Caring With Eyes Wide Open

Posted on January 1, 2009

Fred was a 49 year-old male who was admitted to the hospital for his fifth detoxification from alcohol abuse. Almost as soon as he got to the floor he began developing diaphoresis and tremors, something he had experienced many times before. So he knew that the shaking would only increase unless he obtained his medication, Librium. He saw a passing nurse and asked if he could get his Librium and was told, “You need to find your nurse.” Fred’s long, oily hair and dirty clothes gave off a distinct odor and disheveled appearance. His behavior was increasingly agitated, making him one of those patients that no one wants to engage if they are someone else’s responsibility. He began approaching staff members asking, “Are you my nurse?” Time after time the response was, “No, not today.” or “Look on the assignment board.”

It seemed to Fred that no matter what he did, no one would pay attention to him. After what felt like an eternity to him, one of the staff finally yelled out, “Who is Fred’s nurse?” The staff then realized that patient assignments had been reorganized by the charge nurse since the beginning of the shift, and Fred’s new nurse didn’t know that he had been reassigned to her. Fred was in tears by the time his nurse came to him.

I get frustrated when I see the caring vocation of nursing reduced to a job that becomes a set of tasks where money and productivity outcomes are higher priorities than the health and care of the patient. If nursing as a part of healthcare does not include caring, then the persons who need care are not being given what they need.

Katie Eriksson defines caring in the context of nursing:

Caring is the core of nursing. Caring is also the essence of humanity and the basic constitutive phenomenon of human existence…It is not enough to “be there” – it is the way, the “spirit” in which it is done; and this is, as I see it, caritative. Caring is a deep human and professional communion. The idea of caring is to alleviate suffering in a spirit of caritas, that is, in faith, hope and love. It is compassion upon which true caring is based. 1

There is something about caring that involves the spirit in which it is done. Caring is not simply a list of tasks or an order of responses. As I reflect on situations when I gave good care, as well as situations when I gave solely adequate care, what stands out is whether or not I was fully engaged with the person, whether or not I was treating him/her with respect and truly listening. Times when I have prayed with a patient during a long night, or looked her in the eye and truly tried to understand her life were times when I felt I was fully present. I saw the person beneath the mask of the patient.

One Saturday morning at the clinic where I work in Chicago, I was asked to meet a patient in the waiting room who had a question that needed the specific response of a nurse. I’d had a busy morning being pulled in several directions - phone calls, pages, patients with complaints, medical assistants and providers who needed help - all bartering for my attention. I quickly walked into the waiting room to meet Mrs. Brown,* expecting to be met with a complaint or a question that was not worth my time.

Taking my first few steps into the crowded waiting room and observing children running around, people on cell phones, and names being called by the registration staff, I was overcome with a thought that did not come from me. God impressed into my mind that I was about to enter a holy space as I met one of His precious children. I may never see this woman again, but for this moment, for that initial greeting, it was an honor to interact with her. I stopped for a second and then smiled as I called out Mrs. Brown’s name and she stood. One of God’s precious works of art was this woman, in this place. God reminded me to see her as He sees her.

As I studied the meaning of caring and the biblical view of the concept of “person,” I found a topic that resonates with the frustrations I have felt within the healthcare system. Katie Eriksson in her book The Suffering Human Being, speaks of the suffering of not being seen by others. She states that:

the deepest form of loneliness is perhaps not to be seen by anyone. Perhaps this is also the deepest suffering. Not to be seen is to be considered as “dead.” Unfortunately, there are many living-dead among us. We encounter these suffering fellow human beings daily, but we fail to see them. We meet these people in our hospitals, but they are also in the midst of us. 2

As I hear stories from patients, as well as healthcare professionals, I learn that much of the suffering experienced by patients in the healthcare system stems from the root problem of not being seen. People are referred to as “the patient in room 145,” partly in accordance with patient privacy regulations. We forget that this patient is also a husband, a brother, a son, a father, an engineer. He needs to be seen for who he truly is beneath his diagnosis and current set of vital signs.

Are we in the healthcare profession so concerned with procedures, tasks and measurable outcomes that we fail to look into the eyes of those in need of our care and protection? What could caring look like from the angle of truly seeing another human being? What effect would it have on the person being cared for to be truly seen? What effect would it have on the person to not be truly seen and therefore, to be dismissed?

As we look at and describe ways that we can be seen by one another, we also look to Scripture for descriptions of the ways that God sees His people. The Bible makes the connection between the direction of the “face of God” and either favor or rejec-tion bestowed upon the people. When God’s face is turned away from a person, it is a sign of disapproval. “Why, O Lord, do you reject me and hide your face from me?” (Psalm 88:14). 3

In contrast, when God’s face is turned toward someone, it is described as a sign of blessing, “The Lord bless you and keep you; the Lord make his face shine upon you and be gracious to you; the Lord turn his face toward you and give you peace” (Numbers 6:24-26). God’s blessing is one of mercy that brings shalom for the person and for the community.

If the turning of God’s face toward or away from someone either brings favor or expresses rejection, are there similar consequences in the turning of a human being’s face? Is the way we “truly see” one another a reflection of the way God looks at us?

Being made in God’s image gives humans an innate dignity and honor regardless of social, mental, or physical status. As human beings we alone were created in God’s image – not angels or mountains or any other part of the cosmos. We were created uniquely to represent God to the rest of creation, and to share in His work. I do not know how far to take this, but I believe that in some way reflective of God we bless others and bestow favor on them when we “turn our face” toward them.

S. Halldorsdottir, in “Christian Perspectives on Suffering”, describes her study on individuals’ perceptions of caring and uncaring encounters with persons in authority. According to her study, when someone has an encounter with an authority figure that is perceived as uncaring, that person feels smaller – vulnerable and with diminished authority, and their suffering is increased. However, if they perceive genuine care, the person feels accepted, legitimized and comforted. 4

Caregivers contribute to the suffering of patients when we carelessly miss the opportunity to see their own innate worth. God created humans to be in relationship with one another, and intends for us to view one another through Christ (2 Corinthians 5:16). When we do that in practical ways, we attribute the dignity of being an “image-bearer” to those who are suffering in the oppression of our fallenness. We impart hope and healing, and echo the eternity that God has placed in all our hearts.

All of us have experienced the power of being acknowledged and the pain of being ignored. It does not take great sensitivity to recognize the connection between caring and “turning one’s face toward” another human being. Through turning one’s face toward another, the care-receiver is being truly recognized and accepted, “truly seen” and cared for as a whole person—body, mind and spirit. Being cared for in this way adds blessing. In contrast, turning one’s face away, treating them impersonally, can be taken as a sign of rejection and adds suffering to suffering.

Truly seeing others involves more than a glance and recording of events. It certainly requires that we actually look at people with our eyes, but when we see the person as God sees them, it is a spiritual connection. It has been said that the eyes are the windows to the soul. The most powerful healing happens when people meet “spirit to spirit”. It is on that level where there is a true connection, and where both people experience empathy. That is really seeing someone.

In the story of the Good Samaritan, the Samaritan responded when he saw the beaten and injured man lying by the road. “And when he saw him, he had compassion” (Luke 10:33, NKJV). The Greek word is very illustrative; literally, “pained in the gut”. The Samaritan entered into the other man’s pain. 5

When we first meet our patients, we should acknowledge that they are like us. We are both humans created in God’s image. We should ask ourselves “Why has God brought this person into my life, and me into theirs?” At the very least, we should identify with them. The Samaritan saw the suffering man, was struck by the suffering, reasoned, and chose to respond with care. He dared to enter into the drama of the man’s suffering for he truly saw him, he did not glance and walk by, but he turned his face toward him, involving his full attention and total being.

We can choose not to look at and truly see another person who is suffering. We can decide to look at symptoms, at charts, at diseases, and only glance at the person. We can choose to relate only as an observer. In the story of the Good Samarian, the priest and the Levite both saw the man lying by the side of the road. They were aware of his condition and may have even made what we would class as clinical observations. But their level of awareness allowed them to walk around him and leave him in his suffering.

Did the injured man lying by the side of the road see them pass? Did he cry out, “Look at me!” Was his suffering magnified as he witnessed the rejection as they glanced at him and then chose to not get involved?

This is unknown from the text, but experience tells us that it must have been. Being uncared for in a dependent situation develops feelings of impotence, a sense of loss, and a sense of having been betrayed by those counted on for caring. If on top of that the patient is treated by the nurse as if somewhat less than human, the patient’s feelings soon develop into feelings of alienation and identity loss. The patient feels he has no value as a person, that he is indeed less than a person: ‘a side of beef,’ ‘an object,’ or ‘a machine’. 6

Science, the Bible and our personal encounters of experiencing caring or uncaring affirm that there is a way to truly see others. Being truly seen may look different in different situations, but it always entails treating our patients with respect and dignity. God has demonstrated that favor can be bestowed on another when one’s face is turned toward another. It is a mystery, and yet somehow we are able to connect with one another on a level that goes beyond physical presence. We are able to “truly see” one another, and empathize with one another. Perhaps in one another, we are able to see the imprint of our Maker, and a glimpse of the face of the one who turns His face towards us.

*Patients’ names have been changed. done slows even the church from addressing healthy living in a serious way. Think about it. The least healthy meal we eat is at a church supper. The fact that we do not see this as an issue of justice as it relates to caring for God’s children is simply wrong. The failure to give children hope for their future is at the core of what the New Testament regards as justice.

ENDNOTES

1 Karen Eriksson, “The Alleviation of Suffering - the Idea of Caring,” Scandanavian Journal of Caring Science 6-2 (1992) : 79.

2 Karen Eriksson, The Suffering Human Being (Chicago: Nordic Press, 2006), 9.

3 Unless denoted otherwise, all Bible references are New International Version.

4 S. Halldorsdottir, “Christian Perspectives on Suffering” (paper presented at the meeting of Healthcare 2000: What Hope?, Fiesch, Switzerland, May 2000) 9.

5 Kari Martinsen, Care and Vulnerability, trans. L.E. Kjerland (Oslo, Norway: Akribe AS, 2006), 83-84.

6 S. Halldorsdottir, “Five Basic Modes of Being with Another,” in Caring: the Compassionate Healer eds. D.A. Gaut & M.M. Leininger (New York: National League for Nursing, 1991), 40.

Renee Lick, RN is a clinic nurse at Lawndale Christian Health Center in Chicago, IL, and serves as Student Ministries Director for Nurses Christian Fellowship.

Tags: H&D, Nursing, Working With the Poor

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