Following Jesus in Nursing

Welcome to Following Jesus in Nursing, a podcast for nurses and students produced by InterVarsity's Nurses Christian Fellowship. I'm your host, Lara K. Kiser, and together, we'll be inspired by our guest stories, tackle big questions with experts in the field, and walk together in following Jesus at the intersection of faith and nursing.

Nursing. So with that, I know based on studies that resilience can help them cope. It also helped nurses regulate their emotion. It protects them against burnout. And it also helped provide quality and safe care for patients, which is the ultimate outcome of what we wanna do.

Sometimes life throws really tough situations at us that push us past what feels like the end of ourselves. How could we possibly flourish in those seasons when it feels hard to keep putting one foot in front of the other even? And most importantly, where is Jesus when everything feels like it's falling apart? Today's episode is part 1 of my conversation with Dr. Santhiny Rajamohan on the topic of resilience in nursing. She's gonna unpack for us what it looks like to move forward with Jesus in hope and perseverance in the hardest of times. Her framework for how to do this is an acronym called REST. Each letter, R, E, S, T, stands for one of her 4 pillars of practicing resilience. As you hear from our guest, keep an ear out for what each letter stands for and how to practice each pillar. Welcome, Dr. Rajamohan. Thank you so much for joining me. I'm really excited to hear some of your wisdom and stories today.

Well, thank you, Lara. I am so grateful to be in this space to share my passion with you. So thank you for taking time.

Thank you. Well, could you just start off with a brief brief introduction of yourself, who you are, where you're situated in the world?

You know, I just want you to take an imaginary trip to an island called Sri Lanka where I was born and raised. It's an island, so think about all the tropical birds, fruits, anything you can think of, and, even having peacock as your pet growing up. Imagine that life. So that is how I grew up. God's favor and blessing were on our family. We were well known in the community. My parents were in education. My dad was a principal. My mom was a teacher. They were very much hardworking, loving, committed parents, well respected in the community, and we were trained to respect our parents.

Right? And they also valued education. So they had high expectations for me. I'm one of the 4, youngest of 4. I was chosen to go to medical school.

So that is how I grew up. Now in my role, I serve as the chief nurse administrator and professor of nursing at the University of Northwestern Saint Paul, Minnesota. I graduated with my BSN from Robert Sussan University in Rochester, New York, and also my master's in nursing from Saint John Fisher University, and my PhD from University of Buffalo. Throughout my nursing career, I held several positions in different health care settings. But in the last 13 years, I've been in higher ed.

Wonderful. Thank you so much. And this podcast is all about following Jesus in nursing. So I'd love to hear what are some key moments from your life that led up to you going into nursing. You talked about medical school, so I'm curious how you got into nursing and how you became someone who follows Jesus.

Absolutely. You know, I grew up in a family where my mom was a Christian. My dad was from a Hindu background, but he became a Christian when he got married to my mom. I grew up in that faith, reading the Bible, going to church. And, early on, I developed that connection with God. I would say around 8 or 9, I would always, like, read the Bible. I'm always interested in listening to Bible stories. But, unfortunately, where I grew up, the beautiful island I was describing, we had a civil war that started in the early 80s due to ethnic conflict, and discrimination. I was in the minority group, Tamils.

So that was my native language. There were a lot of abuses by military. Even Indian government came to help at some point, but they took advantage of the minority. I remember having a running back. In the middle of the night, when we hear shooting and bombing, we'll just run to the jungle to hide. And then later on, my parents ended up building a a bunker for safety. We lost a lot of friends and, relatives because of that. And, you know, Jeremiah 29:11. That's something early on I memorized, you know, through all these hardship. Like, God has a plan for me.

Like, what does that look like coming, and living through the civil war? My family actually relocated quickly to India in 1987 because that was the closest country that we could go with the visitor's visa. And there, God did a miracle. We ended up going to a nondenominational church where I learned scriptural baptism. So I was in my teens. I rededicated my life to Christ, God, the water baptism, and we did street ministry. I grew closer to God. That became my coping for life challenges at that time. And then we had to go back to Sri Lanka to wait for visas to immigrate to Canada because that is where my parents wanted to take us because they want us to have better future and a safe place. By then, I'd been to 3 different high schools in 2 different countries and cities.

So, you know, when we ended up coming to Canada in 1990, we started going to a church where we met someone. His name is pastor and Dr. Lysander, who took interest in our family and told us about Robert Wesleyan University. He was one of the board of trustees. This is where God's really divine connection happened. And the next year, me and my sister, Nan, ended up coming to Roberts to pursue our bachelor's degrees. I did not think that going into medical school was even an option, so I chose nursing because I figured that's close enough to, you know, being the second best choice. Right? So that is how I ended up choosing nursing, and I even thought about becoming a missionary nurse at some point.

Wow. That is an incredible story, and I am really glad that we are talking with you about resilience in nursing because it sounds like your even your childhood, you experienced a lot of resilience, and you've been through a lot. So thank you for sharing about that. Yeah. So you've written a lot and talked a lot about resilience in nursing. Could you just, before you get into what it is and how we practice it, could you set the scene a little bit for why developing resilience is such a high priority for nurses right now?

Absolutely. You know, before I talk about nurses, I just want you to know, like, my own background of bouncing back from adversity or challenges, which is what resilience means, really pushed me towards this work. Right? And, you know, the scripture from Psalm 34:18 where the Lord is near to the, brokenhearted, and he saves those who are crushed in spirit. That was the soul, near and dear to my heart when I was going through my undergrad studies where I didn't know the language.

I didn't know the culture. People couldn't even say my name, Santhiny. They all just gave me gave me a name. Sandy became my nickname. I didn't have any family here in Rochester, and, it was really difficult, but I ended up growing closer to God because I was in a Christian school. And I had to learn how to bounce back. Right? I didn't have an option to stay down. So I think my fate became that strong foundation for me.

So when you're talking about nurses, I want you to know, nurse burnout is such a huge issue right now. They are struggling, with stress and burnout. I think the stats right now is that 100,000 nurses left the workforce during the pandemic and expected to have this massive exit, even up to 2027. 90,000 or almost 1 fifth of 4,500,000 total registered nurses, they are intending to leave. This is based on a national survey because of the stress burnout in retirement.

I mean, can you imagine how threatening that is to the nurse, the health care system altogether? So, we know nurse resilience is so critical. I mean, resilience is important to anyone, but when a profession is struggling to this degree, how do we make this as a high priority? Because, without that, it is difficult for people to cope with and bounce back from these challenging situations. Right?

How do we help them to navigate this hardship in a way that they can find a renewed purpose and meaning? So with that, I know based on studies, that resilience can help them cope. It also helps nurses regulate their emotion. It protects them against burnout, and it also helps provide quality and safe care for patients, which is the ultimate outcome of what we wanna do with helping our nurses work through them. That also helps them cultivate teamwork and supportive work environment. When we do that, it help them to develop themselves personally and professionally why this is important to nurses.

Yes. Thank you. So really quick, I just have to ask this question because also we have a lot of student nurses listening. So you're sharing some of these stats of a lot of people leaving the profession.

Could you just speak really quickly to those students who are right now studying to go into that profession? I would find that kind of intimidating. Like, oh, I'm studying to become a nurse, and a lot of people are getting discouraged and burning out and leaving that profession. You know? What's gonna keep students continuing to study and continuing to pursue the profession of nursing?

Absolutely. That is a scary thought, isn't it? I think it may be helpful if I share a little bit more about my personal journey and how I got to this point for students to really understand the context of how I ended up developing this model. If that's okay with you, let me just tell you. You know, when I started, anywhere I was the only student of color, woman of color, faculty of color. I was in the minority group, and I did not even think of that. I was very naive, but I've been through some unfair treatment, some discrimination issues. Just to give you some specific example, I would be left out of some invitation when everybody else got an invitation for a special meeting or even, passed up for promotion, devalued about ideas, disrespected, and things were shut down even in a public meeting. What I said was ignored. So these are some of the things that I was living through, and I didn't understand why.

It was really difficult. But going back to my early nursing career, I just have to tell you, when I made the first and the last major medical medication error that happened during the first 6 months of my nursing practice. I ended up giving my patient a double dose of chemo. I mean, that's like a death sentence for somebody with the immunocompromised body, right? And I thought my career was ending. I just didn't know what the future would hold.

But God made me realize that I made a mistake. Nobody found out but me. As soon as I did the administration, I knew I did something wrong. So I went to my charge nurse, told her, and, she made me call the doctor. She made me go and talk to the patient that about my mistake, and I didn't know how to do that.

Remember, I was just out of college, right, my first 6 months of practice, and I was almost in tears trying to hide that, going to this patient, trying to explain what happened. And I thought that's it. They're gonna sue me. I'm done. I probably have to now go back to Canada. But you know what really helped me that time is the kindness the patient and his wife showed me. They forgive me. They just were very kind and graceful. And, of course, after that trip was over, I just didn't wanna continue with nursing. But I called my mom.

She's the most spiritual person I know. She's actually in heaven with the Lord. She she died due to stomach cancer in early 2000. So at that time, she was alive. She prayed for me, and I was so grateful God helped me through that season of uncertainty.

Thank God the patient was stable. And I learned a significant lesson not to rush, but to always double check, you know, before giving meds. But when I'm feeling like a victim, especially the those other examples I was sharing, when I feel, you know, that I'm disrespected or devalued and people don't care, quitting would have been the easiest things for me. Right? Like, it doesn't take much to quit something. It takes a lot of courage to stay in that situation. Right? So I prayed to God to take me home. There are times when I was treated in such ways.

I'm like, God, life shouldn't be this hard. Can you just take me? Like, I wanna disappear from this end. You may think that's like, okay. I was suicidal. Maybe. But I wasn't gonna plan something to end my life. I know better. Like, that is not something that God will be pleased with, but I know I can gain the strength from him. Right?

So I became much closer to God, and that became my coping. So, also, deep down, I did not wanna give up, on God, my parents' dream, and also the nursing profession. Like, I worked so hard to get there. Right? It wasn't easy going through nursing school.

So all that to say, you know, another part of me is, like, I did not want to give the abusers the upper hand. And if I quit, they are going to get the victory. Right? Something in me did not want that to be the case.

That faith journey continues so that I continue to learn and work through more of those challenges, and my prayer life became more of conversation with God. I'm always having this conversation in my head with him. So my prayer life is much different because I'm in constant communication with God. I don't know how else to do life. So that became my hope and my strength and coping through all of that.

And then I got involved in other accountability things, having, you know, people in my life, that are prayer partners or leading some prayer group or doing book study with, you know, ladies that have like mindedness, you know, to have a focus of growing in the Lord. So that also allowed me to reflect on God's purpose and calling which helped me to focus on here and now. So, I would say to the nursing student or nurses, it matters how we think. Right? Remember the Scripture from Proverbs 23:7.

It says, for as the man thinketh in his heart, so is he. So everything we think about our self matters. And I also like this quote from Thomas Edison. He talked about how he has not failed. He just found 10,000 ways of something that won't work. So even when doubts happen, shifting our thinking in a way that if God called you to be in a nursing program, to become a nurse. And you know that deep down, when you're hearing all these statistics, yes, it is scary, but we need to trust God that he's gonna give you what you need to get through the program. Right? So I hope that would be an encouragement to them to really, you know, work through and learn through that. Does that help?

Yes. That is so helpful, and I really appreciate you sharing personally from your own life and experiences because that, I mean, that experience sounds so hard and hard to share sometimes. So thank you for for being willing to share that part of your life with us. Well, I would love to get into what resilience is and how you do it. So when you use the term resilience, what is your kind of definition and framework that you're looking at?

Resilience means, it's the mental ability to seek value and meaning in life's hardships by embracing them and intentionally growing holistically, allowing one to persevere with hope to a functional state instead of giving up. So that is my own definition of what resilience is. And the framework I came up with is called REST. It is a pathway to becoming resilient. Each of the letters in the word REST has different pillars, and different pillars have different concepts.

So R is a relationship. Not only relationship with God, but also relationship with self and others and how that actually helps strengthen and help us grow our resiliency. And there are definitely signs to back that claim as well. E is for exercise, for not only our body, but also our brain, mind, and spirit. How to bring balance of exercising. All of that so that can actually help strengthen our resilience. And then S is for self compassion or soul care.

We know from data that people who are more self compassionate are more resilient. So we need to find out how we care for ourselves. I can talk about that more later. And then, T is for trusting God's timing when we are going through these hardships and how that helps us to transform our thinking that would lead to action that we can take to move us forward. Right? You know, for me, the REST means peace.

Thank you. So this is a great framework for anyone to use, and I appreciate that you have sort of made it. It includes God, but it also includes, you know, self, the body. So anyone could use this model of rest, but I'm curious as a follower of Jesus, what strength or perspective does the Christian faith uniquely offer in developing resilience?

Absolutely. In order to answer that question, I think it's important we think about what our relationship with ourself truly means. You know? To get that clarity, I would ask a question. On a scale of 1 to 10, 10 being the best relationship you can have with yourself versus one is a horrible relationship right now.

I don't even think of any value of myself. Where would we place ourself? Right? So that's the self assessment question. So how are we getting along with ourself?

What does that mean? What does it even mean to have a healthy relationship with myself? And do I matter? Especially when knocked down by life circumstance or hardship, when you're feeling devalued or disrespected, whatever the case may be. Does it even matter?

What is the purpose and what is my calling and how do I pursue my purpose in the midst of all of that? Right? So for that, it's important that we recognize we need to continue to lead. My value comes from my relationship with God. Right?

So I can't have value because I have my PhD. You know, that's a credential I earned with God's grace, but that doesn't give me value. Right? My value comes come from who I am in Christ. So that is so important.

Think about the time you really felt rested. What were you feeling? Was it a rest from work, worries, anxiety, stress, trouble, or physical labor? Was it when you were on vacation? Was it external or internal? Think about that, and I'm sure your answer would fall under 7 types of rest. It's physical, mental, sensory, creative, emotional, social, and spiritual. So just to give a context, everybody knows about physical rest. Right? When you don't have to do much and you can sleep all day, like, that's your physical rest.

And, also, you can do some exercise. Right? Yoga, stretching. Now sensory is like us unplugging from all the electronics to get that sensory rest.

Emotional rest is something being authentic to be able to share your feeling without holding back and to be yourself. Right? That's emotional rest. Social rest is, being with people that are positive and supportive. And, creative rest is something that we use our nature, God's creation and being outdoors, that give us that creative rest. And then mental rest is truly the scheduling time and break for us to just take a break from everything and to truly be present, the mindfulness of that. And spiritual rest, of course, is prayer, meditation, any kind of service we do in the community, in order to serve God, you serve others. Right? So consider that, and we'll come back to that question at the end of our time here.

But for me, I think I mentioned rest means peace. So even looking at the Scripture, what's God's peace all about? Like, John 14:27 talks about peace I leave with you. My peace I give unto you, not as the world giveth, but give I unto you. Let not your heart be troubled, neither let it be afraid.

That was just so powerful to me. Anytime I feel that I'm in turmoil, my mind is not at rest, I go back to that Scripture to remind me God has already given that peace, and I have to claim that. Right? But peace from Jesus also give us rest and stillness in our heart. So getting to that place sooner is helpful.

Not only that, that also gives us inner confidence and hope. It gives us the ability to thrive and bounce back, which is literally what resilience means. So having Jesus in our heart is really what matters. I love this quote from an unknown author. It talks about peace.

It does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and still be calm in your heart. So it's important that we get to that space sooner than later. Right?

In order for all of that to happen, we need to become self aware. So the relationship with our self matters because when we pay attention to our feelings and make time to reflect on that, not to ignore, because remember, ignoring our feeling is not gonna make it go away. Right? When you're angry, you go to bed angry, you get up, your anger isn't gonna go away. Right? It's still gonna be there until you deal with it. So, hopefully, that answered your question.

Yeah. That was wonderful. Thank you. So I'm curious. I wanna ask your advice for a couple of different groups of people.

So one is maybe people that have power to make systemic and cultural changes in the health care spaces. Maybe they're in administration or a floor leader or instructor. What is maybe just one step that they can take to improve resilience for the nurses under their care and for themselves?

Sure. That's a great question. So supporting nurses or students means that we need to be very intentional cultivating a supportive and nurturing and empowering safe environment. That is the foundation of anything we can do to support nurses or students. Right?

And to have an open and honest conversation with individuals and teams. You know, when you create that safe environment that's nurturing, the communication would naturally happen. Right? And then being intentional about gratitude and to be thankful for the team and even for the students being in the program. I know higher ed, we have been challenged. Not many people are pursuing nursing anymore because of all the reasons we talked about. So how do we show our gratitude to those who are in the program? Right? We are so grateful that there are students still coming and wanting to be nurses. Like, how do we show that gratitude to them?

Right? Now, I had to get to that place of appreciating my calling to serve my patients and students, more than the situation I'm in. Right? Even though I'm in a challenging situation, I had to intentionally become more grateful because my calling for my life is much bigger than the circumstances I was living through. Right?

So how do we foster that gratitude? When we do that, actually, believe it or not, it also help cultivate resilience. When we cultivate resilient, it help us to cope with adversity. Right? It help us to improve the holistic health of our nurses or students.

You know, we know study support. It reduces symptoms of depression and anxiety. It lowers the stress and strengthens our immune system. Think about, like, staying healthy. Right?

It's going back to us taking care of our people that got trusted in our care, right, in a way that's just meaningful and supportive. And it helps when we have that gratitude environment. It helps improve outlook in life. Even when they're going through negative things, they're gonna have an optimistic outlook. Like, looking at a glass half full versus half empty.

Right? It helped them regulate their emotions better. And, as a result, they'll have a better self confidence. Ultimately, it's gonna help them increase job satisfaction, the morale, whether it's in the program or in the work environment, and, also, they are motivated to keep going, right, even in the midst of challenges. So it's so important the leaders create that place of gratitude, to cultivate that and to find ways to encourage nurses and students, right, in a way that it's meaningful.

Not meaningful to them as leaders, but meaningful to the actual population you're serving, whether that's students or nurses. Maybe I can give you one example, as an educator when George Floyd was killed, he was, what, 46, and then he was killed by a cop who was 44. That was in May 2020 that happened. So I was teaching few classes, and one of the classes I was teaching that week had 50% of my students were students of color. And, when I saw them, it was actually in a synchronous Zoom space.

They were all, like, beaten down. We weren't going to talk about what the content was that day. When I saw that, you know, taking the pulse of the class, I just stopped. I said, let's talk about it. Let's share what's in your heart. That went on for an hour. We ended up crying and praying, and we became united in the justice advocacy we have to do for each other and how to navigate that space. So that's one example if you're an educator just to feel your classroom. Same goes for nurse leaders and managers. You come in.

Your nurses are looking pretty down, you know, even taking, like, 5 minutes to listen to them and find out what's happening. So we need to become the change. Right? And value everyone. We can be very intentional valuing people even if we don't like them. Right? It's like love is a decision. We don't have to like people to love them. God called us to love humanity. Right?

We need to listen to understand and not to judge. And then really getting to know each of your team members to know what does caring means for them. You know, sometimes it's just, hey. You're doing a good job. Thank you for coming in early. Thank you for staying late. Right? Those things matters to nurses. And that needs to be an intentionality that needs to happen every day to build them up. And, not only that, you know, it's hard for nurses to stop and care for themselves.

So the management need to be very intentional about planning those opportunities for self care activity. Even if it is few minutes in that given day, is there a space for them to go and just take a little break? Right? Do some meditation, praying, or walk outside for a few minutes. And then ask the team what's going to be meaningful. And then listen to their feedback and make that happen so that they can really build a team, and have that teamship going, right, in addition to everything else we just talked about. Does that help?

That was wonderful. There's so much in what you just shared. I really appreciated your story about seeing the impact of George Floyd's death on your students and taking the time to check-in with them and see how they're doing. I think that is very insightful and requires us to take a pause and look and really see the people in front of us. I think sometimes it can be easy to just get in get it done mode, and, oh, we have so much to accomplish today. We don't have time for this. We have an agenda. We have a curriculum to get through. And instead of realizing that there's no point in, you know, trying to push through if people aren't with you, if they're emotionally spent, they need to take a pause, and that's more important than anything else that, you know, needs to get done, quote, unquote.

Absolutely. And you know what? When they are not emotionally present, they're not gonna learn anyway. So who are we getting getting through a lesson that you have planned? So it is important that we do pay attention and pause.

Yeah. And gratitude. I mean, gratitude and affirmation go so far. Like, I think you shared, that you're the baby of your family too. I'm the youngest in my family, and there's just something about, like, someone older, you know, an older sibling or a mentor or someone that you look up to, a supervisor, even just one sentence of, like, true gratitude, not just attaboy, you know, good job to say that you've, you know, done a good job.

But true affirmation, like calling out something that I did well and being giving specific appreciation for that. It just makes your heart sing. It just makes your, you know, your walk feel like you're floating a little bit through that. And it's it's such an easy thing to give away. I wish everyone, you know, give away more affirmation and gratitude.

And I would imagine that would be such a an easy thing to do to bolster nurses when they're, you know, going through a lot of hard things in a daily shift.

Absolutely. Totally agree. And it's free. Right? Yeah.

But it is an issue, but smiling is free. Just saying, you know, everything you're saying is just, definitely encourage them. It also encourages you as a leader, you know, when you see smiles on your teams.

So what is resilience? Dr. Rajamohan said it's the mental ability to seek value and meaning in life's hardship by embracing them and intentionally growing holistically, allowing one to pursue with hope to a functional state instead of giving up. I love this definition and love these 4 pillars that she gives us for practicing resilience. So did you catch the 4 pillars? As I read them, reflect on which one comes most easily to you in this season and maybe which one is a little harder.

Here's the 4 pillars. R, relationship with God, self, and others. E is exercise. That's for the mind, body, and spirit. Self compassion or soul care is the s. And then t, trusting god's timing. Keep an eye out for the rest of my conversation with Dr. Rajamohan in our next episode, and check the episode notes for her JCN article on resilience and rest as well as NCF resources for minorities in nursing. If you'd like to keep growing in resilience, here's one super easy next step that you can take. Join us for our next journal club meeting. The topic just happens to be, get this, praying the Psalms as a strategy for resilience.

How perfect is that? You can catch the live meeting on Thursday, February 8, 2024 at 7 PM CST zone. Or if you can't make that time or you're listening to this after that date has already passed, you can still access the event recording and even get professional development credits for it through your NCF membership. Speaking of which, don't forget about your $10 off of membership at ncf-jcn.org using the coupon code following. Hey, thanks for joining us for another inspiring episode of Following Jesus in Nursing.

We hope you've been encouraged and equipped in integrating your faith with your nursing practice. Be sure to check out our show notes for info about connecting with Nurses Christian Fellowship as well as links and resources mentioned in today's episode. And remember, as you go about your work as a nurse, you are not alone. Jesus is right there with you guiding your steps and using you to bring healing to those in need. Thanks for listening to Following Jesus in Nursing, and may your faith continue to be a light in the world of health care.