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 Kay Kaiser, and together, we'll be inspired by our guests' stories, tackle big questions with experts in the field, and walk together in following Jesus at the intersection of faith and nursing.

But that's the whole thing about spiritual care. When your spirit touches their spirit, when the Holy Spirit of God works through you and touches their spirit, it undoes us. It melts us. It frees us.

Welcome back to season two of Following Jesus in Nursing, where we're taking a deeper dive into spiritual care. Today you'll be hearing part three of my conversation with our director, Dr. Kathy Schoonover-Shofner. But before we get to that, I do have some exciting news for you about an upcoming event that Kathy and I will be hosting.

We would love for y'all to join us in this conversation about spiritual care. And I'm guessing that as you've been listening to this season, maybe you've had some questions or some stories coming to mind around your own experiences with spiritual care in your practice. So we'd love to have you join us for one of two Zoom gatherings coming up in June. We're offering a couple different time options so hopefully one of them will work with your schedule. They'll be on Monday, June 2 and Wednesday, June 4, both at 7PM Central Time.

For more information and registration, please visit tiny.ccdivewithus. You can also find this link in our show notes. We look forward to seeing you there. And now let's jump back into our conversation with Kathy.

Well, welcome back, Kathy. It's always good to hang out with you and have these conversations. So today, we're back in with a new topic on spiritual care, and I just love these words that you're coming up with, organically prepared. And today, we have fully integrated spiritual care. So let's get right into it.

What do you mean by fully integrated spiritual care?

Well, and I love that word too. It's so comprehensive. In nursing, we understand people are really fully integrated biological, psychological, spiritual beings, that our body, mind, and spirit are fully intertwined. What happens to our bodies impacts our minds and our spirits, and what happens to our spirits impacts our bodies. And so it's all a package thing together.

So it makes perfect sense to think about incorporating spiritual care into all of our nursing care. When we see the person physically, we simultaneously see them as spiritual beings. And we think about caring for their spirit as we care for their bodies. We care for their spirit as we care for their minds when we explain what's happening to them, when we do patient teaching. And so we really can't separate out care of the spirit because we see the whole person.

And you come to this realization in your nursing that spirituality permeates every encounter with every patient. And so fully integrated spiritual care is just kind of a natural thing because people are fully integrated beings. And in nursing, it's about promoting, maintaining, and restoring health. We have this focus on health and good spiritual care just facilitates health. It facilitates the healing process.

I think that spiritual care is a part of all we do as nurses. We also come to realize that it's a natural thing. It's not forced. It's not like, oh gosh, I gotta give spiritual care. And it's not separate from everything we do.

We see the spiritual in all we do. And I'm not saying that there's not a place for formal spiritual assessment, asking what are your beliefs, what's meaningful for you, what gives you hope. There's a place for formal spiritual assessment and spiritual intervention. And what we have often thought of as official quote unquote, official spiritual care, there's a place for that. But what we're trying to figure out here is that spiritual care is also just spiritually caring for patients, for families, and all of my nursing care.

That spiritual care is a part of all that I do. I'm touching their spirits. So that's what I am thinking of as fully integrated spiritual care.

Yeah, I love that. So where does this fully integrated spiritual care start? How does it happen?

Well, you know, we talked in our last episode about spiritual care starting with our own spiritual well-being, that we can organically prepare for spiritual care--we are spiritually alive and we're attending to our own spiritual well-being. We keep our relationship with God fresh. And as much as we can, we're in right relationship with others. So personal spiritual well-being is where it starts, that in and of itself--so I'm okay spiritually, or I'm working on my own spiritual well-being. And that facilitates this awareness of spirituality in others, of seeing their spirit, of seeing their spiritual needs, because I'm aware of my spirit and my spiritual needs.

We talked about when I'm spiritually okay, I can better offer myself to the patient in my nursing. And in nursing, we use the term active presence. My full attention is on the patient or the family member that I'm with in that moment. So I have this active full presence and I'm listening attentively. I'm closely paying attention.

Spiritual care really starts with listening attentively and hearing what the patient's really saying and what they're asking, maybe asking reflective questions. So when the patient says, What's happening right now? I say, well, Tell me more, or help me understand what you need right now. We're trying to understand the patient. And I pick up on that because I'm listening attentively and I'm catching the full meaning, the full nuance of what they're saying.

This being their spirit, I'm okay spiritually, I'm working on my spirit, and then I'm fully present with them. I'm listening attentively. In that moment, I might have a zillion things to do, but in that moment in time, I'm with the person and I'm not rushed. So my voice, my eyes, my body language doesn't say, I'm really in a hurry and I'm already out the door mentally, but I'm relaxed. I'm fully present with them and I'm using a calm voice.

And I'm thinking about, Who are you? What do you need? What are you saying to me? I think that's how spiritual care starts and how it happens. So I'm not in a hurry. Even though I'm really, really busy, I'm not in a hurry with you in that moment.

Yeah. Exactly. So that sounds lovely. I love the active listening, the presence. That sounds like a beautiful picture, but the reality is that nurses are really busy. So tell me more about this, Kathy. How is that realistic for busy nurses? How do you find time to do that?

I think in our minds, we need to consider that it's not about the amount of time that I'm spending with the patient, but it's about the quality of the interaction. So I can be actively present and listening attentively and carefully to you in a one minute interaction. Things can happen very quickly. They can also take more time, but it's not about, gee, I have thirty minutes to sit down and talk to you. Also, it's okay to say when needed, I need to go and check on another patient right now, but I'm going to come back and let's continue this conversation.

I really want to understand what you're saying and what you need. So don't think quantity, think quality about the interaction. And I think you can communicate connection, you can communicate caring, you can see a spiritual need, you can fully hear the patient in a very quick conversation. And if you need to come back and finish it later, it's okay. But the point is that if you've communicated to this patient, I'm with you. I hear you. I understand you. Let me help you. For Christian nurses, can I trust the Holy Spirit to do what he wants to do with my time and with my work? Like, God knows if I'm going into a shift, he knows I'm gonna have too many patients or too much to do, or there's gonna be a crisis.

But I think as Christians, can we consider, is it possible for God to organize our workday? Is it possible for him to accomplish the spiritual care for him to lead in an interaction? He knows what that patient needs. He knows what that family member needs. And so can he figure that out and organize that and leave me and do what he wants to do in a very small amount of time?

If there's more time and more time, I would say yes, God can do that. And my experience in nursing, I've experienced him doing that in very, very busy work days. And I've also experienced days that were maybe not quite as busy and I needed more time with the patient and God provided that. So it's leaning into the Holy Spirit and letting the Holy Spirit lead and guide, believing that He can set up those miraculous quick conversations. In the end, the big picture is this fully integrated spiritual care, this deep caring for the patient's spirit.

I'm actively listening, I'm carefully listening, I am intentionally present in the moment. I'm not distracted. I'm focused on the patient and I'm looking at them as the whole person, body, mind, and spirit. Yes, I'm attending to a physical need or I'm checking an IV or I'm, you know, I'm doing a dressing change or I'm doing care, but I'm thinking about them as a whole person. I'm actively listening. I'm silent and I'm listening and I can respond with good questions. And I think keeping in mind, I'm not trying to fix the patient or fix the situation in the moment. I'm just trying to listen. People so desperately want to know that someone hears and understands as listening to them and what they're needing, what they're trying to say, trying to get at what they really need. That's really integrated spiritual care.

So what's the story that patient's telling me? What's the meaning behind what they're saying or doing? So like, again, if a patient says, Nurse, how serious is this? Rather than saying, Well, you have an infection and we're treating you with antibiotics and we know we can take care of this, but this is very serious. Like maybe that's not really what they want to know.

So maybe, and yeah, they do want to know that, but maybe I say, Well, tell me more what concerns you're thinking about right now. What's going on? Try to open up an opportunity to hear more from them and to have this deeper conversation. What are they afraid of? What is it they really want to know?

Like, are they thinking I've got children and am I gonna survive? Or they wanna talk to me about their family, or they're saying, I'm afraid I'm going to lose my job. It's trying to get behind what's the real story. What is it the patient really wants to know? Or what is it they're really asking me?

And then that allows me again to get in touch with their spirit and what it is they're really needing. I don't know if that makes sense, but, you know, what's the real story? What's the story behind what they're really saying?

Yeah. I really like that. And it does require some patience and slowing down and being present. It strikes me as you're talking that you're talking about integrated care in terms of the patient is a fully integrated being. But it sounds like you're also talking about you as the caregiver are also, as the nurse, an integrated being in the sense that you're integrating your faith with being present with that person.

Because I would imagine when I've got a hundred different tasks going through my mind, it's so easy to think that I'm the one in charge or think that I've gotta get it all done, and it's hard to be present to the person in front of me because my mind is bouncing between them and the task that I've gotta do next. But I loved what you said about trusting that God is orchestrating your day, that he knows what patients you're gonna have, that when you integrate that faith piece of really trusting and believing that God is the one in charge that day and that He's directing our steps and guiding which patience we're gonna have and giving us space to be present, that he's gonna hold on to the other things while we are present and patient, and getting these stories from people.

And I think the cool thing about it, too, is I don't have to have all figured out and walk into the patient situation and be perfect. Like I can be really struggling and maybe I just take a breath prayer inside myself and say, Jesus, help me see what you see right now. Jesus, help me to just rest in this moment and really focus on this person. What are you wanting to say to them? What do you want to do?

So I can get help along the way, you know, like, God help me be present for this person and help me please, God, just manage and organize this and figure this out and help me hear what you're hearing. Help me see what you're seeing.

Yeah. I love love breath prayers, and I call those arrow prayers where you're just kinda throwing up a quick prayer before you walk into a room. Yeah. That's great.

Well, let's do a story. What example do you have to share about fully integrated spiritual care with us, Kathy?

Well, you know, I think admissions for me were always like, oh, I've got to get the assessment done. I've got to get this done. I've got to get that done. And I'm very focused on the nursing tasks and what we can do. And I remember this middle-aged man who was admitted to our behavioral health unit.

He had type one diabetes and hypertension, and it was a beautiful Sunday afternoon and he had supposedly had a suicide attempt and he'd overdosed on insulin. And once he was medically stabilized in the regular hospital, he was transferred to our behavioral health unit for mental evaluation. And, you know, you're always busy. You're trying to get work done. And I just remember thinking, I gotta get this guy admitted.

And we do a full physical assessment, a skin assessment, and, you know, we're just trying to make sure and document where the patient's at in this moment in time. And so this guy, he's like a very well educated, put together kind of businessman, but he was very angry about coming to behavioral health. He was belligerent. He kept saying he didn't try to hurt himself and he didn't feel like he needed to be there. He was very upset.

And so he really wasn't cooperating with me and answering my questions. He thought it was very stupid. But the situation was, he'd been taking insulin for several years. And so the overdose didn't seem accidental. How could he have messed this up? And his wife also was concerned and said he'd been under a lot of stress. And so she was kind of wondering, did he overdose on himself? Was this a suicide attempt or was this, you know, a cry for help? So I'm thinking I've got to get this assessment done.

I've got to get back to my other work. This man is very different from a lot of our behavioral health patients. If you have long term mental health issues, it can really impact your ability to work. Sometimes we see a lot of homeless people. So this guy's very astute.

He's well educated. He's well dressed. He has no prior mental health concerns, and he's arguing with me. And the more I tried to finish the assessment, he's getting very belligerent and argumentative. And finally, it hit me, what's going on with this man?

I'm thinking body, mind, spirit. I'm thinking I'm pushing and pushing to get done what I needed to get done, and he is not having it and not wanting it. And so I thought, why don't I just stop and think about what does he need? Because the story he's telling me on the surface is that I don't need to be here and this is ridiculous and this is stupid. So I decided to stop what I'm doing, stop the assessment.

And I put my laptop down and I closed the lid because I was trying to send a message to him that, let's stop. Let's just see what's going on here. And I remember pausing and taking a deep breath, and I looked at him, you know, trying to look at him empathetically and gently, and I tried to say in the most sincere voice I could. I said, Well, what's the most important thing I need to know to help you get out of here?

That's a great question.

And I remember he stopped, and he says, What do you mean? And I said, Well, I want to help you get discharged. I want to help you get out of here. And that starts with trying to understand what you need right now. And there was this long pregnant pause and then he started crying.

So he's turned from belligerent and angry. He started crying and it was like somehow getting the message that I needed to just focus on him and really get to what he really needed, really kind of undid him. You know, he has tears rolling down his face. And I remember waiting for a while with him silently and not trying to rush him and just what's going on in this moment. What's happening?

And then finally he started talking and he said, Giving that overdose was the stupidest thing I've ever done. I don't know why I did it. And then he looked at me and he says, I think I was just trying to figure out how to make life easier.

Wow.

And so he's undone now. He's talking to me and I wait a little bit and then I said, Maybe being here could help you start to figure some of that out. Maybe we could help you figure out how to make life easier. And then we went on with this conversation about what his stresses were and what he really was needing. And he was much more willing to engage in entering into behavioral health, you know, and getting admitted, cooperating with what was going on and trying to figure out what did he need in his life right now, because he had come to a crisis. He had overdosed himself with insulin. My point is, like, when I stopped trying to do what I needed to do and do my intake assessment, and when I thought like, how can I be fully present with this man? And I was trying to actively listen. I find, you know, what's the story he's trying to tell me because clearly something's going on here and he had overdosed it, but he's angry. I don't need to be here.

He's looking at other patients and realizing I'm not like these other people. When I did that, I was actually able to really fully hear him comprehensively. Like I was able to touch his spirit and enter into the situation with him and hear what he needed. And he realized this nurse really cares. She's trying to be with me.

And that totally changed the whole event for him. And as I recall, he was cooperative then, and he ended up being discharged within a few days and he started on therapy. He got into counseling with his wife. But that was one of those moments where we're pushing and pushing and pushing against each other. But by trying to finally be fully present with him and realize what I need and what he needs are two different things. Why don't I just stop and be what he needs and let him tell me what he needs.

Seeing this man's spirit and turning my attention to him instead of focusing on what I needed to do. To me, that's fully integrated spiritual care. That's trying to be open to what your patient needs and what they're doing. And I got what I needed to get done anyway, and I finished my nursing assessment and recorded it. I think to me, was a great example of trying to integrate spiritual care and seeing the whole person.

Yeah. Absolutely. So if I could just press into this a little bit. So you had this moment. This man is belligerent. It's frustrating. You're not able to get done what you need to get done. I think I and my fallen human self would just feel stubborn and want to dig in my heels and be like, no, you've got to follow this system that we have in place. This is a thoughtful assessment and we got to get this done. But you pivoted and were able to recognize a different way forward.

How do you see your faith coming in there and integrating with your nursing practice in that moment? How did Jesus help you make that pivot?

You know, in the hospital, we often think these are the rules, we've got to do this. You know, we take vital signs at these moments. We don't pull back and stop and see the whole patient and the whole situation and say, Hang on a minute, what are we doing here? What's the big picture? And so I think about that a lot, but I remember in the moment praying and sending a flashcur up and saying, Jesus, what do I need to do?

And then this thought came into my mind, stop doing what you're trying to do and see and ask this man what he really needs. You know, and in a way, isn't an admission assessment trying to figure out what they really need. I mean, in a way, wasn't I really doing what I needed to be doing as a nurse rather than, okay, I've got this form and I gotta ask this question and then this question and then this question and go through the lines of the form. Wasn't the whole point of it trying to figure out what he needed and what was going on. And, I mean, I really fully believe as a Christian nurse, like, if I'm walking with Jesus, I'm in the Word, I'm in close connection with God and I'm praying. Jesus can open my mind. There's more than one way to do this. I'm bullheadedly thinking, God gets the assessment done. God, you know, this man, I've got to do this. I've got to do that.

You know, that God can just press these, He can drop these little thoughts, like a drip of water in a pond that ripples out. You know, He can drop something in our mind and say, Hang on a second. Why don't you try this? And so I asked him and the Lord gave me that. You know, I actually was really surprised at the time that the man, I mean, I didn't expect it to totally undo him, but I think it was the message to him of, you know, he'd been forced to come to the mental health hospital, behavioral health.

He'd been, okay, I don't think he really wanted to kill himself. I think he just was really it was a cry for help. The insulin overdose, they were able to manage it and he was fine. I think it's like somebody saying, Hey, you're crying for help. What what is it you really need right now?

I was really kind of surprised when it undid him like that, but that's the whole thing about spiritual care. When your spirit touches their spirit, when the Holy Spirit of God works through you and touches their spirit, it undoes us, it melts us, it frees us, you know. It gave him the freedom to say, I really didn't want to do this. I'm really struggling right now. I need help. Because I got in there with him and I was like, no, I really want to know how to help you.

Help me know what you need. In healthcare, it's real easy to just say, We know what you need. And so we have to do this, this, this, and this to you. You have to do it at this time and you have to take your meds and you have to, you know, and it's like, wait a minute, what do they really think they need? How can we let them open up and get inside their spirit, inside their head, inside their situation and let them express to us what it is they really need.

Yeah. I love that. Thank you for sharing that. Well, any final closing thoughts that you'd like to share about fully integrated spiritual care today?

Well, I think keeping in mind that the Holy Spirit always knows what's going on and he will guide us. He will lead us. Yes, we need to study spiritual care. Yes, we need to understand spiritual assessment and think about spiritual interventions. But in the moment, you know, it's God working in the moment and us being willing to be open and we're intentionally present, we're actively listening.

Sometimes, do I fully care? Am I as concerned about this patient as I need to be? Well, most days I would like to hope so and think so as a nurse that I fully care about you. But if I don't, you know, help me, Jesus, to care in the way that you care. But realizing that Jesus loves this person so much and he really wants to help them.

Jesus fully integrates his spiritual care of me and he can help me care spiritually for others. Letting the Holy Spirit lead and guide us, being prepared ourselves in our own spiritual walk, our own spiritual well-being. We fully see, we fully hear our patients as we care for them, and then entering into that present moment to be with them. And what is the way that we need to be with them? And, you know, people respond when they realize that you truly care.

Oh my goodness, how they respond. It totally, you know, I can trust this person or I'm gonna be okay. This person's gonna take care of me. They care about me. I think that's huge.

Yeah. So this fully integrated spiritual care, again, this awareness that spiritual the spiritual aspect is a part of all we do. And we're touching people's spirits whether we realize it or not. You know, I could have touched that man in a bad way and just pushed and pushed and pushed and gotten in an argument with him. And I'm sure we would have had to call security and it would have been a big mess.

Or I can just say, well, what is it you really need? What's the story here to me? What is it you really need right now? I really don't want to envision what would have happened if I kept pushing this man. But I think by being spiritually attentive to him, what a privilege, what a joy that by seeing trying to see his spirit that I got to be the person.

I was the nurse, I was the psych person who connected with him and touched his spirit. And that was pivotal to help him begin a healing journey. When we think about the spiritual and we integrated into all we do, and yes, we're trying to do something else that has to do with a physical task, or patient teaching or whatever, but we're seeing the spirit and being aware of that and hearing their story and being present with them that we get to have these miraculous moments that help people begin healing journeys. Know, it's a miraculous work of the Holy Spirit. That's one of the coolest things about nursing is I get to be present with people and their greatest need. God can direct my questions. He can direct my care and God can touch their spirit and it can start a healing journey.

Yeah. You're talking a lot about presence and the word with-ness. You said you were with him and that with-ness is such a Jesus word. Jesus came from heaven to be with us, to be incarnate. He became a human and he's so present with us.

And I think that moment of pivot in your story, it felt like he was sort of battling against you. That question seemed to shift and he understood that you were really with him and in it with him, next to him. And I just think that's such a beautiful image of how Jesus is with us, how the Holy Spirit is with us.

Yeah. And the Holy Spirit can ask great questions of us. Yes. But yeah, I think this fully integrated spiritual cure is realizing that that it's a with-nness and what's really going on here and there's something else besides maybe the immediate task at hand.

Well, thank you as always Kathy This was just lovely and I look forward to our next conversation.

Yeah, thank you. I look forward to it as well.

To be integrated is to be whole. You heard Kathy describe integration and spiritual care as being fully present and attentive right here, right now, not scattered, not taking on different personalities in different contexts, and not pushing our own agenda. We become disintegrated when our mind is in a different place than our body and our heart. We disintegrate when our soul is malnourished, but we pretend like we're healthy. Or when we suppress and numb ourselves to compassion because the ache of caring feels too heavy.

In the grand narrative of the Bible, we see that we were created by Yahweh to be whole and integrated in the presence of the Lord. Sadly, humankind has fractured ourselves by rejecting God's leadership and relationship. We became disintegrated. And we see the results of disintegration all around us and inside of us as we rush around scattered, worried, fearful, or perhaps on the other side, overly confident in ourselves, independent and defensive. But here's the good news.

God, in his grace and compassion and deep love for us, pursues us and chases after us with mercy and kindness. It really is a beautiful thing. Through Jesus' life, death and resurrection, he continues to offer us a way to be reintegrated in ourselves, in our relationship with him, and with one another. Again, to be integrated then is to be whole. And it really means to just stop running away hiding and rejecting God's love for us, to stop and to receive what he generously gives.

Just as you nurse patients back to health, wholeness, and integration, Jesus is doing the same for you. He's continually offering you the guidance of the Holy Spirit to bring you toward wholeness and integration in him. So I invite you to pause wherever you are right now, whatever you're doing, take a few deep breaths, be still, and ask the Lord what it looks like for him to help you reintegrate and be whole in him.

Thank you for joining us for this 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. Don't forget to check out NCF membership at ncfjcn.org and use the coupon code following for $10 off. 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 healthcare.