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

No Fear

Many of us know the story of Paul, who was Saul. The person instrumental to Paul’s conversion is Ananias, “a disciple of the Lord.”  The Lord comes to him in a vision and directs Ananias to go and present the gospel to Saul. Remember, Saul had been violently persecuting Christians. So when Ananias receives this personal directive from God, he argues and says, “Excuse me Lord, do you know who this Paul is?” Ananias is trembling with fear and not sure if the Lord is really saying, “Go”.

Fear is a powerful deterrent to our obedience to God. Many of us may not be asked to go someplace fearful, but we may be asked to talk with someone who frightens us. Or we may be asked by God take on an unfamiliar role in nursing, or provide care for patients different from ourselves. The Lord will ask you to do something that is uncomfortable. It is also important to note that, what is fearful for me, may not be fearful for you.

The Lord responds to Ananias' fear by saying, “Go, because this man (Saul) is my chosen instrument to carry my name before Gentiles and kings and the people of Israel”(Acts 9:15). So, Ananias follows the Lord’s instructions and meets with Saul to baptize him. Saul receives the first hand of love and forgiveness through Ananias.

The Lord will call on us and we will have fears. But, the Lord will guide us, strengthen us, and most importantly work through us for His glory.

Global Fellowship

If you were recently at the NCFI international conference in Chile or a regional/national conference, you probably connected with nurses from another country or region. During these conferences we not only enjoy beautiful scenes, explore new cultures, and gain nursing knowledge; we also open our eyes and hearts to our brothers and sisters in Christ.

             

Our connection with nurses outside our area helps us see how nursing is different, yet the same around the world. We may have different jobs in nursing, yet we share the bond of caring for patients. We learn of the various hardships in nursing. Some nurses lack supplies, some lack enough nurses, while others lack money.

            

We also share our personal struggles with one another. Some nurses face persecution for their Christian faith. While others may be experiencing health and/or family concerns. In fact, global fellowship is one of the many exciting things about NCFI. For through our connection with a large multi-member international organisation, we can build relationships founded on Christ. Take time this month to pray for each region. 

“Be on alert with all perseverance and petition for all saints” (Ephesians 6:18). Praise God for his work across the globe in nursing and lift up those who experience hardships. 

Blessings,

Carrie Dameron

NCFI Cares - A meditation on the Cross

With Good Friday tomorrow, I wanted encourage you to meditate on Isaiah 53 using "The Message" translation. "The Message" is a Bible that uses more figurative and paraphrases then actual words translated from the original Hebrew and Greek.

Reading Isaiah 53 in this translation will be a more personal and heart wrenching portrayal of Jesus' sacrifice.

Carrie Dameron 

Isaiah 53  [The Message]

1Who believes what we’ve heard and seen?
Who would have thought God’s saving power would look like this?

2-6The servant grew up before God—a scrawny seedling, a scrubby plant in a parched field.
There was nothing attractive about him, nothing to cause us to take a second look.
He was looked down on and passed over, a man who suffered, who knew pain firsthand.
One look at him and people turned away. We looked down on him, thought he was scum.
But the fact is, it was our pains he carried—our disfigurements, all the things wrong with us.
We thought he brought it on himself, that God was punishing him for his own failures.
But it was our sins that did that to him, that ripped and tore and crushed him—our sins!
He took the punishment, and that made us whole. Through his bruises we get healed.
We’re all like sheep who’ve wandered off and gotten lost. We’ve all done our own thing, gone our own way.
And God has piled all our sins, everything we’ve done wrong, on him, on him.

7-9He was beaten, he was tortured, but he didn’t say a word.
Like a lamb taken to be slaughtered and like a sheep being sheared, he took it all in silence.
Justice miscarried, and he was led off—and did anyone really know what was happening?
He died without a thought for his own welfare, beaten bloody for the sins of my people.
They buried him with the wicked, threw him in a grave with a rich man,
Even though he’d never hurt a soul or said one word that wasn’t true.

10 Still, it’s what God had in mind all along, to crush him with pain.
The plan was that he give himself as an offering for sin so that he’d see life come from it—life, life, and more life.
And God’s plan will deeply prosper through him.

11-12 Out of that terrible travail of soul, he’ll see that it’s worth it and be glad he did it.
Through what he experienced, my righteous one, my servant, will make many “righteous ones,”
as he himself carries the burden of their sins.
Therefore I’ll reward him extravagantly—the best of everything, the highest honors—
Because, he looked death in the face and didn’t flinch, because he embraced the company of the lowest.
He took on his own shoulders the sin of the many, he took up the cause of all the black sheep.

A Nurses Prayer...

A prayer from Mother Teresa and used by her Sisters of Charity in their care for the sick, poor, and dying:

Dearest Lord, may I see you today and every day in the person of your sick, and, whilst nursing them, minister unto you.

Though you hide yourself behind the unattractive disguise of the irritable, the exacting, the unreasonable, may I still recognize you, and say: "Jesus, my patient, how sweet it is to serve you."  

Lord, give me this seeing faith, then my work will never be monotonous. I will ever find joy in humoring the fancies and gratifying the wishes of all poor sufferers.

O beloved sick, how doubly dear you are to me, when you personify Christ; and what a privilege is mine to be allowed to tend you.

Sweetest Lord, make me appreciative of the dignity of my high vocation, and its many responsibilities. Never permit me to disgrace it by giving way to coldness, unkindness, or impatience.

And O God, while you are Jesus, my patient, deign also to be to me a patient Jesus, bearing with my faults, looking only to my intention, which is to love and serve you in the person of each of your sick.

Lord, increase my faith, bless my efforts and work, now and forevermore. Amen.