continue on the 'A'road to Brighton and then
follow the south coast road or cut across
country. On this trip the driver went across
country.
Travelling under blue lights I generally find
exciting - cutting through red lights and
shooting down the wrong side of the road...
no problem. What I had a problem with on
this trip were the sudden accelerations and
decelerations! And the journey to Worthing
is a long one - and felt interminable as I
started to feel queasy. I wound down the
window and took some sips of water, but
as the relentless stopping and starting took
its toll on my stomach I knew that I wouldn't
be able to hold onto the contents much
longer. As soon as I admitted that thought
I started chucking up.
Cramped in the back of the vehicle I just
managed to grab a 'sharps bin' in the nick
of time to receive my stomach contents.
And the journey went on and on and on....
with me heaving into this receptacle the
rest of the way. Eventually I had nothing
left to vomit but I was still retching.
After an eternity we pulled up at the
hospital in Worthing and got out of the
car. As soon as I stood up my legs buckled
under me and I felt faint and clammy.
"Pete, are you alright?"
"I'll be fine. I'm okay", I said wanly as I slumped
back into the car.
"You look awful!"
"I'm okay, I'm okay", I said bravely.
"Well you don't look it - go lie down somewhere
and join us when you feel better."
"Okay."
Then Gavin and Caz continued on their 'mercy
dash' while I stumbled into the Accident &
Emergency Department of Worthing Hospital.
I found some chairs and lay down on them among
all the drunks and other casualties of 'chucking
out time'; it was around midnight by now.
I lay there for some time and realised that
the nausea wasn't going to go away, so
I hobbled over to casualty reception and booked
myself in!
The staff took pity on me - I was in uniform
remember - I got seen quickly and was
prescribled an anti-emetic... which I had as an
injection in my bum!
Eventually Gavin & Caz retrieved me from
A&E and we made the journey back to
London. They kindly sat me in the front
of the ambulance so I never even saw
the patient we had gone for until we
arrived back at SNC; for all the use I
was on this retrieval I needn't have gone!
Fortunately the child Gavin & Caz collected
was absolutely fine without my ministrations
- which only goes to prove that none of us
are indispensable!
Thursday, February 01, 2007
FAITH in "FAITH" or FAITH in GOD?
One of the most perplexing problems that occasionally
arises for Christian health care workers is when a
purported divine promise is quoted for a terminally ill
patient's healing.
The scenario I have in mind is a conflation of several
real incidents; combined to blur particularities and so
aid confidentiality and for dramatic effect. The situation
develops like this: a young child is admitted to intensive
care with irreparable brain damage.The senior elder in
their faith community gives a prophecy to the believing
parents that the child will recover.This is certainly the
outcome everyone wants - including the staff on the unit.
But 'the wish becomes father to the thought' and the
parents home church rejoice in the promise given. The
parents are urged to trust in "God's Word" and not give
way to the fear Satan would attack them with.
I was the senior nurse in charge when this very situation
arose. One of my colleagues was reduced to tears when
the childs mother turned her wrath on her for 'undermining
their faith' when she sought to raise the grave nature of
their childs condition. I spoke to the parents who told me
that there was a conspiracy to undermine their faith and
all the staff were party to it. If only their child were back at
their home rather than here - they "knew" all would
be well....the perceived barriers to their childs wellbeing
were the very medical and nursing staff caring for them!
(To them the child was dying because he was in hospital
- he was not in hospital because he was dying!) One
might wonder why they brought him to the Accident and
Emergency Department in the first place: they brought him
only because they realised that he needed some suction
to clear his airway, the staff had to restrain them from
removing him even as the team resuscitated him.
It struck me that their concept of 'faith' was much more to
do with 'the power of positive thinking'. Almost as if "faith"
was some sort of inanimate spiritual force to be manipulated
by sheer will power, it was certainly nothing I could describe
as biblical faith, which is always a personal expression of
trust rather than an abstraction. In many ways this view of
"faith" is more pagan than Christian. It is more akin to 'spirit
channelling' - only in this case the 'spirit' being so channelled
is, ostensiby, The Holy Spirit: as if He is an impersonal
force rather than God: if only the 'right' spiritual conditions
could be engineered then a healing must inevitably follow.
I spoke to them at some length, seeking to assure them that
we are on the side of 'health' and affirmed that their child was
in better hands than ours and no-one would be more delighted
than me for us all to be proven wrong and for God to be glorified
by their child's miraculous recovery. "We are not against miracles",
I said, "but I would be failing in my responsibility if I didn't tell you
what we are up against". They listened politely to what I had
to say but were unmoved.
A few days later some members of the church youth group
came to visit along with the senior pastor. They were visibly
shocked by what they witnessed of the patients condition;
comatose and ventilated. I spoke to the pastor who was
baffled by the conflicting reports he had heard. What had
been reported to him was the child was indeed staging a
miraculous recovery - and that the patient would be well
enough to receive visitors. My interpretation of this hearsay
was that their particular church had received back the vibes
it was transmitting. In short the parents fed back to the church
every scintilla of positive news (which was largely imaginary)
and edited out all the negative (which was overwhelming).
The parents and their church were effectively caught in a
cycle of mutual deception masquerading as 'faith building'.
At this point I want to flag up a practice common among
some faith ministries of encouraging public testimony
of a healing which has yet to occur as if it already has.
This is justiified on the dubious basis of "declaring that
which is not, as if it were!" Or by suggesting to the supplicant
that the healing will occur as the testimony is given.This in
my opinion is fundamentally dishonest and is indefensible
as a practice.True faith cannot be bolstered by such
(let's face it) manipulation. The lack of integrity belies the
Spirit of God invoked.
The pastor and I spoke together for a while. It seemed
to me that he was too keen (given his miraculous convictions)
to explore further courses of treatment and investigation. The
parting comments indicated that he felt that the onus was
wholly on the parents faith whether the child was healed or
not - he had done all he could. The youth group was ushered
out in an embarrassed silence. He was clearly positioning
himself ready for failure.
It is difficult to imagine what a parent feels when they
lose a child. It is even more difficult to imagine what it
is like to feel that their fate was determined by one's own
lack of faith and to feel estranged from the church
community one had had implicit faith in: and that is where
their "faith" does lie. Stranger still is the notion that the
unbelief' of the medical and nursing staff was the principal
cause of death. The child did die as anticipated and the
promise of miraculous recovery proved false. Unable to
countenance such a loss of face and to reconcile their
conflicting feelings the parents phoned the police to
report that their child had been murdered! Their official
theological position was that the parents and their
community were all on board for a miracle - it could only
have been thwarted by Satan using a staff member as
an agent of his will. This rationalisation was as inevitable
as it was preposterous. How do we unravel a situation
like this? First by realising that every one starts by
meaning well - everyone wants the child to get better.
But that natural wish clouds people's judgement and
problems arise because the people directly involved
do not have a theology of suffering. Don Carson in his
book "How Long, O Lord?"*, says we need to have our
theology of suffering in place before we enter such a
time of trial - unfortunately such a theology is anathema
among believers who have a theology of 'glory now'.
In their 'time-line' we are not in an in-between phase
(between the First and Second Comings of Jesus Christ)
in their minds eye it is all 'Glory' now. To reconcile reality
with their theology when 'glory' fails to materialise
requires a fundamental shift in focus - from God to
Satan as the one in ultimate control. And whether this
is a psychologically tenable position must be disputed;
regardless of the dubious theology involved.
In my own feeble way I attempted to challenge such a
view of events. Surely it is more of a comfort to know
that the child died in God's arms, and not as a
consequence of Satan's activity? Apparently not!
Over and above the usual grieving process of anger,
denial, bargaining, resignation and acceptance over
the dying patient, there was a parallel process over
their "faith", each interwoven with the other, and
conflicting with their immediate church community.
In such a situation I would regard the parents as victims
of false teaching and syncretism.The onus actually lies
with the church leadership who had created an environ-
ment of unrealisable expectations in general and then
spoke a falsehood in particular invoking God's name
as their authority; and who, when confronted with the
reality of the situation, sought to shift responsibility for
their failure elsewhere rather than actually guide their
flock through a pastorally challenging time. One elder
was more concerned with saving face. It was a classic
failure of leadership. By their teaching and actions these
leaders had actually created a nightmare world for
acutely vulnerable people - I have no sympathy for
such wolves in sheeps clothing. False teaching has
nasty consequences and opposition to it is motivated
by compassion; not by dogmatic nit-picking.
A few years ago I attended a Christian convention and
during a meeting and greeting session I happened to
mention where I worked. An individual commented to
me that I must have witnessed a well known event when
a famous healer had healed everyone on the intensive
care unit. I replied that I was indeed working there at the
time and have no such recollection. We both smiled at
each other and made eye contact; my interlocutor
moved on to more fruitful conversations elsewhere.
I could not help feeling that if he had genuinely believed
in these miracles I could have expected a more robust
response: either for him to feel utterly deflated or for
him to denounce me as a liar. I could understand either
response but I cannot understand this 'easy come,
easy go' attitude to such claims. This is no casual matter
for those personally involved; and perhaps that relaxed
approach to God's honour actually belies a lack of true
faith.
Let me suggest some criteria for assessing prophetic
promises of a healing miracle: first there has to be a
confirmed diagnosis by a qualified diagnostician. I have
worked extensively as a nurse in adult and childrens
intensive care and could probably make an educated
guess about someone's symptoms, but I would never
claim to be a diagnostician: it would be unethical and
unprofessional to do so. My best guess would be no
substitute for a proper medical diagnosis. Also self
diagnoses by attention seekers known as the "worried
well" aren't good enough either. Nor is a "spiritual"
diagnosis by the healer themselves sufficient evidence
of a genuine medical problem. Secondly, the person
issuing such a prophetic promise cannot delegate
responsibility for its fulfillment elsewhere in order to
indemnify themselves against failure - they would
(I'm sure) be the first to claim some credit if a healing
did come to pass. Manipulative strategies invariably
indicate false teaching, especially when there is an
abuse of a position of trust, and even more so where
the manipulated are emotionally vulnerable.
Thirdly, a miracle proper only exists when all treatment
has ceased, for example the recovery of patients being
actively treated in Intensive Care is hardly evidence of
a visitors miraculous healing ministry whatever self
serving claims they might make for themselves! And
that brings me to my fourth point; is the "prophet/healer"
more concerned with building their own reputation than
they are about actually serving God's people? These
are some of the key issues I would flag up.
I should also mention the pastoral care of ones work
colleagues in a situation where the Gospel is seemingly
compromised and where they too have been abused in
the name of God. It is important to share that the display
of "faith" they have witnessed should not be attributed to
all Bible affirming Christians. Perhaps it may even be
an opportunity to talk about what true faith is! This may
be the only positive thing which can be redeemed from
such a situation.
As a Christian and a health care worker I see no conflict
in using my God given skills to help relieve the suffering
of others - in fact it is quite perverse to suggest otherwise.
Perhaps my decision to move into nursing was partly
motivated by a Christian urge to be part of God's answer
to a suffering world; I don't believe I am unique in this
because you will find many Christians within all the caring
professions and in public service. You will also find many
Christians serving their Lord in the voluntary sector in their
own time.
Sadly there are occasions when one has to break bad news
and that needs to be done truthfully and compassionately.
Even children die and children of believing Christians die
- we do not live in Disneyland we live in the real world. It is
entirely appropriate to pray to God for his help, and it is
also entirely appropriate to pray for those who care for our
loved ones to enable them to bring about a speedy recovery
....and when that is not possible to continue to care to enable
the patient to die in a dignified and comfortable way. In fact,
for those who die in Christ, we can by faith rejoice, knowing
that death will not have the last word. The Gospel enables
us to face reality and to do so without despair. I must add
that that has been the gracious response of the vast
majority of Bible believing Christians I've met in the course
of my career; the scenario outlined above was a minority
view.
Death and suffering are part of the common human
experience; that is the clear teaching of scripture. One
day Jesus will restore the creation and death itself will
be destroyed - but that time isn't yet. True faith looks
to the future when God himself will wipe away our tears.
Come, Lord Jesus!
* "How Long, O Lord?" by DA Carson, published by IVP.
Don Carson also wrote a helpful little book called
"The Difficult Doctrine of the Love of God" also published
by IVP.
post-script; A shortened version of the above article
was subsequently published in the Spring 2007 issue
of "CNM News" (No 17).
One of the most perplexing problems that occasionally
arises for Christian health care workers is when a
purported divine promise is quoted for a terminally ill
patient's healing.
The scenario I have in mind is a conflation of several
real incidents; combined to blur particularities and so
aid confidentiality and for dramatic effect. The situation
develops like this: a young child is admitted to intensive
care with irreparable brain damage.The senior elder in
their faith community gives a prophecy to the believing
parents that the child will recover.This is certainly the
outcome everyone wants - including the staff on the unit.
But 'the wish becomes father to the thought' and the
parents home church rejoice in the promise given. The
parents are urged to trust in "God's Word" and not give
way to the fear Satan would attack them with.
I was the senior nurse in charge when this very situation
arose. One of my colleagues was reduced to tears when
the childs mother turned her wrath on her for 'undermining
their faith' when she sought to raise the grave nature of
their childs condition. I spoke to the parents who told me
that there was a conspiracy to undermine their faith and
all the staff were party to it. If only their child were back at
their home rather than here - they "knew" all would
be well....the perceived barriers to their childs wellbeing
were the very medical and nursing staff caring for them!
(To them the child was dying because he was in hospital
- he was not in hospital because he was dying!) One
might wonder why they brought him to the Accident and
Emergency Department in the first place: they brought him
only because they realised that he needed some suction
to clear his airway, the staff had to restrain them from
removing him even as the team resuscitated him.
It struck me that their concept of 'faith' was much more to
do with 'the power of positive thinking'. Almost as if "faith"
was some sort of inanimate spiritual force to be manipulated
by sheer will power, it was certainly nothing I could describe
as biblical faith, which is always a personal expression of
trust rather than an abstraction. In many ways this view of
"faith" is more pagan than Christian. It is more akin to 'spirit
channelling' - only in this case the 'spirit' being so channelled
is, ostensiby, The Holy Spirit: as if He is an impersonal
force rather than God: if only the 'right' spiritual conditions
could be engineered then a healing must inevitably follow.
I spoke to them at some length, seeking to assure them that
we are on the side of 'health' and affirmed that their child was
in better hands than ours and no-one would be more delighted
than me for us all to be proven wrong and for God to be glorified
by their child's miraculous recovery. "We are not against miracles",
I said, "but I would be failing in my responsibility if I didn't tell you
what we are up against". They listened politely to what I had
to say but were unmoved.
A few days later some members of the church youth group
came to visit along with the senior pastor. They were visibly
shocked by what they witnessed of the patients condition;
comatose and ventilated. I spoke to the pastor who was
baffled by the conflicting reports he had heard. What had
been reported to him was the child was indeed staging a
miraculous recovery - and that the patient would be well
enough to receive visitors. My interpretation of this hearsay
was that their particular church had received back the vibes
it was transmitting. In short the parents fed back to the church
every scintilla of positive news (which was largely imaginary)
and edited out all the negative (which was overwhelming).
The parents and their church were effectively caught in a
cycle of mutual deception masquerading as 'faith building'.
At this point I want to flag up a practice common among
some faith ministries of encouraging public testimony
of a healing which has yet to occur as if it already has.
This is justiified on the dubious basis of "declaring that
which is not, as if it were!" Or by suggesting to the supplicant
that the healing will occur as the testimony is given.This in
my opinion is fundamentally dishonest and is indefensible
as a practice.True faith cannot be bolstered by such
(let's face it) manipulation. The lack of integrity belies the
Spirit of God invoked.
The pastor and I spoke together for a while. It seemed
to me that he was too keen (given his miraculous convictions)
to explore further courses of treatment and investigation. The
parting comments indicated that he felt that the onus was
wholly on the parents faith whether the child was healed or
not - he had done all he could. The youth group was ushered
out in an embarrassed silence. He was clearly positioning
himself ready for failure.
It is difficult to imagine what a parent feels when they
lose a child. It is even more difficult to imagine what it
is like to feel that their fate was determined by one's own
lack of faith and to feel estranged from the church
community one had had implicit faith in: and that is where
their "faith" does lie. Stranger still is the notion that the
unbelief' of the medical and nursing staff was the principal
cause of death. The child did die as anticipated and the
promise of miraculous recovery proved false. Unable to
countenance such a loss of face and to reconcile their
conflicting feelings the parents phoned the police to
report that their child had been murdered! Their official
theological position was that the parents and their
community were all on board for a miracle - it could only
have been thwarted by Satan using a staff member as
an agent of his will. This rationalisation was as inevitable
as it was preposterous. How do we unravel a situation
like this? First by realising that every one starts by
meaning well - everyone wants the child to get better.
But that natural wish clouds people's judgement and
problems arise because the people directly involved
do not have a theology of suffering. Don Carson in his
book "How Long, O Lord?"*, says we need to have our
theology of suffering in place before we enter such a
time of trial - unfortunately such a theology is anathema
among believers who have a theology of 'glory now'.
In their 'time-line' we are not in an in-between phase
(between the First and Second Comings of Jesus Christ)
in their minds eye it is all 'Glory' now. To reconcile reality
with their theology when 'glory' fails to materialise
requires a fundamental shift in focus - from God to
Satan as the one in ultimate control. And whether this
is a psychologically tenable position must be disputed;
regardless of the dubious theology involved.
In my own feeble way I attempted to challenge such a
view of events. Surely it is more of a comfort to know
that the child died in God's arms, and not as a
consequence of Satan's activity? Apparently not!
Over and above the usual grieving process of anger,
denial, bargaining, resignation and acceptance over
the dying patient, there was a parallel process over
their "faith", each interwoven with the other, and
conflicting with their immediate church community.
In such a situation I would regard the parents as victims
of false teaching and syncretism.The onus actually lies
with the church leadership who had created an environ-
ment of unrealisable expectations in general and then
spoke a falsehood in particular invoking God's name
as their authority; and who, when confronted with the
reality of the situation, sought to shift responsibility for
their failure elsewhere rather than actually guide their
flock through a pastorally challenging time. One elder
was more concerned with saving face. It was a classic
failure of leadership. By their teaching and actions these
leaders had actually created a nightmare world for
acutely vulnerable people - I have no sympathy for
such wolves in sheeps clothing. False teaching has
nasty consequences and opposition to it is motivated
by compassion; not by dogmatic nit-picking.
A few years ago I attended a Christian convention and
during a meeting and greeting session I happened to
mention where I worked. An individual commented to
me that I must have witnessed a well known event when
a famous healer had healed everyone on the intensive
care unit. I replied that I was indeed working there at the
time and have no such recollection. We both smiled at
each other and made eye contact; my interlocutor
moved on to more fruitful conversations elsewhere.
I could not help feeling that if he had genuinely believed
in these miracles I could have expected a more robust
response: either for him to feel utterly deflated or for
him to denounce me as a liar. I could understand either
response but I cannot understand this 'easy come,
easy go' attitude to such claims. This is no casual matter
for those personally involved; and perhaps that relaxed
approach to God's honour actually belies a lack of true
faith.
Let me suggest some criteria for assessing prophetic
promises of a healing miracle: first there has to be a
confirmed diagnosis by a qualified diagnostician. I have
worked extensively as a nurse in adult and childrens
intensive care and could probably make an educated
guess about someone's symptoms, but I would never
claim to be a diagnostician: it would be unethical and
unprofessional to do so. My best guess would be no
substitute for a proper medical diagnosis. Also self
diagnoses by attention seekers known as the "worried
well" aren't good enough either. Nor is a "spiritual"
diagnosis by the healer themselves sufficient evidence
of a genuine medical problem. Secondly, the person
issuing such a prophetic promise cannot delegate
responsibility for its fulfillment elsewhere in order to
indemnify themselves against failure - they would
(I'm sure) be the first to claim some credit if a healing
did come to pass. Manipulative strategies invariably
indicate false teaching, especially when there is an
abuse of a position of trust, and even more so where
the manipulated are emotionally vulnerable.
Thirdly, a miracle proper only exists when all treatment
has ceased, for example the recovery of patients being
actively treated in Intensive Care is hardly evidence of
a visitors miraculous healing ministry whatever self
serving claims they might make for themselves! And
that brings me to my fourth point; is the "prophet/healer"
more concerned with building their own reputation than
they are about actually serving God's people? These
are some of the key issues I would flag up.
I should also mention the pastoral care of ones work
colleagues in a situation where the Gospel is seemingly
compromised and where they too have been abused in
the name of God. It is important to share that the display
of "faith" they have witnessed should not be attributed to
all Bible affirming Christians. Perhaps it may even be
an opportunity to talk about what true faith is! This may
be the only positive thing which can be redeemed from
such a situation.
As a Christian and a health care worker I see no conflict
in using my God given skills to help relieve the suffering
of others - in fact it is quite perverse to suggest otherwise.
Perhaps my decision to move into nursing was partly
motivated by a Christian urge to be part of God's answer
to a suffering world; I don't believe I am unique in this
because you will find many Christians within all the caring
professions and in public service. You will also find many
Christians serving their Lord in the voluntary sector in their
own time.
Sadly there are occasions when one has to break bad news
and that needs to be done truthfully and compassionately.
Even children die and children of believing Christians die
- we do not live in Disneyland we live in the real world. It is
entirely appropriate to pray to God for his help, and it is
also entirely appropriate to pray for those who care for our
loved ones to enable them to bring about a speedy recovery
....and when that is not possible to continue to care to enable
the patient to die in a dignified and comfortable way. In fact,
for those who die in Christ, we can by faith rejoice, knowing
that death will not have the last word. The Gospel enables
us to face reality and to do so without despair. I must add
that that has been the gracious response of the vast
majority of Bible believing Christians I've met in the course
of my career; the scenario outlined above was a minority
view.
Death and suffering are part of the common human
experience; that is the clear teaching of scripture. One
day Jesus will restore the creation and death itself will
be destroyed - but that time isn't yet. True faith looks
to the future when God himself will wipe away our tears.
Come, Lord Jesus!
* "How Long, O Lord?" by DA Carson, published by IVP.
Don Carson also wrote a helpful little book called
"The Difficult Doctrine of the Love of God" also published
by IVP.
post-script; A shortened version of the above article
was subsequently published in the Spring 2007 issue
of "CNM News" (No 17).
Sunday, June 11, 2006
St JAMES' UNIVERSITY HOSPITAL, LEEDS [aka "Jimmy's"]. 1981-85. It is almost exactly twenty five years ago that I started my nurse training at Jimmy's in Leeds. At the time it was [and perhaps still is] the largest teaching hospital in Europe. There was an active Nurses' Christian Fellowship [NCF] group there which I got involved with and later went on to help lead. Later in life I had the privilege to help re-launch a group for Christian nurses called "Christian Nurses & Midwives" [CNM] but that's another story...check out http://www.cnm.org.uk/ if you're interested! I recall one funny incident as a student there; I was working on a ward and it was lunchtime. I was merrily serving out meals from a food trolley when one of the qualified staff sidled up to me and whispered in my ear that I was doing a great job but that she couldn't quite understand why I was ladeling chocolate sauce for the dessert onto the roast beef! I was so embarrassed! Of course, there were difficult experiences too. My most chilling memory was to watch someone die of bleeding oesophageal varices. Yet I look back on my time at "Jimmy's" with a lot of fond memories - the whole experience was very formative. Nurse training then was [and perhaps still is] one way of "putting an old head on young shoulders"! And the friends I made were an enormous support and help - more so than I probably credited them with at the time. We also had some great adventures together exploring The Dales, The Peaks and The Lakes. I made some wonderful friends there - people who proved better friends to me than I ever was to them. ---------------------------------------------------------- tagline: Peter Swift. St James's University Hospital. Leeds. 1981. 1982. 1983. 1984. 1985. School of Nursing. RGN. Student Nurse. Staff Nurse. RSCN. Nurse Training. NCF. Nurses' Christian Fellowship. ----------------------------------------------------------
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