How America reckons with its fractured reality

The first thing is always to listen. To sit. To feel.

Jared Stacy

Jared Stacy holds a Theological Ethics PhD from the University of Aberdeen. His research focuses conspiracy theory, politics, and evangelicalism.

Two people sit at the table, one dictates as the other types. Behind a banner reads: write a postcard to the next president.i

Artist Sheryl Oring types messages to the president.

instagram/usf_npml

Yesterday, the day after the election, I preached a funeral. I heard the name of our President-elect only once. But I did speak on Jesus and Lazarus. About pain and loss.

I named our enemy, death, that robber, cheat, and swindler. And I spoke about grief—we all grieve in so many different ways. And then about tears. I shared about the man from Nazareth, whose public grief before the tomb of his friend drew hushed whispers from onlookers.

It was, you may remember, a tomb he was about to open. He knew, Jesus did, what he was about to do. And did it so that those who were there would become witnesses to precisely what God is about: defeating death. “Come out, Lazarus!” says Jesus, and he does.

The Christian faith, I told the grieving, would have us believe that even in our grief, there is a hope that hems it in. That Jesus enters our darkness and comes to rob death of its finality. I love too that Jesus says next— “Unbind him!” —turning onlookers into witnesses and participants.

This was how I spent my day. I’m not sure I could have spend it any better. Not because it was an escape from the election, but it forced some perspective on me. Because T.S. Eliot is right: “we cannot bear much reality.”

Here, political autopsies are everywhere. Some talk of the Democrat’s conceit, of denying President Biden’s liability as a candidate, bypassing the primaries, refusing to meet economic concerns. There’s talk of Trump’s genius and what looks to be the end of his legal troubles. There’s talk of the downfall of America, of ascendant and aspiring authoritarianisms. Perhaps. Especially if we take Trump at his word.

But as the funeral ends, I’m weighed down by the messages I’m starting to read. Not about the results alone. Not questions about political strategy and futures. No, these are pained voices from a Christian community in America betraying itself.

My phone messages are filled with stories of pain and loss. Friends and strangers alike, enduring the same loss, the same betrayal. The communities that taught us the faith now distort it. And none of this is new.

Howard Thurman, who mentored Martin Luther King Jr., said it back in 1946: “the tragic truth is that the church permits various hate groups in our common life to establish squatter’s rights in the minds of believers because there has been no adequate teaching on the meaning of the faith in terms of human dignity.” This loss has been with us for generations. But these fissures and fractures are ours to bear today. And they are not unconnected from the social and political chaos of America.

Martin Luther once said, “living, dying, and being damned makes one a theologian.” This has taught me to welcome, rather than despise, accusations that question the validity of my faith. It’s also made me suspicious of the misplaced messianic hope from which such questions emerge. It’s a false hope not easily displaced.

Before I returned to the States from living in Scotland these last few years, a good friend told me honestly: “perhaps America will have to ride it out, all of it, until it’s done.” The thought seemed a far-off scenario then. But I think he’s right.

When Israel built the golden calf in the wilderness, Moses made them grind it up into powder, mixing it in their drinks. The Christian community in America, whether we realize it our not, will soon be drinking our idolatry down to the dregs with consequences beyond Christian community itself.

And people ask, “what should we do?” And I think that time is near for that question. But the first thing is always to listen. To sit. To feel. And to remember that it’s not for nothing that Jesus, who pronounced so many woes over Jerusalem, also wept over it.

This article’s image is of Sheryl Oring, an artist who invites the public to write to the next president. She has typed and sent thousands of messages to the White House every election since 2004 as part of her performance series I Wish to Say. Read more about her and the letters: Artist Invites the Public to Write Letters to the Next US President

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.