CNM Carol Service - London

On Wednesday 19 December CNM held it's annual London carol service with Christian Medical Fellowship at All Soul's Langham Place.  Around three hundred people joined us to worship with carols and readings from Luke's gospel.  Sam Leinster (Emeritus Dean of the UEA Medical School in Norwich) gave an address focussing on the true meaning of Christmas - God entering into our world of pain and turmoil, to transform our individual lives away from selfishness and sin, reminding us that true change in the world starts with change in ourselves. Change that only God in Jesus, can bring about.

We would like to wish all our members, visitors to our blog, followers of our Twitter feed and friend of our Facebook Page a blessed and peaceful Christmas, and pray that the God revealed in Jesus of Nazareth would be present in your life, work and family over this Christmas season and throughout the coming new year.

Cardiff Carol Service

I have just returned home from the CNM/CMF carol service which was kindly hosted by St Marks church in Cardiff. It was a great evening singing carols, hearing a choir sing beautifully and sharing mulled wine and mince pies. Dr Michael Glenn spoke on the gospel of Luke highlighting various interesting points including Luke being a doctor himself. Dr Glenn closed by challenging us to bring to our reading of Luke's account of the life of Jesus the training that we have received in healthcare to judge for ourselves the account of a doctor who investigated everything carefully in order to provide an accurate account.

It was wonderful to be able to join together as healthcare professionals to celebrate the birth of our Saviour, and to be reminded me of the unity that we all share.

Thank you to everyone who was involved in organising such a lovely evening.

For those in the London area, we are holding another Carol Service with CMF at All Souls Langham Place tonight - you and your colleagues are most welcome to join us at 18:30 - mulled wine and mince pies afterwards.

Rose Ball - CNM Council Member

Partners In Care – Nurses Christian Fellowship International World Conference

CNM Delegation - L to R Rose Ball, Tim James, Liz Capper, Steve Fouch and Sue Allen

Try imagining what 300 voices singing and praying in dozens of different language sounds like.  Beautiful and strange, but it is, I think, a faint foreshadowing of what it will be like in eternity when ever tribe nation and tongue will gather before the throne of God. But that was what we experienced in the worship at the NCFI International Conference at the start of November.

Some three hundred nurses from over twenty countries attended the first International Christian nursing conference that NCFI has ever held in Latin America, including delegations from Spain, Nigeria, South Korea, Australia, Canada, the US, Norway, Peru, Bolivia, Columbia, Argentina, Costa Rica, Chile and Uruguay.  There were at least seven delegates from the UK – two from Nurses Christian Fellowship Scotland (NCFS) and five from Christian Nurses & Midwives (CNM is the member body of NCFI for England and Wales).

The opening evening set a very strong note for the conference, with the Chilean Minister of Health speaking passionately about the role of faith in Jesus in the best of healthcare, and that his government has put the right to good spiritual care into national law!  Patricia Bennar followed with a scholarly look at the Biblical idea of the ‘Compassionate Stranger’ as exemplified in the parable of the Good Samaritan.  Both the carer and the cared for in this parable are outsiders – but with which do we identify ourselves?

The theme was ‘Partners in Care’, and we looked each day at themes ‘Partnering with God’, ‘Partnering with Patients and Families’ and ‘Partnering to Change the World’.  Each day started with a Biblical exposition from Raquel Contreras (a Chilean pastor who ministers in the USA), and a professional session that looked at how these scriptural truths impact upon our professional practice.

There were two training tracks in the concurrent sessions – one on Leadership and one on Teaching Spiritual Care.  Both training programmes are geared at giving a distinctly Christian approach to developing the next generation of nurse leaders and equipping nurses to give competent spiritual care to their patients.  We are looking at how we can develop these further for members of CNM.

NCFI presented its Eight Year strategic plan from 2013-2021, and a new structure to take this forward. This includes the development of an Institute of Christian Nursing under NCFI that will develop professional development programmes for nurses and midwives with a strong Christian and professional ethos.  The first two resources are the leadership and spiritual care programmes, but these are seen as the starting point only, the idea being to focus on training trainers in regional and national fellowships with the long term vision of equipping Christian nurses around the world to be agents for change in the culture of care in their own nations.

CNM is very involved with the leadership of NCFI – CNM Council member Sue Allen has been developing the leadership training programme as part of the NCFI International Board, and remains on the board as part of the development team for the Institute of Christian Nursing, while Steve Fouch (CNM General Secretary) is European Regional Chair and European regional Board Rep on the International Board.  Former CNM Chair, Liz Capper was also, until very recently, on the UK Trustee Board for NCFI.  We see involvement with the international movement as a vital part of CNM’s ministry – sharing learning and experience and being part of a wider movement to bring a Christian influence and voice into our profession.

But the main joy of these conferences remains the fellowship with other Christian nurses from around the globe, and learning from their struggles and experiences more of what it means to serve Christ in caring for our patients (one of the main themes of the conference, from the opening address by Patricia Bennar to the closing plenary).

The next NCFI European Conference will be October 2014 in Madrid, with a students’ conference on spirituality and care in Lisbon in 2013.  The 2016 World Conference has yet to be confirmed

Nurses Christian Fellowship International Conference Days 4 & 5

Tomorrow we fly home, but what an exciting week we’ve all had!!! We have greatly appreciated the opportunity of being here and would definitely recommend that everyone come along to the Regional NCFI conference in Madrid in 2014, and the next NCFI conference in 2016 (venue tbc!).

This week Tim and Rose have been attending the leadership track, looking at the leader as shepherd, servant, scholar and steward. Dr Sue Allen (UK) and Dr Kamilini Kumar (USA) taught from the Leadership course that they have developed for nurses exploring the essential leadership role from a Christian perspective.

The excursion took place yesterday and was a wonderful time to relax and see some of the sights of Santiago.
The morning Bible studies have continued to be excellent, challenging and inspiring us to be more Christ like in our nursing practice as well as in our daily lives. Today we were looking at John 4v1-7, where Jesus meets the Samaritan woman at the well. The focus was particularly on verse 7 where Jesus asks the woman for a drink as He is thirsty. Focusing on this specific request led us to question how we can serve Christ by meeting the needs of those we come into contact with, in line with the verse from Matthew 25 v 40 “...whatever you did for one of the least of these brothers and sisters of mine, you did for Me”.

The UK has been represented well by excellent seminars by Jo Caisley, Tony Kemp, Huw Morgan and Steve Fouch. Jo presented on wise and responsible stewardship in healthcare. Tony and Huw represented PRIME speaking on disaster preparedness and partnerships in international medical education. Steve led two seminars, one on writing publications and challenges and opportunities with keeping the faith amongst nurses in the UK. All were well attended and received positive feedback – well done guys!

In addition Steve attended a three part training of trainers programme in teaching spiritual care from a Christian, nursing perspective. This programme has been developed by Amy Rex-Smith (USA), Tove Giske (Norway) and Grace Morillo (Colombia), and has been developed to equip trainers to help student and qualified nurses develop key skills in spiritual assessment, intervention and evaluation. We are already looking at how we might use both the leadership training and spiritual care training with members in the UK

Prof. Barbara Parfitt (Scotland) spoke on the last day on partnering with the world, using the WHO model (of Partnership through relevance, ownership and community engagement), in order to have a positive impact on global healthcare in the name of Christ.

Bishop Hector led us in Holy Communion to close, with a traditional Chilean evangelical call to worship... Who lives?JESUS!
to His name; GLORY!
to His people; VICTORY!

And on that note adios amigos!

Rosanne Ball

Nurses Christian Fellowship International Conference - Day 2 & 3

We have had another two exciting days out here in Chile; being inspired, challenged and enjoying multinational fellowship! Each morning we have enjoyed Bible studies. So far theses have been on Mark 2v1-12 and Mark 5v40-43, looking specifically at their implications for nurses.

God is so good at revealing in familiar passages new things that will change our practice. For example, in Mark 5v40 we looked at the way that Jesus cared for and involved families in His healing, and were challenged about whether we treat the families of our patients in the same way.

We then met together for professional plenaries, on Tuesday exploring the role of the nurse in partnering with God and on Wednesday exploring the role of nurses partnering with patients and their families. The two points that stood out were the importance of being yoked with Christ and therefore walking in step with Him, not rushing ahead or lagging behind but watching where He wants us to go and partnering with Him.

The second point was a reminder that we need to see our patients as children of God, remembering in our workplaces the verse “everything that you do for one of my little ones; you do it for me” (paraphrased).

This afternoon we went to visit a public hospital in Santiago, which was a fantastic opportunity to get a glimpse at how another country provides care. All the Staff at the hospital, including the patients and families were keen to welcome us and say hello. We were very impressed at the fingerprint recognition equipment used to log in and off shift, and received a talk from the Director of Medicine and saw videos about the evacuation of their hospital during the 2010 earthquake. It was interesting to note that the pressures we experience in the NHS, such as lack of beds, waiting times, particular winter illnesses and infection rates are just as much a problem in the Chile as they are in the UK. Other international delegates in our visiting party could also sympathise. It’s a worldwide challenge!

Right now we’re off to the Nursing Christian Fellowship International Forum – the slightly more boring but equally important part of the week!!!!

Rosanne Ball (CNM Member)

NCFI World Conference Day 1

The Chilean Way

TheNurses Christian Fellowship International conference began Tuesday (5thNovember) in Santiago, Chile, and for all of you reading this in the UnitedKingdom...it is hot here in Santiago with wonderful views of the Andes mountainrange.

Despitehaving only been to the Opening Ceremony today, we have already been blown awayby what we have heard and seen. The evening opened with an introduction by DrBarbara White (NCFI President), followed by a procession of the flagsrepresenting 350 delegates from over 30 nations. This reminded us that despiteall our different backgrounds and cultures we all had two things in common:Jesus & Nursing. Wow!

The moststriking part of the ceremony came straight away when Jose Alvear, director andpolitician from the Chilean Ministry of Health spoke of the need "to show Jesus in the midst of illness".This is so evident within Chilean healthcare that a law has recently beenpassed that states that every person has a right to spiritual care. Howmind-blowing is that?! In the UK it is common place to see spiritual care aspart of the nursing care plan for patients. However, it is not mandatory and inour experience is rarely seen being effectively put into practice. But we havejust heard a politician saying how important Jesus is in the midst of spiritualcare and that he recognises the effect of spirituality on patient recovery. WouldJeremy Hunt (Secretary of Health, UK), if he were a Christian, be able topublicly say the same?

Next weheard from Patricia Benner, author of the Novice to Expert, which has provideda model to many nursing institutions, across the world, with a tool to assesscompetency within nursing practice. Patricia spoke to us about the story of theGood Samaritan, challenging us to identify with the Samaritan and also thebeaten man in the pit. The importance of being a compassionate stranger in theimage of Jesus as the healer was very thought provoking as clinicians. Animportant point that Patricia made, which captured our minds was that if a nurse does not care about what thepatient cares about, then a patient will not feel cared for.

It's beena really exciting day...wish you all were here...we can't wait to update you onwhat God does the rest of this week.

Quote ofthe day: "We need to see that we are human beings helping other Human beings".

Written by: Rose Ball (CNM Member) & Tim James (CNMChairman). 

Nursing - Unchanging Values in a Changing World

A couple of months ago, a number of nurses met together at our regular London Refreshment Dinner where a retired nurse shared her experiences of nursing in the UK during the years of 1971 – 1996.

What was it like nursing in the 1970’s?

 I vividly remember my first day! On arrival a porter took my bags to my bedroom, where I found my uniform laid out on the bed. That first evening all ‘fresher nurses’  donned their uniforms and learnt how to make beds,  something that epitomized the apprentice training that we were about to undertake.

Another memory. The ward layout was different.  Most patients were nursed on Nightingale Wards. These wards had about 15 beds on either side, with the nurses’ station situated somewhere in the middle. Because of this layout, it was rare for a nurse not to be in the ward at all times. Added to this, there were no buzzers and so nurses were dependent on patients calling out for help or assessing a patient’s condition as they passed by.

Looking back – What ethos helped you care for patients in the 1970’s

Teamwork – Nurses worked closely together to get their work done. There was a camaraderie that said ‘that we could cope with anything as long as the team worked well together’!  On some wards, nurses were not able to go home at the end of their shift until all their colleagues had finished their work too. 

Authority and discipline. Sister was the person who took responsibility for overall patient care. This meant that as long as a student/nurse followed her instructions, they were free from fear of being disciplined.

Kindness and honouring patients. We were taught to treat patients as honoured guests. That somehow, the ward was seen as a place where nurses were ‘practicing hospitality’ and where kindness was practiced and encouraged.

Were there special moments?

There was a patient who had been unresponsive and unable to speak for many months due to a cerebral haemorrhage. On the day of Prince Charles's wedding to Diana, the ward was celebrating the occasion. The day-room had been decorated and patients and staff were all watching the event unfold on the television. This lady too had been wheeled into the day room. As she watched the television she was fairly unresponsive. Then she suddenly said ‘look there are the horses’. For me, that was one of my most precious moments.

Do you think it was easier to share your faith during your time nursing?

Yes, because people were more accepting of the Christian faith. In fact, in the hospital where I worked, prayers were said on the ward at 08:00 every morning.  I also had a time when I prayed with another Christian nurse who worked on the same ward. I believe that this led to opportunities to share faith with staff, patients and relatives.

Is there a specific example of you sharing your faith with a patient?   Yes. One patient came back from Easter day, and asked what it meant that Jesus had risen from the dead. I sat down and explained what the resurrection meant, and she wonderfully became a Christian! I do want to say, that opportunities like that were very rare.

  

What advice would you give to Christian nurses today?

Well, Nursing today is very different but God’s timeless truths are relevant for all Christian nurses at any time, any place! And so I want to leave you with two thoughts.

The first thought comes from 2 Thessalonians1:11 & 12.

In these verses Paul is praying for the Thessalonians who are going through a tough time because of their faith. And so he prays that they will continue to live Jesus’ way in hard times so that -  God would count Christians worthy of his calling.  This sounds like an impossibly high call to achieve doesn't it? But the truth is that we are not alone.

Paul continues teaching us that God is the one who will enable us to do this. It will be God who will give us the power to fulfil every good purpose and every act, as we are prompted by our faith. In a nursing context, this means that our faith in Jesus will prompt us to care for our patients and others (both in the little things and the big things) with Jesus in mind.  It might even mean going against the flow of popular opinion at times.  But whatever situation we find ourselves in, we can rely that God will give us all we need. 

Amazing!

As this happens, something will happen to us. The name of the Lord Jesus will be glorified in us and us in him.  In other words, what is at the very heart of Jesus, the beautiful, sacrificial heart of Jesus will shine in us, and furthermore we will know more and more that we are in Jesus. It is like a two way traffic. You see as Jesus shines in us so we know more and more that we are safe in Jesus.

What is more, Christians will know that they can take no credit for what happens, but that it is all due to the gift of on-going grace from God the Father and the Lord Jesus Christ. When Paul’s prayer is answered in our lives, we as Christians can’t lose, and many others will gain!

Second thought. Your smile goes a long way!

Transforming Failure

John 21:1-19

How often do we feel that we have failed, that we haven't lived up to our own, other's or God's expectation of ourselves, and that we have disqualified ourselves from being of any use to others or to God as a consequence?  You may feel that constantly, or occasionally, or maybe regularly but fleetingly.  But we all feel it at one time or another.

John's story about the unexpected post-resurrection breakfast on the beach of Lake Gallilee is one of my favourite stories of an encounter with Jesus - there are so many things going on in this story, so many nuances and details that you could write a whole book just about these few verses - and I have no doubt someone somewhere already has!

Trying to get back to normal life, those disciples who came from a fishing background had gone back home to their old business, and were out fishing in the pre-dawn cool, when the fish were usually nearer the surface and easier to catch. Only today they weren't having much luck - the fish just weren't 'biting'.  Then an oddly familiar figure on the shore encourages them to try on the other side of the boat - a request that must have rung a few bells, because when the huge trawl of 153 fish comes in, John immediately realises it is Jesus, and the ever impetuous Peter pulls on his clothes and plunges in to swim and wade to shore.

Smell is amazing in its ability to trigger memory, and I am told that charcoal fires have a very distinctive smell.  The last time Peter stood around a charcoal fire it was in the courtyard of the High Priest's house in Jerusalem the night Jesus was arrested a few days  earlier.  The darkest night of Peter's life, when a quick succession of serving girls and others recognised him by face and accent as one of Jesus' disciples - and where in fear of his life he had denied that he even knew his master and best friend.  I wonder if that was in Jesus' mind as he cooked his breakfast over such a fire, triggering that recent, painful memory in Peter.

So, over a familiar fisherman's breakfast, Jesus spends time in with his old friends in a way that was so ordinary and normal it must have been hard for them to reconcile it with the amazing and awful events of the last week. Indeed, they really don't know what to say. While he bids them come and bring their fish to share in his breakfast, it seems he already had enough fish and bread there to feed all of them - he had come well prepared. He did not need their fish, but encouraged them to share with him anyway - it was a meeting of friends, peers, brothers, not a wealthy master sharing his favours with his poor servants.

Then Peter and Jesus go for a post breakfast stroll along the lake with young John in tow behind them - what Jesus has to say is for Peter alone.  I doubt Peter had, at this point anyway, shared with his fellow disciples his shame in disowning Jesus. I am sure that they were all probably feeling some of sense of having let their master down in his hour of greatest need. However, Jesus had no interest in humiliating Peter in front of his friends. Even so he asks three times if Peter loves him, and three times Peter affirms that he does, and three times Jesus commissions Peter to go and feed and care for his sheep - meaning his church, his people.  Three questions, three affirmations and three commissions to balance Peter's three denials. Jesus did not revisit what had gone before, he didn't turn it into a time for soul searching - he gave Peter a job to do.  Despite letting Jesus down badly, Jesus was giving him another chance.  Follow the story of Peter in Acts and the letters of Paul and you'll see he managed to blow his second and third chances as well, but each time God gave him another chance.

We set ourselves high standards - we have to, we are professionals on whom patients and colleagues rely. If we get it wrong, people suffer or even die. But even then, sometimes we get it wrong, and have to learn from our errors to do better next time.  As Christians we also want to be good examples - to show our colleagues and patients the love and character of Jesus in our attitudes, speech and actions, but sometimes we blow it - getting cross and short with people, back biting, or failing to show care because we are under pressure of time or targets.  Someone says 'call yourself a Christian?' after we say or do something in an ill judged moment, and we feel a huge sense of failure.

But Jesus isn't into making people feel bad, or wallowing in introspection and self-analysis.  He has a kingdom to build, and in the example of Peter we can see the sort of people he is building it with - people to make mistakes, who deny him when they are scared, who misunderstand his teaching or misapply it, but who love him and want to follow him despite (and maybe especially BECAUSE) of our failings.  He is not in the business of using perfect people, he is in the business of transforming sinners into his people and through us building his kingdom. That is a hard process, a slow process, but he does not give up on us, so we need to not give up on him.

Our Willing Hands

While Jesus was in one of the towns, a man came along who was covered with leprosy. When he saw Jesus, he fell with his face to the ground and begged him, “Lord, if you are willing, you can make me clean.” Jesus reached out his hand and touched the man, “I am willing,” he said. “Be clean!” And immediately the leprosy left him.” (Luke 5:12-13, NIV 1984)

The nurse will find it easy to apply this short story from Luke’s gospel to him- or herself. We have made it our daily duty to be willing to clean, serve and heal the sick and the dispirited. The committed Christian nurse will find it easy to use this account as a sharp rebuke, “I must be more like Christ as I work! I must show the compassion that Jesus shows here!”

We quote in ferocious and exasperated tones to ourselves the poem by St Teresa of Avila:

Christ has no body but yours,
no hands, no feet on earth but yours,
yours are the eyes with which he looks compassion on this world,
yours are the feet with which he walks to do good,
yours are the hands with which he blesses all the world. 

 As we grow in our love for Jesus, we grow in a deep desire to serve him as we minister to the frail elderly in the nursing home, the dying young man for whom older parents keep a worried vigil at home, the shocked family around the ITU bed, the labouring mother. And so this story of Christ and the leper becomes our model, our duty, and sometimes, our burden.

This is not wrong. Christ is our model; to serve him, our duty; to share in the suffering of others, our burden. But, the problem in applying this story in that way is this: we are not intended, at least not first, to see ourselves as Jesus. We are not first, the compassionate healer. We are not first, the source of cleansing, reconciliation, hope and peace. We are first, ourselves, the lepers. We are wounded, broken, outcast, unclean. We are those who need to hear the concern in his voice, feel the tenderness of his touch, and receive the spiritual cleansing that he willingly provided as he laid his life down for us at Calvary.

Before we aim to be like Jesus in our work, we must first model ourselves on the leper. We must see Jesus, and do so as the leper does. When the Nazarene carpenter walks by, the leper does not simply look upon the good teacher or the wise man. He sees his Lord and his only hope for restoration. He does not fear to cast himself in humility at the feet of God, seeking a kindness he knows he does not deserve. And, (what sweet relief!) he does not find Jesus lacking in compassion, mercy, willingness or healing power.

Before we use our willing hands, we must first receive the willing touch of his. Easter affords us the opportunity to remember that out of his love for those who were far away from God, Jesus resolutely faced the horrors of death on a cross, so that we, the damaged, the sinful and the needy might be healed and reconciled to the Father. Let’s worship the Lord of compassion with the humble manners of the leper, and marvel at the response of Jesus, “I am willing.”

Nothing short of an encounter with Jesus like this one will be able to sustain us to do His work.

Dimity Grant-Frost

CNM Student Staff Worker

Compassion vs Academia in Nursing & Midwifery

A report by the NHS Confederation in February 2012 said that compassion and dignity are as vital as academic and professional qualifications in providing care for the elderly. It may seem an obvious point, but in the recent debates about falling care standards it is a very important point to remember. Because both compassion and professional skill are needed – without compassion we have care that may be competent but all to easily treat people as problems and not as human beings.  With professional expertise, we may be caring but we may also not meet the more complex needs and address the deeper health and social ills that beset the sick. 

It is a reflection of our society’s misplaced values that we have had to state once again a simple truth that should be so obvious – but we are a society that increasingly seems to devalue the elderly and the disabled. 

But we are also a society that struggles to understand the notion that care and compassion are neither innate, nor that they are all it takes to be a good nurse. Somehow the misplaced notion exists that academic or professional excellence and compassion are mutually exclusive. Maybe that says something about our professional culture that people so readily see it as uncaring.

Jesus had to regularly challenge his hearers to understand that true compassion was difficult, dangerous and costly.  And above all, that it was a choice.  In the parable of the Good Samaritan, he showed that to be caring not only one had to take risks to one's personal safety (stopping on the notorious road between Jericho and Jerusalem ran the risk of making one prey to bandits), but also to cross the racial and faith boundaries of the day and care for someone of another ethnic and religious background simply as another human being in need.

In the parable of the Sheep and Goats, he makes an even stronger point that showing care for the needs of others in difficult situations -whether homeless, destitute, sick, or even imprisoned, was an act of service to God himself.  Not easy, but costly. The bit of that parable that we so often gloss over is Jesus' condemnation of those who did not show compassion, who did not go the extra mile.

Compassion is a choice then, a habit, a skill even.  It is one that we should make integral to our practice as nurses and midwives.  It should so underpin what we do, that our desire to care more compassionately effectively is what drives us to seek the training and skills to be more effective.  It should be compassion, rather than our own, personal professional advancement that is our motive.

And the ultimate motive for our compassion? That we love others because we are first loved totally and unconditionally by God.

Living Counter-Culturally for Christ in Nursing & Midwifery

As I write this I am uncomfortably awaiting the arrival of my second son in 2 days’ time and regard with fondness – and rose-tinted glasses – those days when at the end of an exhausting shift I could flop into bed, snuggle down and sleep soundly until the alarm woke me next morning / afternoon / evening!

When Christian Nurses & Midwives was launched I was working for the Universities and Colleges Christian Fellowship (UCCF) as their Staff Worker for student nurses and midwives (Christian Student Nurses & Midwives, or CSNM). Since then I have worked in a central London church as their women’s worker; got married; seen a little of missionary work in Latin America; been privileged to study theology for a couple of years at Oak Hill Theological College alongside my husband, and have spent the last three years getting to grips with being a mother to a lively little boy.

During this time I think the question that has been looming ever larger in my mind is what does it really mean to say 'Whatever you do, work at it with all your heart, as working for the Lord, not for men', (Colossians 3:23). What difference does the gospel really make to the way we live and think, to our priorities and values on a day to day basis?

When I took up the post of Staff worker for CSNM I inherited the organisation of a conference entitled Counter-Cultural Living. I don’t think I realised then the enormity of this phrase, or the astute diagnostics behind its selection as a conference theme; In particular in my three years as a women’s worker I saw on a daily basis the way in which the gospel had become something we added to our lives instead of the thing that transforms every bit of our lives.

It is all too easy to begin with the situation we find ourselves in and then ask how does the gospel apply? How do I act as a Christian faced with these set of circumstances?  But in truth Jesus says to us seek first his [God’s] kingdom and his righteousness (Matthew 6:33). Instead of saying “I am Christian in a place where I cannot talk to my patients about Jesus, so how then should I conduct myself?” we should be saying “Can I be a Christian in a place where I cannot talk to my patients about Jesus?” This will inevitably mean making the kind of sacrifices that we’re unused to making (for example are there jobs that Christians ought not to be doing?), and trusting God in a way we’re unused to trusting Him (how will people in those places come to faith without us there to witness to them?).

CNM has tried to support and encourage its members in this task of counter-cultural living within the workplace. I pray that it has been of help to its members over the past ten years, but sadly we have always struggled to increase our membership and so our impact on the profession has been minimal. Given the current anti-Christian enviroment, the need for CNM has never been greater because it has never been harder to be a distinctively Christian nurse or midwife.

One thing I think CNM can do is to encourage our churches to help us more specifically in this task of approaching our work Christianly and then to be ready to support us when we face serious trouble at work as a result. This will help CNM members lead the way in restoring the gospel to the heart of healthcare and should encourage other Christian nurses and midwives to join the vision of CNM and count the cost of discipleship.

CNM E-News Edition 2

The second edition of CNM's E-Newsletter is now available to download here

Elderly Care: Do we care?

A report by Age UK on Monday suggests that despite claims by Government that they are increasing funding for elderly care, the level of demand has outstripped funding as more and more people are living longer but with increasing levels of dependency. The report suggests that in the last half decade the actual funding has stagnated, while in the same time a quarter of a million more people need care.  Age UK estimate that the spending on elderly will be £7.3 billion this year, but needs to be nearer £7.8 billion.

Furthermore, local councils appear to be treating care of the elderly as a lower priority, diverting funding away to other services, while increasing charges for care, such that many face poverty just paying for essential help with washing, dressing and shopping.  An increasing number from a generation who grew up in the post-war austerity of this country, and helped rebuild it, as their parents had helped fight for its freedom, are being left destitute and unsupported. This is in the face of a seemingly never ending barrage of reports criticising the poor quality of nursing and social care for the elderly in this country, and by attempts to cap and reduce benefits for the disabled, dwindling pensions, collapsing social support from families, increased life expectancy (but not health expectancy), etc. etc.  It is not a great time to grow old in Britain it would seem.

No wonder some now look upon assisted suicide and euthanasia as the only viable alternative.  Some, I fear would see that as not only more compassionate but also cheaper and frankly less of an inconvenience.

It can be hard work looking after older people with health needs or disabilities.  I know, because I was a district nurse and a senior staff nurse in an acute medical unit for elderly men for several years.  But no more so than caring for any other group, such as children – and I should also know as I have been a parent for even longer!  But just as we find joys and delights in parenting alongside the testing and trying bits, so caring for our elders brings positives alongside difficulties.  I learnt so much from my grandmother and mother in their last few years of life about that quiet generation who grew up before and during the last world war, and their willingness to just get things done, however hard things got.  I learnt from elderly patients from this and other nations about what it was like to live through the great moments of our world’s history in the 20^th century, and about the joys and sorrows that await all of us as we age.  My life is richer for knowing them all.

So why are we, as a society, underfunding and institutionalising our elders?  I could ask a similar question about the appalling struggles facing those with disabilities, especially children, whose parents have to fight doggedly for every single service and area of support (again, something I know only too well from the experiences of close friends and family).  Maybe we are afraid of growing old or facing disability in a youth obsessed culture? Maybe we are so self-absorbed that we would rather not deal with problems that seem millions of miles away, and maybe we are happier with the bread and circuses of reality TV and celebrity scandals, than face the realities of what is happening to the vulnerable?

Or maybe we do care, but our governments just think we don’t. (Do the elderly and disabled vote in large enough numbers to sway the parties I wonder?) Whichever way the truth lies, we need to seriously rethink where our priorities lie before we find ourselves abandoned in our dotage!

this post originally appeared in the blog of the Christian Medical Fellowship

Government Nursing Initiative: more tinkering at the edges?

In the face of a growing and alarming number of reports on poor standards of care for vulnerable patients in the NHS and the community, the Prime Minister earlier this month launched an initiative to try and tackle the problem in hospital nursing.

This is after yesterday also announcing a move back to integration of health and social services in the community.

The measures all make sense – reduce the amount of bureaucracy nurses are tied up with (devolving it down to ward clerks or other administrative posts), instituting hourly monitoring rounds, etc., etc.  These are all sensible measures in and of themselves, and along with reintegration of health and social services, are based on evidence that these measures really can improve patient care.

In addition, David Cameron has announced the launch of Nursing Quality Forum to explore further what measures can be taken to improve nursing care.  Interestingly, this is only a couple of years after the previous Prime Minister held a similar Commission on the Future of Nursing and Midwifery in England, which reported back in 2010.  Despite Cameron pledging not to tinker and  micro-manage the professions, it seems no government can resist the temptation of being seen to do something!

But this announcement does nothing to tackle two difficult issues that I feel lie at the heart of the problem. Firstly, staffing – in an NHS required to make £20 billion of savings by 2015, it is already apparent that most trusts are cutting nursing and administrative posts that would be needed to ensure the Prime Minister's new measures were properly implemented.  With recruitment freezes, and a shifting of skill mixes to reduce the proportion of RNs to care assistants on the ward, it is going to be harder and harder to achieve these goals.

Even more fundamental though is the deeper social attitude that devalues the elderly and disabled as nuisances to be kept out of sight and mind.  The recent reports of the CQC, Patients Association and EHRC all suggest that it is the attitude of staff and the culture in some hospitals, wards and care homes that is also the problem.  Where the care of the most vulnerable is seen as low status and low priority, and that those providing such care see themselves as doing the least valued roles, it inevitably affects the care that is given.  And such attitudes are transmitted from the top of the organisation, particularly in how resources are allocated.  And the values that determine such choices come from the wider society and culture – based on what we value, how we vote, how we spend, how we care for those around us in our communities.

Like it or not, as a wider society we are responsible, in part at least, for the standards of care in our hospitals.

Headline grabbing initiatives are one thing, putting in the resources and shaping the values that determine how they are deployed is something totally different. In the meantime, as nurses and as Christians we have the ability and the responsibility to shape that change one patient at a time.

Industrial Action: How should Christians Nurses respond?

Many Christian nurses and allied health professionals have been asking me how they should act in the face of a mounting industrial dispute. On 30 November, around100,000 health workers in the UK joined an estimated 2 million other public sector employees in a one day strike in protest about the government’s proposal for the future of public sector pensions. 


As the negotiations between government and unions reached a climax, we already know that Unite has rejected the latest (and possibly final) offer from the government, with the other health and professional unions likely to follow suite (including the Royal College of Nursing and Royal College of Midwives, to which most of our members will belong).

The arguments about the pensions issue are fairly well covered in an opinion piece in Prospect, needless to say that the issue of lower pensions, bigger contributions and later retirement are not unique to the public sector, – nor to this country.


Not all health sector unions joined in the day of action in November, including the BMA and RCN.  The RCN Council meets tomorrow (10 January 2012) to decide what their next steps would be, but industrial action has been mooted as a possibility.


In short, there is a real possibility that there will be ballots for nurses and midwives on industrial action over pensions in the next few months, and certainly more public protests.


So, how should Christians respond? The RCN has some guidance for members on the issue from a purely professional angle here, but I have found relatively little useful guidance on Christian websites and blogs, so here are some thoughts and pointers in relation to the current dispute.  This is not a full theological and practical shake down of the subject, but it is a humble attempt to look at the underlying principles.


The first point to make is that the removal of labour is a coercive act, and therefore should be the last course of action in any dispute.  Consider the implications for your patients, their relatives and carers, your colleagues (not just medical and nursing staff, but ancillary, administrative and managerial), employer (the trust, the NHS as a whole), and your profession if you withdraw your labour. That being said, there are precedents for Christians taking direct action, from boycotting sugar during the anti-slavery campaigns during the eighteenth century, to the bus strikes during the US Civil Rights movement.  These were not purely Christian boycotts, but Christians did join in with them.  Where the cause has been just, Christians (and others) have found it well within their conscience to take direct action and practice civil disobedience.


But are NHS pensions in the same league?  If we have good grounds to believe that some of our colleagues are going to be left far worse off, even destitute as a result of these measures, then the answer is probably a qualified ‘Yes’.  On the other hand, if everyone in the country is going to have to pay more and work longer than we expected in order to have a reasonable (or even comfortable) retirement income, are the Government proposals really a major injustice, or just learning to live with the new economic realities of the decade?  I do not offer an answer to those questions, and I myself am not going to be retiring on an NHS pension, so cannot offer a personal perspective.


The Bible has a bit to say in general about industrial relations, although most of the scriptures you will see quoted relate to slaves and their masters.  I won’t go into the arguments about whether modern workers are wage slaves, or that we have rights, and our employers responsibilities (that would be undreamt of New Testament times), let alone the ethics of slavery. Nevertheless, they do highlight some general principles.

Colossians 3:22 ‘Slaves obey your earthly masters in everything’

1 Peter 2:18 ‘Slaves, submit yourselves to your masters with all respect, not only to those who are good and considerate, but also to those who are harsh.’

1 Timothy 6:1 ‘Let all who are under a yoke as slaves regard their own masters as worthy of all honour, so that the name of God and the teachings may not be reviled’.

It is clear that Paul and Peter, in writing these messages were urging slaves not just to do their jobs, but to be exemplary, going over and above the call of duty.  The motivation for this is also clear:

Colossians 3:23-24 ‘Whatever you do, work heartily as for the Lord and not for men. Knowing that from the Lord you will receive an inheritance as your reward. You are serving the Lord Christ’.

Matthew 25:40 ‘The King will reply “I tell you the truth, whatever you did for the least of these brothers of mine, you did for me”

We serve God when we serve our employers (and more importantly, our patients) well. But we are also enjoined throughout the Bible to have a concern for justice and to stand up for those who are disadvantaged or poorly treated: Isaiah 1:17 ‘Learn to do good, seek justice, correct oppression, bring justice to the fatherless, plead the widow’s cause’.

We are also called to make peace where there is conflict – Matthew 5:9 ‘Blessed are the peacemakers’– and to act with good conscience, putting others needs ahead of our own – Philippians 2:3-4 ‘Do nothing from rivalry or conceit, but in humility count others more significant than ourselves. Let each of you look not only to his own interests but also to the interest of others.’

(Scripture references taken from BibleGateway.com)

So, in Christian workplace ethics, obedience and service are vital, putting the interests of others first, standing up for what is right, but seeking to honour our employers, and in so doing honour God. We serve God ultimately through serving the needs of our patients in obedience to our employers (NHS Trusts and GP practices, etc.).

I would suggest that based around these theological principles, when we are facing questions about industrial action there are four key questions to ask when making a decision (listed here in reverse order of priority):

1: Is the cause just – regardless of whether I will be significantly worse off or not, will my colleagues on lower pay be badly affected by these changes? Would I be perpetuating an injustice by not joining in?

2: Have the Unions and Government exhausted all other avenues to settle this dispute?  Is there room for reasonable compromise on either side that has not been taken? And can I encourage my union and my government to make further efforts?

3: Will taking industrial action adversely affect the health, wellbeing and distress of my patients? What level of service will be left if I am striking, and will the cancellation of elective operations, clinics and other procedures cause significant distress?

4: Will I be honouring God in taking this action?

There are several challenges that arise, whatever our conclusions to these questions:

1: We should take trade union membership seriously.  Get onto union committees, become a shop steward in your workplace, be active in influencing the policies of the union and its relations with the NHS in your workplace.  Christians should be right at the coalface of industrial relations, standing for justice and righteousness in the workplace.

2: Following on from that, always make sure that you vote whenever there is a ballot, even if your feelings are not strong either way.  Choosing not to vote implies a passive agreement with the decision of the majority who do vote.  But only those who cast a vote actually decide the action to be taken.

3: Recognise that your colleagues and friends will have different perspectives, so try to act with integrity, grace in pursuit of justice, rather than offering judgements on their decision. Be gracious and forgiving.

4: But be prepared to be unpopular for taking a principled stand – whether to strike or not to strike.

5: Finally, however you choose to act – never lose sight of those higher principles behind your actions and the attitude you adopt. It is God that you serve ultimately, and your conscience should be clear with him throughout.

There is no right or wrong answer about whether to join in with industrial action that may be called during this coming year, but thinking and praying through these questions and challenges may help you come to a wise decision.

CNM E-News Edition 1

Edition 1 of CNM E-News now available to download here 

News of upcoming events, prayer items, links to news and comment and more.

Next edition due February 2012

Spiritually Confused Care?

Archbishop of York, Dr John Sentamu, recently spoke of the need to remember the spiritual needs of patients in NHS care – and was promptly accused of bringing back medieval exorcism! In the following week, the Royal College of Nursing published a new online training resource to equip nurses in spiritual care, after a survey of its members two years ago showed that they felt hopelessly ill equipped to deliver a type of care that the majority considered a fundamental part of good nursing.

The GMC and BMA acknowledge the need for spiritual care, but when a seriously ill friend of mine asked the GMC if not receiving spiritual care from his consultant was in some way negligent, they could only give the vaguest of answers, despite the well-researched benefits of doing so.

The National Secular Society continue to campaign for all chaplains to be funded by religious bodies, rather than the NHS, as they do not regard spiritual or religious care (a term they seem to mistakenly use interchangeably) as being a core NHS function.

At the same time, we see a GP reprimanded for talking about Jesus to a patient, a nurse suspended for offering to pray with a patient, and countless other cases where complaints have been brought (invariably by third parties) against a health professional for talking about any issue of faith with patients, even when this has been at the patient’s own behest.

Looking at these stories in summary, you could easily conclude (possibly quite correctly) that when it comes to caring for the spiritual needs of patients, the left hand of the NHS does not know what the right is doing! There is a growing body of evidence that spirituality, faith, religious observance etc, have an impact on health (mostly good, some bad). This body of research is growing, although to be fair, most of it is very local and small scale, so even when done well it is hard to draw too many general conclusions from the findings.

At a conference earlier this month in Amsterdam we discussed these issues at length as they relate to the training and education of nurses. One of the key points was that there is a need for multi-centre studies across countries and religious and secular world views to try and get away from small scale local studies. One early multi-centre study identified that those nurses and midwives with a clear faith or belief system were the ones most willing and able to give spiritual care. While this is unsurprising, it is a nostrum that is now backed up by hard evidence from a study across centres in Wales, Netherlands, Norway and Malta.

Furthermore, spirituality is not singular – it is different for different communities and individuals. The spiritual care of a British agnostic is a different matter to that given to a French Muslim or a Maltese Catholic. And this also highlights that spiritual care (broadly speaking attending to the need for meaning, significance, purpose, hope and connection) is different from caring for religious needs (e.g. maintaining a relationship with God through prayer, religious services, reading scriptures, etc.), even if the latter may help those of faith address the former.

For Christians working in healthcare, our faith has always informed our understanding of the spiritual needs of our patients. It requires us to show compassion, and an awareness of the deepest needs of other suffering human beings. We need to have a spiritual attentiveness to, and presence with, our patients as well as a readiness to speak gently and respectfully of the faith that we have within us if asked. And we should be able to provide such care without fear.

In the UK, only Scotland and Wales have produced any standards or guidelines for good practice in spiritual care in the NHS, but in England there is not even a move in that direction. It may be a coincidence that almost every single case of a doctor or nurse facing disciplinary cases for talking about faith and spiritual issues with a patient has been in England. But I doubt it. Until the NHS in England starts taking this seriously, the current confusion in spiritual care will continue.

More training, more research, better guidelines, all will probably help, but I suspect that in a secular culture, which is still unsure of the meaning of ‘spiritual care’, misunderstandings will continue to occur. And, as many recent reports on how poorly we care for people in the NHS have shown, in a health system increasingly obsessed with measurable outcomes, budgetary controls and ‘productivity’, alongside the gradual erosion of the Christian faith from the public sphere, the human dimensions of care – compassion, kindness, the recognition of the spiritual dimensions of our humanity – will inevitably get more and more squeezed to the edges.