Moved with Compassion

As they were leaving Jericho, a large crowd followed Him. And two blind men sitting by the road, hearing that Jesus was passing by, cried out, ‘Lord, have mercy on us, Son of David ‘ The crowd sternly told them to be quiet, but they cried out all the more, ‘Lord, Son of David, have mercy on us!’ And Jesus stopped and called them, and said, ‘What do you want Me to do for you?’ They said to Him, ‘Lord, we want our eyes to be opened.’ Moved with compassion, Jesus touched their eyes; and immediately they regained their sight and followed Him.

Matt 20:29-43 (NASB)

There is a lot of talk in this country about ‘compassion’ at the moment –particularly in relation to nursing, and why people perceive that there is a lack of compassion in the profession. But what does compassion really mean?

Most Bible translations use the English ‘compassion’ (literally meaning, ‘to suffer alongside’) to translate several different words in the Bible – none of which has so simple a meaning.

In this passage, the Greek word translated ‘moved with compassion’ is splagchnizomai, literally meaning ‘to be moved in one’s innards’ – either the bowels or the organs within the rib-cage.  It is an expression of the most visceral, physical response to the needs and suffering of others. When Jesus hears the plea of the blind men to have their sight restored, he is moved to his guts.

But when we see Jesus profoundly moved here, he does not stop with feelings. He acts, decisively and firmly to address the need that he sees, and heals both men there and then. Compassion in the Bible is a verb, not a noun – like love, it only means anything if it leads to decisive action.

In our nursing, we are often told to keep a professional distance, not to get involved. But to be truly compassionate, we need to be open to the pain and suffering and need of our patients, at any level, and be willing and able to be truly moved and to respond decisively – whether that is sorting out displaced pillows to make someone comfortable, or ensuring that appropriate analgesia is provided on schedule, or simply being present with a person in the most profound and inexpressible distress.  If we cannot be moved and spurred to action by our patient’s need, how can we be truly compassionate?

Compassion – thoughts along the way!

Something to make your heart sing

The Call the Midwife series has touched many viewers’ hearts. One reason is that there have been beautiful precious moments where someone with compassion has reached into a another's life and met them at their point of need. One such time was when Sister Julienne, the head nun draws alongside a nun who is confused and suffering from Alzheimer’s. This nun, Sister Monica Joan, has made an error which could have proved fatal for a pregnant lady. Now in the chapel she asks the Lord to forgive her and protect everyone from the ‘demons’. And here comes the heart –touching scene. For Sister Juliene draws alongside her and gently says ‘ there are no demons, your mind gets tired that is all. When your mind gets forgets – we will remember.’

When I am old and losing it, this is the kind of person I want drawing alongside me. Don’t we all want someone who will reach into our lives when we are helpless and say ‘we are with you, we will walk the walk with you’ and where possible, even more ‘we will make things better!’ And there is more - don’t we want someone to do this because they want to do it? That they almost feel compelled to do it! This is what compassion is. It is when someone has a desire to reach in and help someone who is helpless and- unable to help themselves. To reach in at their point of need. Com  = with, passion = suffering. It’s about being open armed, not holding back but reaching out to help. Rather like a mother dropping her shopping and open armed – rushes over to pick up her child who has fallen over. But it’s not just about the initial reaching out, but that in her response there is a commitment to give on-going compassion, love and care , just as to Sister Monica Joan promises when she says ’when you forget – we will remember’”.

When we see this happening in films and more preciously in real life– it makes our hearts sing!

No singing here!

In contrast, many of us have read or heard stories from the Francis Report. Here the lack of compassion that many patients experienced has caused shock waves and disbelief across the country. It would seem that once too often there was no nurse available to step in, no one to help those who needed help – and as a consequence, patients were left in their faeces, patients were left dying of thirst, and patients were just left!    No hearts singing now, just questions and lots of them.

Maybe a question to ask is – where does compassion come from?

The short answer is that our ability to be compassionate comes from God. The Bible teaches that all human beings are capable of being compassionate because all human beings are made in the image of God – in other words we are made to be like God, to reflect him. And to be like God is to be compassionate, because God is described as the God of all compassion.

And so when we see others being compassionate, in big ways –  or little ways, maybe a kind smile, or a squeeze of an arm, just indicating that they are with someone who is sad or distressed, we shouldn’t think how amazing they are – but rather we should thank God for them. For in that small or bigger way, they are reflecting God’s image in their lives and others are benefitting.

That is all very well, but what about the times when there is lack of compassion shown in our own lives and in the lives of others.  What has happened then?  The answer is – The Fall.  The Fall marked the time when sin entered the world. It’s the time when mankind decided we wanted to rule God’s world. We wanted to decide what is right and what is wrong.

As a result, God judged mankind by sending them away from his presence, never to be able to return by their own efforts. No more close fellowship with God, no more perfect relationships with each other, no more perfect living in God’s world, all to end in death and a fearful future beyond.

But in God’s kindness, he didn’t remove his image from us completely. We still reflect something of God, but our image is distorted. Rather like when I look into a cracked mirror.  There is some thing about the image looking back at me that is me! But at the same time my image looks all wrong too.

And it is the ‘cracked mirror image’ that helps us understand why all human beings have a desire to reach into some ones’ life and meet them at their point of need – to be compassionate.

It helps us understand that when we reach in with compassion, the compassion we give, might not always be the best for those we seek to help, whether behind closed doors in families or in society generally.

Furthermore, it helps us understand that when societies start crying out for compassion, for example in the euthanasia debate and their cry is not rooted in a desire to reflect God’s image –then whole societies can find themselves going down a dark and dangerous road.

It also helps us understand why there are times when compassion is sadly lacking in our lives and the lives of others. It helps us understand why we can be so horribly cruel to each other, why we can walk past someone who is crying and not be stirred at all.

How unlike God we are when we are like this and sadly our behaviour confirms God’s judgment on us - that we all deserve a fearful judgement.

Something to make our hearts sing forever!

But again, God in his kindness had a plan to restore people like you and me back to himself for EVER! His plan exposes the very heart of who he is – a beautiful God of love and compassion.

As God looked out at mankind – his heart broke. For he saw our ruined image, once so beautiful as we reflected (and brought glory to) our maker. He saw Satan the great deceiver, influencing our very being and, as John Owen writes:

‘knowing that eternal distress was at everyone’s door, this aroused a desire in him to reach in and meet us at our greatest need…….”Come forth from your vain shelter, your hiding-place I will put myself into your condition. I will undergo and bear that burden of guilt and punishment which would sink you eternally into the bottom of hell. I will pay that which I never took; and be made temporally a curse for you, that you may attain to eternal blessedness”’.

And this truth is the key to any Christian as they consider what it is to be compassionate.

Come to Jesus first

That first, we need to come ‘forth’ as John Owen would say to Jesus. recognising in ourselves our terrible condition before God and knowing that Jesus and Jesus alone can help. Rather like leper’s encounter with Jesus in Mark 1:40-45:  He knew his need, he was desperate to be healed, and he came to Jesus, knowing that ‘if he was willing he could make him well’.

Come to him with humility. Because in coming to Jesus, we are recognising how far we have got things wrong and that we are dependent on Jesus stepping in and helping us.

And know the compassion of Jesus.

Jesus response to the leper’s request is immediate. He is filled with compassion, stretches out his hand and heals him. And so it is with us. As we sinners, turn and repent, so Jesus through his spirit rushes out to greet us and brings us into a relationship with his Father in heaven starting in this life and will go on forever!  And not only that, daily as we continue to acknowledge our dependence on Jesus, as we come to him in daily repentance in humility, so in little ways and big ways, he continues to reach into our lives with all compassion. Furthermore, with God’s spirit in us, we can start being renewed in the knowledge in the image of our creator (Col 3:10), knowing that one day, in the future we will fully reflect the image of our creator for ever!

As we are being renewed in this way daily, so we will start to feel the compassion that God feels, we will begin to be compassionate as Jesus is compassionate!

Coming to Jesus is the key to reaching out to others with compassion

Christian compassion means no more discrimination; Knowing this kind of love and compassion in our own lives will help us, even more, free us to reach into others’ lives with the compassion of Jesus. After all, we know that there was nothing about us that led Jesus to show us compassion. But he was! The cross proves it. And so, as we look out at others, we should not discriminate either.

A friend recently told me how she had been frustrated and angered by a patient who was both demanding and difficult. One morning she prayed to Jesus and asked for his forgiveness for not loving this patient. She then prayed that Jesus would give her his compassion. The result was that she now gets on much better with her patient and is developing a real love for her! Something of the image of God is shining through her! And what is more, other colleagues are noticing and are amazed! 

But even as I write these words, I am aware that I often lack compassion. There are times when I ignore others cries for help. It is true that I am still a work in progress, but my lack of compassion may be due to not grasping a key component to Christian compassion – that Christian compassion always includes sacrifice.  

Christian compassion always includes sacrifice

Returning to the encounter of the leper with Jesus. We read that Jesus commands him to ‘show himself to the priest and offer the sacrifices that Moses commanded for his cleansing as a testimony to them.  You see, before the leper could enter back into society, before he could join others to worship in the temple, the law had to be fulfilled by a sacrifice being offered.

And so it is with the sacrifice of Jesus for us. In living the perfect life, Jesus fulfilled God’s law perfectly. And the law stated that a perfect lamb was the sacrifice for our sins. Jesus was that lamb, the lamb of God – who came to take away our sins – once and for all.

Here is the connection with compassion. The only way that Jesus could reach in and help us, was through his painful death on the cross. There was no other way!

Furthermore, if we are to be compassionate as Jesus is compassionate, then it will cost us too. When we wrestle with our lack of compassion toward others behind closed doors; when we are prepared to be spent for others. It will cost us in the way we spend our time as we put others needs before our own. It will cost us in the way we speak to others, with kindness and generosity. It may even cost our health.

Living like this will make our hearts sing, as we experience something of God’s power working in us changing us to become like his Son Jesus. It will make God’s heart sing as he works in us for this to happen. Others’ hearts might sing as they experience something of God’s compassion. Furthermore, for some, their experience will cause them to ask where it comes from, leading them to respond to the gospel! And that leads to a party heaven and – not wanting to overstate things – this will be good for our nation. 

To finish! A personal note for Mr Francis. If I were to write to you Mr Francis, I would like to recommend that gospel compassion (people hearing and responding to the gospel) will go a long way to answer our challenges within the NHS!

Salt and Light after the Francis Report: What Does it Mean for Christian Nurses?

The horror stories that emerged from the evidence gathered in the series of enquiries into the failure of care at Mid Staffordshire NHS Trust have shaken the long held national belief and trust in the NHS. Horror stories of patients left in soiled bedclothes because nurses were too busy to take them to the toilet, people being triaged by A&E receptionists, others being left unable to reach food or drink and literally dehydrating and starving to death.  The catalogue of neglect makes for horrific reading.  Hundreds, if not thousands of patients, are thought to have died and suffered unnecessarily as a result of poor care at just one hospital.  At the time of writing, thirteen more NHS Trusts are under investigation after patients and staff raised
concerns about care standard.

The second Francis Report published in February sought to address the reasons for wider, systemic failure to police the care standards at Mid Staffs and across the NHS.  The Trust management are castigated for a blind focus on targets and cost savings at the expense of frontline staffing and quality of patient care. The professional bodies (most notably the Royal College of Nursing) are attacked for a failure to
support or take seriously whistle-blowers.  Other regulatory bodies, professional bodies, educational institutions, the NHS Executive and the Department of Health all come in for criticism.

Francis makes 290 recommendations – it is not a short or easy read, even for a public inquiry, which means, sadly, that few if any of them will ever be taken up.  Central to his recommendations is that transparency becomes a legal duty for NHS trusts and professional bodies – a ‘duty of candour’ should be legally enforced on all NHS staff, requiring honesty about mistakes.  Furthermore, gagging orders to stop disclosure of ‘unpleasant’ stories in the media should be made illegal, and professional bodies must be more
proactive in supporting whistle blowers reporting on failures of care.

The other central theme is that there needs to be an overall culture change in the NHS that puts patients and their needs at the centre of the system. This seems so fundamental that the inquiry’s need to state it explicitly and in detail suggests how far NHS structures and institutions have drifted away from their original purpose.
Significantly, while good leadership is vital to this, Francis makes it clear that the culture change is the responsibility of every NHS employee, from ‘porters and cleaners to the Secretary of State’.  It is a bottom up change, not further top down restructuring that the inquiry advocates.

Sadly, the government’s response seems to have missed the boat on this last theme, focusing instead on the exact opposite – more top down regulation with yet more new sets of quality targets, a new inspectorate for hospitals, and a proposal that nursing students be required to spend a year before training working as care assistants.  Legal measures to stop NHS managers responsible for failing trusts being re-employed in the health service and a legal duty of candour on health professionals and institutions finish off the main responses from government.

It is hard to be in nursing in the UK at the moment, as it seems everyone is blaming us for the systemic failure of the health service.  But it cannot be laid at the door of a single profession or single set of values or government policies.  It is institutional sin at its worst – a culture within institutions and professions that promotes the needs of the providers over the needs of patients.

Paul reminds us that ‘our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms’ (Ephesians 6:12).  There is a spiritual side to this – something of the enemy that blinds even the best of us to the truth at times.  So first and foremost we need to pray – for our professions, our workplaces, our managers, and our political leaders.

But most of us go into nursing because we are compassionate people. As Christians we also have the strong motivation to do as Jesus taught us – to do for the least of those in need what we would do for Jesus himself.  So we also have a prophetic responsibility to speak truth, to be whistle-blowers, to care in a different spirit when those around us seem to have lost compassion, and to encourage, commend and work alongside those who are caring to the highest and most compassionate standards (Isaiah 1:17, Psalm 82:2-4 and Proverbs 31:8-9).

We need to be salt and light in the NHS more than ever, and to win back trust from the public.  It will take prayer, it will take faithfulness and courage and it will take leadership. Above all, it will take time. This may seem impossible, but with God, nothing is impossible (Matthew 19:26).

What can you do? Start with prayer. Start everything with prayer.  If you can, find one or two others who will pray with you—and pray for others who will also join you to pray, who will act with integrity and courage and compassion.  Pray for your workplace, your colleagues, your leaders, your patients.  Let God transform your workplace one person, one prayer at a time.  Ask God to show you the way—at whatever level you work, from student to Charge Nurse, from Director of Nursing to Staff Nurse.  It doesn't matter that you feel you cannot make a difference—God can, and he uses those who doubt their own influence and voice to speak, if they will just trust him to speak.

And, above all, do not despair, but trust God and seek to honour him wherever you work.  This is a golden moment for God to work in our health system.

Steve Fouch