Christian Ethics and Nursing Practice. Richard B. Steele

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СКАЧАТЬ upon all these important works in what follows, but we attempt something they do not, namely, to determine what light the Bible sheds on contemporary nursing practice, as normed by the Code. See the Annotated Bibliography for a brief explanation of the relationship between those works and this one.

      The Uses of This Book: A Word to Educators

      Here we wish to offer several suggestions for nursing educators who adopt this book for courses in nursing ethics. First, we encourage that it be used in tandem with two other books, namely, a critical, annotated edition of the Bible with the Apocrypha, and Marsha Fowler’s (2015) Guide to the Code of Ethics for Nurses with Interpretive Statements, which includes the full text of the official Code (ANA, 2015) as an appendix. Our task in this book is to identify the connections between the main themes of our chosen biblical texts and of the Code, but students will profit greatly from drilling deeper into the primary sources for themselves. Second, we recommend that this book (along with the Bible and Fowler’s Guide) be used during the first half of the course, and that other resources be used in the second half, especially those that analyze complex issues in contemporary health care or offer thought-provoking case studies in nursing ethics (e.g., Grace, 2018). Our students sometimes report that the material included in the present book seems a bit abstract until they apply it to their own practice or to hot-button issues in their field, at which point the framework provided here proves its worth. Third, we suggest that students prepare for the class session during which a given chapter in this book will be under discussion by writing out definitions of the Keywords and answering the Reading Comprehension questions provided at the end of each chapter. Fourth, we propose that in the days after a given chapter in this book has been discussed in class, the students be required to answer the Making Connections questions likewise provided at the end of each chapter. This will encourage them to apply the material covered here to their own practice even before moving to the case studies and current issues in the second half of the course. (Note: the Making Connections questions tend to work better with advanced practice nursing [APRN] students, who already have a rich fund of clinical experience under their belts, than with undergraduates, who are still mastering basic skills and concepts.) This learning activity is especially valuable if students have access to an online discussion board, where they can interact with each other’s reflections. Examples of such discussion board interactions appear in the Clinical Voices sections toward the end of each chapter.

      Figure 0.4. Nursing postage stamp. This US postage stamp was issued on December 28, 1961. For details on its historic significance, see Olin (2011, December 8). We display it here as a tribute both to the students in our classes, who have contributed so much to this book, and to the book’s intended readers.

      Clinical Voices

      As the reader begins to discover the connections between Christian Scripture and contemporary nursing, our ultimate hope is that these will be useful in a practical sense. Ideally, the nurse is able to integrate the profession’s code of ethics with his personal values and beliefs to provide morally confident and competent patient care. Nurses from many backgrounds have found the discussions of connections described here to be useful on both personal and professional levels. They encountered a new way to wrestle with some of the difficult questions in practice. Each chapter includes some of their thoughts about integrating the strands and Code (ANA, 2015) with their individual approaches to practice. These experienced nurses—APRN students, who have deeply engaged in these discussions—have graciously given us permission to share their stories, thoughts and concerns here as a catalyst for discussions among other readers. Here are some of their initial thoughts about the framework of biblical strands connecting to professional nursing ethics:

      Arely Garza: Integrating strands

      Nursing is a vocation. I have always felt caring for the sick is my calling. Even when considering other career options, they always felt wrong. Jesus cared for and healed the sick outside of work days, an act prohibited on the Sabbath. This demonstrates how nursing is more than a job. Nursing is stressful and often challenging both mentally and physically. My faith and sense of calling provides motivation to continue to care for others even through difficult times. My patient, an older gentleman with cancer, had a complex treatment plan. Over the multiple times I took care of him, my use of the four strands changed. At first, I emphasized the law strand, following policies and procedures to provide the safest care while he was in a critical state; then I became his advocate, committed to involve him in his own care. He had multiple doctors who didn’t always communicate well with him. There was an instance where he and his family were frustrated with his care and confused as to what was happening. I pushed the residents to come speak to the family, which then became a care conference.

      Cindy Mato: Situational connections to faith

      I have never thought much about my decision-making process related to nursing interactions from a spiritual standpoint. I can honestly say that when I am caring for a difficult or angry patient, I rarely think of God or the Bible. Situations where I lean on God are often related to a critically ill patient—praying for them and asking God to grant me the skill, knowledge, and tools to help the dying patient. During further reflection, I believe my spiritual beliefs and nursing practice are intertwined when I am volunteering. I feel happy and close to God when I am participating in an activity that gives me a sense of purpose, such as volunteering. I can see how the four strands of Law, Holiness, Wisdom, and Prophecy are braided together during these times. I may be helping the oppressed (Prophecy) by using my nursing knowledge and skill (Wisdom) to do something that many others would not be willing to do (Holiness).

      Inbok Wee: Holistic care and collaboration

      The highlight of nursing is that we care for people with a holistic approach, not only for their physical needs but also for their emotional, mental, and social needs as a way to promote their well-being. I had a male patient admitted with malignant hypertensive urgency due to noncompliance of antihypertensive medications. There was not sufficient information about why and how long it had been since he had not taken the medications. One day after his symptoms were relieved, before treatment was completed, he wanted to go home. Once all the detailed information was given to the patient regarding his current condition, treatment, and the risks of incomplete treatment, he got upset and anxious. Later in the day, he opened up to me. He had recently divorced and lost a job, and stated he was depressed. I offered emotional support with therapeutic listening and coordinated with the provider and social worker to provide extensive support for follow-up care, charity medications, medical bills, and counseling. As a primary nurse, I promoted the patient’s rights and health with compassion and respect by providing the patient with information and assertive communication regarding his condition, treatment, and risks. By notifying care team members and collaborating with them about my patient’s emotional crisis and situation, I made a prompt decision and took accountability to provide optimal care for my patient’s health.

      Being a nurse, a member of the most trusted profession (Brenan, 2017), is very hard work. It is very much heart work, too. As nurses continue to pour themselves into caring for people who are at their most vulnerable, it is our hope that the connections between ethically strong nursing care and Christian Scripture provide a resource for thinking about practice and how nurses may approach the challenges that come on a daily, if not moment-by-moment, basis.

      Keywords

      1.Canon

      2.Holiness

      3.Interpretive statement (of the ANA Code)

      4.Law

      5.Prophecy

      6.Provision (of the ANA Code)

      7.Strand (of biblical moral discourse)

      8.Wisdom

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