Comments and Responses

The following response to a casual but all too common question coming from a Malaysian Nurse, is a timely encouragement to Nurses around the world who are experiencing the harsh reality of low morale, high attrition and increasing workloads and long hours made worse by the horrendous shortage of Nurses.

Nursing has Values

“Walk worthy of the vocation wherewith you were called.
And whatever you do, do it heartily, as to the Lord, and not to men.
Knowing that from the Lord you will receive the reward.”
(Colossians 3:23,24)

“Let every detail in your lives
– words, actions whatever –
Be done in the name of the Master, Jesus,
Thanking God the Father every step of the way.”
( Colossians 3:17)

Lee Yin Ling

(Contact through the Malaysian Nurses Christian Fellowship, 9, Jalan SSI/1B, Kampung Tunka, 47300 Petaling Jaya. Telephone 012-2876121)

The Reality of Fear

This comment comes from a nurse of Jewish Gentile heritage, who grew up in the Netherlands during the 2 nd world war and German occupation. Married a South African and nursed in South Africa. Migrated to England due to the horrors of apartheid in preference to going to bed with a gun. Later migrated to New Zealand, and was actively involved in the care of intellectually handicapped people.

In addition, this nurse encountered different frustrations and fears when her husband, a gifted teacher became a progressive alcoholic until his death, their eldest daughter entered a same sex relationship and their only son was diagnosed as borderline IHC.

NWAD Response

This expressive comment, while the reaction of one nurse, cannot be viewed as peculiar to her. Rather it spells out a little of the reality of the many fears expressed by nurses over time and in differing situations.

Nursing With A Difference is therefore constrained to respond to what we know to be a major factor in nurse’s lives. A factor that has caused us much concern having too often witnessed the grief of fear that so many nurses are experiencing.

False Evidence

This little acrostic, discovered when catching up on some of the heart rending devastation in the Middle East and many other countries around the world, is a timely reminder for Nurses seeking to bring comfort, strength and healing to those caught in the soul destroying web of fear and are in need.

Midst the ‘seething caldrons of anguish in the sensitive hot spots of the world’, Nurses need fresh courage and renewed energies to fight on with an unfailing wisdom until a better quality life for Nurses and patients is achieved. With danger and death having become such a constant painful fact of life, it is understandable that the fear of death all too often keeps Nurses from being bold in relation to specific nursing issues. This is neither apathy nor mindless resignation to what is.

Fear is a very natural response when bombs and missiles are exploding all around you and when Nurses are fearful and frazzled, is it any wonder that the patient and his relatives are seriously affected?

There are however, many other causes of fear in Nursing which adversely affect the health, wealth and happiness of Nurses, as is evident in the high attrition rate and significantly large older age group of registered nurses in most, if not all countries.

The ‘G’ and ‘Y’ factors can be linked and discussed with psycho-socio-legal and other factors ad nauseam, but the root cause of fear remains a reality that each Nurse must address and resolve to his or her own satisfaction.

There are only two real options, either to ‘grow in nursing’ or ‘quit nursing on some justifiable pretext’, for those who neither leave nor grow become as the walking dead. Statistics suggest that the balance is tipped in favour of quitting.

This is where the Flower of Assurance comes in.

Real Assurance is a direct result of such a strong faith in God that nurses consciously “Trust God with all their heart, and do not lean on their own understanding.” Proverbs 3:5
	This assurance is more than the insurance offered by the best this world can offer.
	This assurance is more than religion, education or politics can provide.
	This assurance is not sentimental pie in the sky flowery rhetoric

This Flower of Assurance is an undeniable reality-based-fact.

Real assurance is the fruit of knowing that God will
	Give us strength to equal each specific need. “As your days, so shall your strength be.” Deuteronomy 33:25. = The fragrance of triumph over adversity It comes, after being utterly exhausted and tempted to give up, strength is renewed.
	Blot out and completely remove all our sins, if we trust Him and obey His word. = The fragrance of tranquility and peace in our heart. Everybody wants peace, but not everyone knows how to find it. The only practical, never fail solution is to get forgiveness from the only One who has promised “For I will be merciful to their unrighteousness, and their sins and their iniquities will I remember no more.” Hebrews 8:12.

Real assurance (continued) is the fruit of knowing that God will
	Hear our prayers and therefore our faith motivates us to pray and to ask God to help us pray aright with wisdom, insight and a higher perspective than is ours by nature. = The fragrance of confidence in unfailing divine help and intervention. A mystery but a fact.
	Dispel all fear as we ask Him to strengthen our faith in Him we are freed from the fear of man. We are fortified against innumerable possible and unknown eventualities in life. When they come He gives us strength and wisdom to meet them. = the fragrance of courage through trust in God, in ourselves and in each other . ‘Not by might and not by power, but by My spirit says the LORD’ .
	Provide Almighty power and loving kindness in wisdom and knowledgeto face with assurance the challenges of life, the deep burdens, griefs and uncertainties in life, the physical, mental and emotional traumas in life and death itself. = The fragrance of strength that sees the invisible, believes the incredible and receives the impossible. True strength is found in the quietness and confidence He provides to stand still and move on.
	Forgive and free each one from the power of sin and of fear. By consciously putting your hand in His strong right hand every nurse can enter and not just echo the words:

May no nurse, for any reason delay entering in and taking hold of that which will:

Transform his or her ability to better manage the fear-pain-fear-anger-fear syndrome.

Generate a three fold faith that dries the tears of sorrow, heals hearts of mourning, lifts the hands that hang down and strengthens the feet that falter.

Strengthen faith and confidence by giving time, labor and tears to strengthen others.

This Flower of Assurance can be guaranteed to get at the root causes of fear in Nursing.

The fragrance of this flower of assurance is found in the abundance of quality blossoms, some ever so tiny, but all powerful in preventing, managing and overcoming fear from every conceivable source.

The source of this fragrant flower of assurance comes from none other than the God of mercy and peace and Christ Jesus our LORD who has “not given us a spirit of fear, but of power, and of love and of a sound mind.” 2 Timothy 1:7

An Open Letter to All Nurses from a Nurse

To all Nursing Students, Staffs, Nurse Tutor friends, Nursing Administrators in hospitals and in the community…

Today, I Mrs. Tshering Yangzum Bhutia, retired nursing tutor would like to share something about my past experience of life which (I hope) may help you to have a totally different view upon your domestic and professional problems which always lead us to dark sad end called DEPRESSION.

My story goes like this……..

My childhood:

The emotional turmoil’s started in my early childhood when I realized that I was a rejected (bastard) child looked down upon by society, family and friends, so, an inferiority complex was dominating my whole personality from the beginning

All of my dreams and ambitions shattered due to lack of financial support. Somehow I managed to pass higher secondary from a Scottish Mission School and I took refuge in my grandparents house.

In 1979 I finished GNM course from Safdarjung hospital after much struggling for 3 ½ years because I found myself acquiring three kinds of diseases, Typhoid, Malaria and TB intestines. But I came back and served in a Government hospital.

My married life:

Next episode of trouble started almost immediately after my marriage due to…alcoholism at home, constant interference from in laws and the negative effects on my nursing profession. Physical and mental turmoil’s started to take toll on my health after having three children. Several times I decided to leave my job.

I had struggled 14 long years to get a single promotion as a nursing tutor.

Suddenly the following events took place in my life:
	The sudden death of my grandfather who alone seemed to understand my problems.
	My Job: I was loaded with other diseases like hydronephrosis, kidney stones, lastly a rare disease called otospongiosis. I leaned on religions, rituals like pilgrimages to seek solace and peace but in vain. So I was compelled to take voluntary retirement after prolonged treatment; that was the saddest part of my life.
	My Children Then the problems started from my children’s side: Physical assault on my son at school, suddenly I was shocked to find my daughter getting involved with a boy who left her in a miserable condition.
	My Relatives In dire need I was totally abandoned by my relatives, which was a big shock to me.
	Sudden death of my brother in law’s daughter on the same night of my daughter’s re-marriage. Single handed management of marriage and social defamation led me to more depression.
	Early divorce of my daughter forced me to look after the rejected baby, my grandson.
	I was hospitalized for a long time with 2 nd degree sprains to both my ankles. I lost hope completely. I tried to end my life, several times I tried to leave the house.
	My husband took shelter in alcohol, leading to daily quarrels at home, fear, anger and frustration dominated my life.
	I started to spend my time in pujas and temples entirely depending on religions.

So, early one morning as usual I was going to my Puja room, a voice told me to open the window and shout that the word is full of sin …reluctantly I started to shout, my husband thought that I was mentally off. Most of my in laws and relatives arrived and summoned priest Lamas, Tantrics and performed Pujas but all in vain. The psychiatrist was called, but more confusion and frustration led me into a worse condition. PEACE VANISHED FROM MY LIFE.

During this time I had a vision of a person praying with bowed head, he told me to keep quiet and not to be afraid. He called me by my name. At the same time two Christian ladies came to our house and prayed for me. After long suffering and without food, I slept peacefully and started to talk normally from that day onwards.

After prayer both my legs got healed. Hence I accepted the Lord Jesus as my savior and got baptized in 2004.

Summary------according to John Chapter 10:10

The Devil stole my job, health, peace, property, self-confidence and marriage happiness.

John 10;10

“The THIEF Does Not Come Except To Steal, and to Kill, and to Destroy.

I have come that they may have life and that they may have it more abundantly.”

So, friends in white when there is still time, remember the Florence Nightingale pledge, repent and turn around and a meaningful and abundant life as Jesus our Lord has showered on me and my family.

According to John 14:27

“ Peace I leave with you, My peace I give to you, not as the world gives do I give to you. Let not your heart be troubled, neither let it be afraid.”

So, my friends I got all the answers regarding my problems because Jesus says:

“I am the way, the truth and the life. No one comes to the Father, except through Me.” John 14:6

P.S. I was a lost sheep. So Jesus says in

John 10:11 “I am the good shepherd. The good shepherd gives His life for the sheep.”

John 10:14 “I am the good shepherd; and I know My sheep, and am known by My own.”

Mrs. Tshering Yangzum Bhutia
Gangtok,
Sikkim

Comment by Ms. T.A. Master in Nursing, Faculty member of a well reputed College of Nursing.

“The website content is commendable from the point of view of Spiritual approach for nurses who are facing different personal/professional problems as it provides a psychological base on which to build their tolerance. However, I personally feel that such an approach is not satisfying in a realistic sense as concrete interventions only can solve their problems. The need is to have a team approach, train and involve them in the problem solving process.”

NWAD Response

This thoughtful comment is appreciated and warrants an equally thoughtful response:

In every School or College of Nursing every Nurse is challenged by the expected outcome by the time she/he qualifies to be competent to demonstrate in the practice of Nursing the following attributes:

• The ‘Nurse must give physical, mental, emotional and spiritual care’;
• The Nurse must understand the ‘Fear, pain, tension syndrome’ that may limit the above;
• All these attributes of care must be given ‘unconditionally to all clients/patients/people’.
• As the patient/client advocate the Nurses must also be able to reconcile and arbitrate effectively irrespective of oppressive regimes that generate oppression from within and from without.

Following graduation there is ample evidence of a significantly large disconnect between the above commendable and realistic expectation of these requirements and the deeds that show the practical application thereof.

Through close interacting with thousands of Nurses in their respective institutions in many States, coupled with the personal observation of the shocking conditions in which Nurses work and the way they adapt to those conditions, the world wide concern with the shortage of Nurses, lack of job satisfaction, the increasing age of Nurses coupled with the decreasing motivation of young people to enter Nursing and the staggering number of Nurses in Nursing purely for economic reasons, Nursing With A Difference has been challenged to use the problem solving process in searching below the surface of education to the cause.

It has become very clear that the increasingly higher standard of Nursing Education is not; as we had hoped and worked for, the whole answer to help Nurses effectively provide Nursing Service in the 21 st Century.

Blaming the ‘Government’ and ‘Those in Authority’ is a popular means of denial ending in legalism that is strongly linked to abdication of responsibility, professional displacement and emptiness and the multifaceted mountain that ‘Disconnects’ Nurses from Nursing.

Nurses around the world acknowledge the need “To be lifted up”, and over the years Nurses have and continue to work hard to “Lift themselves up”. Yet the worldwide alarmingly low and increasingly lower Nurse-patient-client staffing ratio, along with an accepted and respected Nursing presence speaks volumes.

With Higher education not achieving what it was expected, and aught to achieve, even with the team approach and the problem-solving-process, neither of which are new concepts, along with the many psychological perspectives used over the past five decades not providing the ‘missing link, is it not time to re-evaluate and relate points 1-4 to Nurses?

A re-look at what and how we are doing in Nursing is imperative if the current cycle is to be effectively broken, therefore, we would request Nurses to critically re-examine the content of each web page:

While there is a marked discrepancy between ‘Spiritual and Psychological’ there is also a strong tendency in Nursing today to sacrifice the ‘Essence for the Illusion’ and in the process to become ‘Spiritually blind.’

Nursing With A Difference acknowledges that most if not all Nurses are deeply religious. At the same time thousands of Nurses acknowledge that Religion has not helped.

This then is sufficient reason to look at the personal relationship of each Nurse to her Creator, from whom alone comes the power of grace in integrity, and love in service to overcome the horrors and nightmare of Nursing Service.

While all religions advocate ‘Searching for light and working” it is Jesus Christ who said

This in no way suggests that Nurses sit back in an armchair or using a very common expression with hands directed upward sigh and state:

“Do not worry, all is well, it is His Will”

Is it the Will of a Holy God that all the beauty and energy of Nurses should result in more and more suffering for themselves and for patients/clients?

To acknowledge the Will of God requires that we have a personal relationship with Him whereby we can individually and collectively ask for and receive understanding of His Will in every situation.

Thus the means of truth leading to victory must arise from the starting point of obedience to know the person of God who gives the knowledge, wisdom and power to fulfill His will which is unconditional and impartial for all.

The means follows, which is obedience in putting into practice, in the midst of even the most distressing situations, those attributes that transform an unhealthy situation into a viable, vital, vibrant and healthy one

The dynamics involved is not mere psychology it is the life giving and life transforming power that the LORD Jesus Christ said we would receive when the Helper the Holy Spirit came.

This is not mumbo jumbo psychical, immaterial, pious spiritualism, it is not signs and wonders, it is not airy fairy pie in the sky:

It is in Reality

The resurrection power of a Living Christ working in us and through us, in the daily challenges of everyday life, helping us bring order and meaning out of injustice and chaos.

Every Nurse has the freedom to choose to receive, act and receive again.