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A Christian Nursing Philosophy

I'm not only a blogger, but I double as a Nursing and Bioengineering student as well as a Realtor. As a part of our coursework in nursing, I had the assignment of creating a "Philosophy of Nursing." The practical out fleshing of my faith in the workplace is a difficult task. I hope that this is beneficial for fellow nurses and nursing students out there searching for help on creating their philosophy of nursing. For others, I hope that this gives you something to chew on as you consider how faith influences philosophy and philosophy influences profssional behavior, even in a profession in which the job description generally explicitly prohibits "proselytizing". The format and some of the content is somewhat forced due to the assignment parameters. Please feel free to comment at will:

Jacob Hantla's Philosophy of Nursing
This nursing philosophy is dynamic; almost as soon as it is perpetualized in writing, it will have changed. As my life is molded and remolded by knowledge, wisdom and experience, my philosophy of life will be further established and changed. However, my dynamic philosophy is based on an objective, historical, and spiritual document: The Bible. Therefore, although a philosophy statement usually is created and validated internally to the author, mine will constantly draw the Bible. The Bible is where I know truth; I am unable to be certain of my understanding of my experience of the world apart from the Bible. In it, humankind can learn God’s philosophy of and purposes for the world and how God, incarnated in Jesus Christ, interacted with the world. John 1:14 says of Jesus Christ, “And the Word became flesh and dwelt among us, and we have seen his glory, glory as of the only Son from the Father, full of grace and truth [italics added]” (English Standard Version). Furthermore, as mentioned in this passage, my example for life and nursing was full of grace. Indeed, his entire life on earth was spent with those who, in the eyes of the religious, did not deserve the grace of his time, his care, his love, or his teaching. (Matthew 5:31-32). His ultimate purpose for coming to earth was to selflessly die on the cross (John 3:16-17; Philippians 2:4-8) so that he could graciously ransom those undeserving of grace from their deserved eternal death apart from God and give them eternal life with Him (Romans 3:21-26; Colossians 2:14; Romans 6:23). Similarly, the nurse seeking to emulate Christ should be full of grace. So, following the example of Jesus, my philosophy of nursing is not presented on my own authority (John 7:18) but on the authority of the one for whom I now live (Galatians 2:20). I do believe that this nursing philosophy applies in some degree to every nurse, but it is the Christian nurse—the nurse who has acknowledged his or her rebellion against God and deserved eternal damnation, has given up seeking to be justified by his or her own works, and has turned and received by faith the payment of his or her debt to sin paid by Jesus’ substitutionary death on the cross (Galatians 3:13; 2 Corinthians 5:21)—who can most adequately abide by it and understand it (1 Corinthians 1:18-24). The standard of care which this philosophy demands must be provided to all by the nurse. This is my philosophy of nursing; this philosophy dictates the standard of care by which I will abide.

Who Is the Recipient of Nursing Care?
The primary recipient of nursing care—the client—is the individual. However, nursing care of the individual has the benefit of that individual, his or her family, and his or her community (locally, regionally, nationally, and globally) at heart. Loving care for the individual reflects Christ’s love and is motivated by Christ’s love for the individual: “A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another” (John 13:34; cf John 15:12, 1 John 4:7). Some clarification of the individual is necessary at this point. Loving nursing care should be extended to all—friend (Galatians 6:10), stranger, (Leviticus 19:34; Deuteronomy 10:19) and enemy (Exodus 23:4-5; 2 Kings 6:22; Romans 12:14; 1 Peter 3:9) alike. Jesus says in Matthew 5:44, “Love your enemies and pray for those who persecute you.” Because God is sovereign and loved us before we loved him, Paul writes, “If your enemy is hungry, feed him; if he is thirsty, give him something to drink” (Romans 12:20). This nursing care is most needed by those who have the least—the poor, sick, and helpless—and therefore, the primary responsibility of the Christian nurse is to care for “the orphans and widows in their distress” (James 1:27; cf 1 Timothy 5:1-3). By blessing the individual, “all the families of the earth shall be blessed” (Genesis 12:3). Therefore, nursing care is focused on the individual, with the larger goal of caring for communities and all humanity as an additional motive.

How Would You Describe Your Client?
The primary client for nursing care is the individual. The individual must be primarily recognized as being created in the image of God, and as image bearers, all members of humankind (of which each individual client that a nurse will encounter is one) are to be afforded dignity, respect, and right to life (Genesis 1:26-27, 9:6; James 3:9). As creatures uniquely endowed with God’s image, these rights are to be given to all individuals regardless of age (from conception to death), size, cognitive ability, level of dependence, ability to pay for services rendered, political affiliation, religious affiliation, sexual orientation, legal status, cultural heritage, race, gender, or personal relationship. The individual client is a dichotomous being, consisting of the interaction between body and spirit. The body is the physical part of the client where pathophysiological illness works. The body is that part which ceases to exist in its current state at death. The physical part consists of that which is made of matter and can be interacted with and manipulated through physical means. It is the spirit that exists eternally either with God or apart from God (Ecclesiastes 12:7; 2 Corinthians 5:1-10). The body and spirit mesh seamlessly here on earth, completely interacting, each affecting the other so that it is near impossible to determine what behavior or characteristic of the client is spiritual or fleshly in nature (Romans 8:10). Both the fleshly and the spiritual aspects of the client must be attended to in order to fully care for the client; however, when in the professional setting, the nurse’s primary role as defined by his or her job description is to care for the fleshly portion of the client.

What Constitutes the Environment?
The client lives within an environment which, to varying magnitudes, can positively or negatively affect the client’s health. The environment contains physical, psychosocioeconomic, and spiritual factors. The physical environment consists of tangible, physiologic stressors placed on an individual, such as disease, accidents, pollution, food, temperature, and other physical stressors. Closely related is the psychosocioeconomic environment, often manifested the sum of the stressors, both positive and negative, as perceived by a client. The psychosocioeconomic environment is primarily the internal perception of the external environment, such as changing personal situations, poverty or wealth, social status, cultural heritage, interpersonal relationships, and other external forces. Two individuals placed in the same physical environment (same location, background, and major life events) may have different perceptions of their psychosocioeconomic environment. The spiritual environment is comprised of all of an individual’s religious and spiritual influences, both internal and external. Like the psychosocioeconomic environment, the spiritual environment to which we can personally attend is defined by the perception of the client to the spiritual reality which exists around him or her. Without the enlightening of the Holy Spirit, the client will be blind to his or her actual Spiritual environment of being separated from God by sin.

What Is Your View of Health?
Health—and its antagonist, illness—are to be seen with regards to the two constituents of the client: physical and spiritual. By the original sin (Genesis 3) and each person’s individual sin, both components of the individual—body and spirit—were corrupted. “Just as sin came into the world through one man, and death through sin, and so death spread to all men because all sinned” (Romans 5:12). So death, the ultimate spiritual and physical illness, is the result of sin (Romans 6:23). The only way to true physical and spiritual health is the removal of sin’s consequences. Spiritual health (life) and illness (death) is on a binary scale. Spiritually, all are born dead in sin. Some are raised by the gift of the grace of God because Christ paid the penalty for sin and gave us life, truth health (Romans 6:23). That offer of forgiveness of sins—the removal of sin’s consequences—is made available for all (John 3:16). We cannot remove our own sin; this can only be done for us by Christ through faith (Ephesians 2:8-9). “If because of one man’s trespass, death reigned through that one man, much more will those who receive the abundance of grace and the free gift of righteousness reign in life through the one man Jesus Christ” (Romans 5:17; cf Romans 8:21-23; 1 Corinthians 15:22). Spiritually, the only way from illness (death) to health (life) is the forgiveness of sin and the imputation of Christ’s righteousness (John 14:6). This is accomplished once and for all upon justification and is manifested gradually through sanctification. If a client is spiritually healthy, though his or her body may die, he or she is alive with God for eternity (Romans 8:35-39). Ultimately, death (the opposite of health; the epitome of illness) can only be postponed, and even then only by the will of God (Psalm 90; James 4:14-16); however, Christ ultimately conquered death and the way to eternal spiritual health (life) is only by Him (1 Corinthians 15:50-57; John 14:6). Physical health is to be understood as an infinite continuum between health and illness and is relative to the client and, like environment, is interpreted by the client.  Optimal physical health can never be fully attained due to our fallen state (Genesis 3:16-19; Psalm 90). A high degree of healthfulness on the health-illness continuum—determined by the client’s perception of his or her attainment of equilibrium physiologically, socially, emotionally, and cognitively—is certainly attainable. There is a large degree of interaction between physical and spiritual health. God should be seen as sovereignly controlling sickness and wellness, death and life: “See now that I, even I am he, and there is no god beside me; I kill and I make alive; I wound and I heal; and there is none that can deliver out of my hand” (Deuteronomy 32:39). It must always be remembered when attempting to bring health to a client, a nurse is ultimately subject to the will of God. Therefore, prayer will play a large role in the effectiveness of a Christian nurse’s care (James 5:13-15).  Prayer is between the nurse and God and if praying would offend a client, the petition should be made to God silently.

What Is Your Belief About Nursing?
Nursing is the loving care provided to a client to mutually move him or her further toward health away from illness on the health-illness continuum or binary scale, health promotion. This must be done by respecting the views, beliefs, and attitudes of the client toward health, making use of the growing body of scientific knowledge available to the professional nurses. Spiritually, this work of health promotion can only be done by God (Ephesians 2:8-9; John 6:43-44). The Christian nurse’s spiritual responsibility is to live out Christ’s example of true selfless, God-glorifying, loving care and concern for people (Matthew 5:16; Philippians 2:15; 1 Peter 2:12). This gracious loving care of the Christian nurse may move his or her client to ask about the motivation behind his or her supernaturally-empowered care. At this time, the Christian nurse is free to share the reason for his or her hope (1 Peter 3:15). It is of the utmost importance that the nurse respect the beliefs of others and not force his or her beliefs on that individual while providing nursing care to that client. I will always pray privately for my client, and my nursing care will be motivated and guided by my spiritual beliefs; however, I will always respect that client’s beliefs and will not force my own on that individual, nor will I ever let my perception of the spiritual health of a client affect my physical care of that client. It is not my primary role as a professional nurse to assess or treat a client’s spiritual health; however, as a Christian, I am constrained by my love for people to care for their spiritual health (2 Corinthians 5:14-15; cf 1 Timothy 4:8).

Nursing as applied to the physical aspect of the individual seeks to compassionately facilitate a client’s attainment of his or her perception of health through the nursing process of assessment, analysis, diagnosis, planning, implementation, and evaluation. Attainment of physical health through nursing involves both illness prevention and health promotion. Nursing accomplishes this by integrating physician-like medical care (health promotion and prevention) and compassionate holistic care that attends to the perceptions of the client. Thus, the nursing profession must make use of physical, biological, and behavioral scientific knowledge and empirical data as well as loving, self-sacrificing, gracious, joyful, Christ-motivated care for clients’ needs (Matthew 25:35-40). The nurse needs to be culturally informed and sensitive in order to be able to understand each client’s unique background, circumstances, and views so that the nurse is able to enhance the health of that client through use of medicine, loving compassion, and education. Just as Christ sought to heal the whole person (Mark 2:17; Luke 4:40), so the nurse should seek to heal (promote health in) the whole person. It should also be mentioned that if the nurse does not believe that the tasks asked to be performed as a professional nurse (such as abortion or ending a life) are consistent with his or her perceptions of loving care and health promotion for the client, the nurse may conscientiously object. On the other hand, the nurse may not coerce a client to accept care or to adopt the nurse’s beliefs. Likewise, the nurse may not withhold care from one who believes or has done something that is contrary to his or her beliefs. For example, although a nurse may conscientiously object from taking part in an abortion, care for the mother of the aborted baby must not be withheld; indeed, that person should be cared for and loved all the more by the nurse.

What Are The Values You Attribute to Nursing?
My views toward nursing, as described above, dictate that I be selfless, honest, loving, and respectful in my nursing, while always recognizing the client’s human dignity (an image-bearer of God). The Christian nurse must always seek to emulate Christ. A nurse is also inquisitive (Acts 17:11), constantly pushing him or herself to better understand the world, both scientifically and biblically. Finally, my work as a nurse is not primarily to serve an overseer or to please a client, but is done for the Lord. I will work and fulfill my duties in an honest manner as a professional nurse according to Professional Nursing Code of Ethics, abiding by facility policy and protocol, “not by way of eye-service, as people-pleasers, but with sincerity of heart, fearing the Lord...[working] heartily, as for the Lord and not for men” (Colossians 3:22-23). The nurse must abide by a very high standard, but the Christian nurse by an even higher.

What Is the Reason For the Existence of Nursing?
Nursing exists because suffering exists. Nursing exists to relieve suffering, which occurs by promoting health. Health, even simply physical health, cannot be achieved within a medical or pharmacological framework alone. The whole individual must be cared for, which takes a deep, self-sacrificing level of loving, compassionate, and humble care.             Suffering exists because humankind has rejected God; we have by our sinful actions and attitudes, asked God to leave us alone so that we can live according to what we think is best rather than what the Creator says is best. Therefore, we all deserve—indeed, we have asked for—the suffering we experience and more. We all deserve to have the gift of life taken from us because of our rebellion (Romans 1:18-32); therefore, humankind, which was designed live forever without pain now lives in a fallen world of death (Genesis 3:16-19; Romans 8:19-21).  However, God gives us all grace to live and enjoy at least parts of life, “For he makes his sun rise on the evil and on the good and sends rain on the just and on the unjust.” This is called common grace, grace that is given to everybody, even those who have not accepted saving grace through faith. I can follow my nursing philosophy of imitating God-Incarnate’s example by dispensing common grace to all. Nursing is a wonderful opportunity to do that. I can give grace to others only because God grants my clients and me the grace to enjoy some degree of health, the grace to continue to live, even to continue to exist (Colossians 1:17). Furthermore, the special saving grace that I have received moves me to serve even more. I owed a debt that could not have been repaid in a thousand lifetimes (Matthew 18:23-35), yet Christ, even while I was His enemy (Romans 5:10), died as a payment for my sin to be received by faith (Romans 3:25). If I truly believe that he died and has suffered to pay the entire price, I will be—I am—compelled to give my life graciously to all in service to Christ (Galatians 2:20; Philippians 2:4-8). I cannot repay Him, but that’s the point; that’s why grace is grace. My faith is best shown when I serve those who cannot repay (Luke 14:12-14), those who are most in need (James 1:27-2:17), and ultimately, every member of humankind (Galatians 6:10). Therefore, nursing exists to demonstrate God’s goodness and mercy to all mankind. How Do the Client, Environment, and Nursing Interact in the Context of Health?            

The nurse, client, and environment are inseparably linked. The nurse works to promote health in the client. The client must receive the nursing care and mutually work along with the nurse to both promote health and prevent illness. The environment can tend to enhance or detract from the nurse-client health team from achieving health. Some aspects of the environment cannot be changed; however, the nurse and client can work together to affect change on many aspects of the physical, psychosocioeconomic, and spiritual environment in order to better accomplish health promotion. The environment will dictate many of the particulars of the nurse-client relationship. As the nurse prayerfully cares for a client’s physical needs, God may move to bring spiritual health as well (Galatians 6:9-10).

Thanks for posting your thoughts on this…I’m a nursing student thinking through these same things.
by: Anna () - 12 November '08 - 16:41
Thanks for your thoughts – I’m having trouble figuring out my own philosophy for nursing school (3rd year) – I’m a bit behind, I should have developed one two years ago, but I was too busy working out drug calculations and gas exchange ;)
by: Alice () - 26 May '09 - 17:47
Thank you so much for writing and sharing this. I can see it was totally inspired by Jesus living in you. I have to write a Philosophy for the 1st time in my life (51) and this was a great example and very inspiring. May God bless your nursing career, which is very clearly to His honor.
by: Anna-Marie Kriel () - 04 October '11 - 17:03
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