Department: Think About It
While preparing the continuing education feature for this issue, “Prayer in Clinical Practice: What Does the Evidence Support?” by YeounSoo Kim-Godwin (pp. 208-215), I thought are the clinical suggestions for prayer with patients helpful? Could a nurse at the bedside, a student learning about spiritual care, or a nurse educator teaching a class find realistic guidance about prayer from the article? I want information offered in JCN to be practical. JCN content also should be professional; nurses should find evidence for best practices. Most importantly, information should be biblical, consistent with Christian faith.
When presenting content on issues highly significant to Christians like prayer, I sometimes struggle trying to determine how professional and biblical guidelines mesh. Throughout Scripture, God's people are invited and instructed to pray continually about everything (i.e., Deuteronomy 4:7; 1 Kings 8:22-61; Psalm 5; Philippians 4:6; 1 Thessalonians 5:17). Jesus told his followers to pray, and he prayed much (Matthew 5:44; Mark 6:46, 14:32; Luke 6:12, 11:1-13). Clearly, the Bible guides us to pray for others, which logically includes our patients. Professionally speaking, for author Kim-Godwin, prayer with patients in her first job in South Korea was a natural and expected part of nursing care. Then she learned that in other cultures “nurses could be reprimanded, penalized, or even suspended for praying with a patient” (p. 209). So, our natural tendency as followers of Jesus should be to pray, while in professional practice prayer is culturally dependent and literature suggests prayer with patients should be approached cautiously. How do we blend professional and biblical directives in practice?
In my nursing experience (all in the United States), I've worked in cultures where prayer was not natural (i.e., I was concerned about being reprimanded), and in faith-affiliated hospitals where spirituality was more openly acknowledged. Whether prayer with patients was culturally acceptable or not, I discovered that attending to my own spirituality is fundamental in thinking through prayer with patients. I study spiritual care literature to be aware of suggested guidelines for prayer with patients (see Table 1 p. 214). Over time, the guidelines have become a gestalt for me. In brief moments of time with patients, I simultaneously think about presence, assessing and respecting beliefs, and so forth. But a huge component is the still small prompting of the Holy Spirit. If I have tended to my own spirituality by spending quiet time in Bible study and prayer before I go to the hospital, I am less apt to miss the signs that point me to patients' spiritual needs. I don't know that I pray more with patients, but I do know I am much more in tune with the God we pray to, the One who knows the deepest needs of my patients.
Last week, an extremely distraught patient was transferred to my care at 9:30 p.m. As I helped her put her things in her room and take a shower, I listened carefully, offered presence, and tried to be gently reassuring. Her anxiety remained high, so I gave her 2 mg of Lorazepam (Ativan) by mouth. About 40 minutes later when I anticipated the medication would kick in, I asked if she thought lying down would help. She said yes, so I encouraged her to get in bed. To my surprise, she fell to her knees at the side of the bed, clasped and raised her hands to her forehead, and began softly voicing words and sobbing. I dropped to my knees beside her, waited a few moments, and then whispered, “Are you praying?” She shook her head yes. I prayed silently for her and for wisdom about how to respond as I quietly watched her distress. After a few minutes, I asked, “Would you like me to pray with you?” Another nod. “Do you want me to pray to God and his Son Jesus?” She nodded vigorously in affirmation and I prayed a brief verbal prayer asking God to help her.
Moments later, the patient's admitting nurse said she forgot to tell me she had made a chaplain referral because the patient was a Christian and wanted to talk to someone. I laughed to myself as I thought about how God knows what he is doing. He will place me in the situations where he needs a nurse who will pray with a patient.