Hope is the thing with feathers
That perches in the Soul
And sings the tune without the words,
And never stops at all
Emily Dickinson
One of Jean Watson's Carative Factors is the "instillation of faith and hope." I have really been thinking about this because it sometimes seems impossible to do. We take care of children with cancer. Even if a child is diagnosed with ALL and we tell the family, "it has a great cure rate! It is the common cold of all cancers! If there is one kind of cancer to have...this is it!" the family still feels a desperate sense of despair. Their child has cancer. And while telling them the cure rate and other encouraging statistics it is not necessarily offering them the kind of hope that can help them heal and cope.
Jean wants the nurse to honor the hope that comes from our patient's spirituality or religion but at the same time we need to be able to honor our own belief system. It is our own faith and hope that we need to sustain ourselves so we can help those we care for find their own. Jean says, "One of the ways we feel hope is to offer hope to another. Often we discover that in this moment, because we are here we are the hope; we may become the hope for someone who is isolated, alone, abandoned in the prison of his or her despair and illness, fear and suffering...we may be the one who makes the difference between hope and despair in a given moment." When I tell people I'm an oncology nurse their immediate reaction is, "how sad" or "how depressing" when in reality I find it so incredibly fulfilling. I leave work feeling like my cup has been replenished. I restore my hope by offering it to others, by opening myself up in that way I am completely fulfilled. It is a mutually beneficial relationship. I don't feel drained at all.
Interestingly faith and hope have been a part of healing before medicine was ever included. According to Watson, "Hippocrates thought an ill person's mind and soul should be inspired before the illness was treated." Can you imagine? Before we give that first dose of Vincristine, making sure we inspired our patient's minds? What if that was a column on the road map? Watson also says that "in ancient Egypt, the priest and the physician were the same person." No more residents, no more attendings...just Josh Whistler (our amazing chaplain). Talk about the belief that faith and hope had in healing, that's putting your priest where your medicine is. Pretty incredible...
In an article by, Laurance Johnston, Ph.D. there are several examples of the spirituality and healing connection. According to the article, there was "a controversial study carried out by cardiologist Randolph Byrd (Southern Medical Journal, July 1988), nearly 400 heart patients were randomly assigned to either a group that was prayed for by a home prayer group or a control group. This was a methodologically rigorous double-blind study designed to eliminate the psychological placebo effect. In such a study, neither the patient nor doctor knows who is receiving the intervention (i.e., prayer). Patients who received prayer had better health outcomes, including a reduced need for antibiotics and a lower incidence of pulmonary edema." The article also discussed Prayer researcher, Jack Stucki, and his "double-blind studies evaluating the effects of distant prayer on the body’s electromagnetic fields. In these studies, the electrical activity in both the brain and body surface were measured in subjects in his Colorado Springs laboratory. Nearly 1,000 miles away in California, spiritual groups would either pray or not pray for a subject. The electrical activity measured in the prayed-for subjects was significantly altered compared to controls." After the little research I have done I've realized I am not helping my patients and their families reach full healing potential without addressing their spiritual needs for faith and hope.
Jean Watson said, "The presence of a caring professional may be a source of enabling, sustaining, and honoring the other's belief system and source of hope." I have been taking care of a family that is Islamic. This is very different from my own spiritual upbringing rooted in Christianity, yet my interest in their faith helped to deepen the bond of trust between us. By asking questions I was providing this patient's mom with the opportunity to talk about the source of her hope, her faith. And by sharing that with me she was able to renew it in herself. Not only did I learn a lot about Islam but I was able to develop a deep connection with this mom. Her child, too young to take part in the discussion, observed his mother and me interacting. By watching the trust and bond grow between his mother and his nurse he was able to begin trusting me as well. This allowed me to get better and more thorough assessments because he allowed me to place my stethoscope on him, allowed me to palpate his abdomen...because he trusted me which in turn provided safer and more comprehensive care. This was a mutually beneficial relationship; I enjoyed learning about a different religion and different culture and enjoyed sharing the American culture and language with this patient and his mom. We were able to connect on so many levels. I left work feeling fulfilled and looking forward to another day, another opportunity to share hope and faith. According to Watson, "In Caritas Consciousness, the nurse honors and seeks to discover what is meaningful and important for a particular person. The person's beliefs are never discarded or dismissed as insignificant in the treatment and caring process. Indeed, they are encouraged, respected and enabled as significant in promoting healing and wholeness regardless of medical diagnosis, situation or cure outcomes." How many times have we entered a patient's room to see a cross on their bed or an angel hanging from their IV pole? Sometimes it is uncomfortable to address these things, yet it's worth it. If Hope comes from offering it to others we need to provide that opportunity for our patients. Allow our families and encourage our patients to talk about what it is that gives them hope.
