Spiritual Care: A Guide for Caregivers (7 page)

Jon laid his hand gently on Elsie's arm and prayed, "Dear
Lord, we know that you understand what Elsie is going through
and that you are in control of all things. You know how important
her daughter's wedding is to Elsie, and we ask that she will not
only live to get through it, but that she will be pain-free and full of
energy. We pray that you will heal Elsie and keep her close to
yourself. Help her to know your love and presence right now.
Ease her pain. Give her your peace. In Jesus' name. Amen."

Elsie visibly relaxed as Jon prayed. By the time Jon returned
with the pain medication, Elsie was sound asleep.

Many nurses use the excuse that they just don't have time to
provide spiritual care. Even in less pressured settings than a busy
hospital, we tend to think that we are simply too busy to spend
extended time exploring a person's spiritual needs. However, as
Elsie demonstrated so clearly above, spiritual care may save time
in the long run. When the underlying problem is spiritual, medication, surgery or even psychiatric care will not be as effective as
they would be when spiritual needs are appropriately met.

The time factor is simply a matter of priorities. We have been
socialized to believe that physical needs are the most important,
followed by emotional and social needs. We turn to spiritual needs if there is any time left over, but that rarely happens. Jesus turned
this set of priorities on its head in the Sermon on the Mount,
teaching, "Therefore do not worry, saying, What will we eat?' or
'What will we drink?' or 'What will we wear?' For it is the Gentiles who strive for all these things; and indeed your heavenly
Father knows that you need all these things. But strive first for the
kingdom of God and his righteousness, and all these things will be
given to you as well" (Mt 6:31-33).

How can you make time for spiritual care in a hectic schedule?

❑ Put your relationship with God first in your own life. Get up
earlier to spend some quality time with the Lord in prayer, meditation and Bible reading. Or find a time during the day when you
will be undisturbed. Convince yourself that this time is important-confirm your commitment to God in prayer. You can't offer
to others what you do not have yourself.

❑ As you develop a plan for those in your care, put spiritual
needs at the top of the list.

❑ When you assess a spiritual need, follow up on it.

❑ When you find yourself thinking, I don't have time for thce, stop
and pray about how the Lord would have you use the time you do
have.

Naomi began her new role as a parish nurse in the church where
she had grown up. Although she had been a nurse for twenty
years and taken a parish nurse preparation course before starting
the new job, she felt anxious making her first home visit. However, Violet Jones quickly put her at ease. Recently discharged
from the hospital after abdominal surgery, Violet lived alone.
Naomi did a quick assessment of Violet's physical condition and
asked about her support system for meals, transportation and other activities of daily living. Then she settled in to listen to Violet's stories of her illness and hospitalization. The time passed
quickly, so Naomi rose to leave.

"Oh dear," Violet exclaimed, "I misplaced my glasses again.
Can you help me find them?" Naomi searched everywhere without success. Finally Violet continued, "I think I lost them in the
hospital. What I really miss is reading my Bible every day. Could
you read it to me?"

Naomi found Violet's well-worn Bible and daily devotional
guide and read the portion for that day. Violet smiled and nodded
as Naomi read, then stated authoritatively, "Now we pray. You go
first."

Naomi froze. She had been raised in a Christian home and
prayed with her parents as a child, but she did not know how or
what to pray with Violet. She began praying the Lord's Prayer,
but Violet wasn't satisfied. "You have to talk to God like he's your
friend, not just recite things by rote!" she insisted. A long silence
followed. Naomi knew Violet expected her to continue, so she nervously added, "Lord, bless Violet and help her get well."

Even Christians who are comfortable praying in a familiar
small group, or with friends, may feel awkward about praying or
sharing spiritually in a caregiver setting. At one point I worked on
a unit with four other Christian nurses. They talked freely about
their church activities and Bible study groups, but none of them
felt comfortable providing spiritual care. Finally Sue, a pastor's
wife, asked if I would teach them how. We met briefly after work
for several sessions to go over the basic principles of spiritual care.

Sue's "final exam" came one day when she was cleaning a tracheostomy tube. The highly anxious patient kept choking and
blowing the clear plastic tube out of the tracheostomy. When the
tube blew out into the sheets for the third time, it seemed to become invisible. The patient began to wheeze. Sue panicked.
Then she collected herself and said firmly, "We have to pray about
this!" She prayed aloud at the bedside for guidance. The patient
relaxed, and the trach tube suddenly appeared in the sheets
between her knees. Sue confidently replaced the tube, which slid
into place easily now that the patient was relaxed. She emerged
from the room triumphantly, marveling at God's intervention. She
looked at me, laughing, and said, "I don't know why I didn't start
doing this years ago 1"

Even pastors may not know how to offer sensitive, effective
spiritual care. I once worked in a hospital where the chaplain
prided himself on visiting every patient daily. He would stand in
the doorway, mutter an unintelligible prayer, then move on to the
next room without even acknowledging those in the room in a
personal way. New patients would often ask me, "What was
that?" They were not comforted.

Spiritual care in a health care context involves extending the
worshiping community to people in difficult circumstances. Illness
alters a person's status in that community, often making both the
sick person and the church members unsure of how to maintain
their relationship. For example, Pastor Paul Harris suffered a
stroke that left him paralyzed and mentally handicapped. When
friends from his former church visited him at the nursing home, he
often called them by the wrong name and cried when they told
him news they thought would please him. They assumed that their
visits upset him, and so they stopped coming. Even the area clergy
eventually stayed away. His former colleagues felt awkward
around Paul. They simply did not know what to say or do.

Spiritual care does not come naturally. Even after breaking
through the emotional barriers to discuss spiritual concerns, most
people--including health care professionals and clergy-do not know how to proceed. The knowledge base required goes beyond
a basic grasp of Christian doctrine and an understanding of counseling techniques to an integration of the two. Spiritual care in
crucial human situations requires us to extend the worshiping
community to those who are not able to fully participate in the
normal life of the congregation, as well as to demonstrate the
faith-health connection throughout the life span.

Offering our compassionate presence means learning to listen
carefully and respond constructively, in ways that are consistent
with what we believe about God. Spiritual support involves praying and sharing Scripture appropriately, along with offering further resources such as literature, music and touch. Caring for
people spiritually also involves helping them consider the spiritual
aspects of alternative therapies, as well as whether they might be
safe and effective.

The following chapters will give you practical guidance on how
to provide effective spiritual care. However, "book learning" is
only the first step. Skill comes from practice. The sooner you take
the plunge to get started, the more it will become a natural part of
your caring relationships.

Several strategies will make this step easier:

1. Find at least one friend or colleague to read this book with
you. Discuss what you are learning. Practice on each other. Use
the spiritual assessment, pray with each other and study Scripture
together, discussing its application to particular situations.

2. You might also want to consider starting a small group to go
through this book together, then continue as a support group as
you begin to apply what you've learned to your ministry of caring.

3. Finding a mentor-someone who is already experienced in
spiritual care -will provide an example to follow and someone to
guide and support you through the learning process.

4. Helpful tools for examining your spiritual care interactions
include journaling, writing verbatims or case studies and discussing what you have written with your mentor or support group.

5. Don't be afraid to get started. The Holy Spirit promises to
give us the right words to say (Mk 13:11) and to be our counselor
(Jn 14:16-17). The exciting part of spiritual care is seeing God at
work, for ultimately it is not us but God who meets spiritual
needs. Once you get started, it becomes an adventure in faith and
in seeing God's overwhelming love and sufficiency.

hen Herb Jacobs, a long-time member of hie church board
and choir, suffered several fractured vertebrae in an automobile
accident, the congregation rushed into action. The pastor and
other board members visited him frequently in the hospital and
for several weeks after he returned home. Church members
brought flowers, food, a used wheelchair and other needed medical equipment. Cards filled his mailbox. His recovery seemed to
go smoothly, and the entire congregation celebrated Herb's
return to the Sunday morning worship service several months
later.

But Herb, who was still wheelchair-bound, felt a deep sense of
loss as the choir began singing the prelude. He wanted desperately to join them. But even if he had been able to attend the
Wednesday night practice, climbing the choir loft steps presented
a daunting challenge. Going anywhere required major effort.