Sunday, June 1, 2014

Guest Moodler -- Listening to hearts

Here's another beautiful piece from my best friend and guest moodler, who is coming for a visit in 5 more sleeps (yay!). I love to publish her sermons here, because I think her ideas deserve a wider audience, she's a good writer, and a wise woman. Her postings always get a lot of views. She gave this sermon last Sunday...

Listening to Hearts
May, 25, 2014

Cathy Coulter

Let’s play a game. I’ll name an occupation and you picture the person in that occupation. Ready? Firefighter. Farmer. Teacher. Surgeon. Nurse. I’m curious how you pictured the nurse. With a uniform? A white uniform? Carrying a thermometer, or a cup of pills or a bedpan? All valid images and mostly based in hospitals. It’s natural for people to assume I work in a hospital when I say I’m a nurse. But I never wanted to work in hospitals. I gave it a try off and on after graduation but never for long. It’s not that I don’t like hands-on-caring for patients. Hands-on-caring is one of the things I love best about nursing. No, it was the hospital environment, system and culture that made my heart sink. Not to mention the brutal shift work of which I put in my time. I worked in the Jubilee Hospital for eight years but for Victoria Hospice which, while set in a hospital, is not hospital nursing.
          Now I work for Home Care Nursing. Not many people know what an RN does in Home Care. It’s not the same as Home Support workers who provide personal care. It’s not the same as a Public Health Nurse. It’s hard to keep all the different kinds of nurses straight.
          So imagine people’s bafflement when I tell them I’m also a Parish Nurse, a nurse who works for a church. “You work for a church?” some of them say in bewilderment. I can see their minds trying to picture what I do. I wonder if they have visions of me tiptoeing around in my white shoes during a church service with a thermometer and blood pressure cuff, quietly checking out people’s vital signs during the sermon.
          I understand why people so commonly ask, “What does a Parish Nurse do?” and I certainly don’t mind being asked but it’s hard to give a short, snappy answer. People are used to thinking of nurses in terms of the tasks they do: the hands-on-care, carrying out doctors’ orders, monitoring vital signs, changing dressings. But they do a whole lot more that’s not as obvious to the casual observer. It’s the “whole lot more” that for me is the heart of nursing, and much of that whole lot more takes a whole lot of time to explain because it’s about relationship and intuition and seeing into the heart of people to assess what is really going on. Nurses listen to people’s hearts.
          The visionaries in this church who wanted a Parish Nurse and paid for one (me) out of the Visioning Fund, recognized that pastoral care visits often included questions around medical or health issues and having a pastoral care person with a nursing background would be helpful. There was also the insight that we have many seniors in our congregation, many who don’t have their families nearby and a Parish Nurse could be resource for them, especially in navigating the health care system. We have an amazing health care system that works well for the most part but as we all know there are cracks. A Parish Nurse can help prevent people from falling between the cracks. I hear stories of people outside of our church family who needed support of some kind, whose family perhaps wasn’t near, who didn’t know how to access services or even that there were services to access. “They need a Parish Nurse,” I think. Someone who could provide information, translate what the doctor said, educate about medications, guide on what to expect, connect people with resources and help ensure people are getting the follow-up they need.
          In the 5 years I’ve been Parish Nursing, I have been able to help many members of this church family on this practical level. But after 5 years, I see this role as a whole lot more… the whole lot more that I mentioned before that’s about relationship and healing.
          As a Parish Nurse I accompany people on their life journey and that journey often takes us through places of suffering. Sometimes that suffering is resolved, for example, a successful medical procedure or end of an illness, and sometimes that suffering is transmuted into an ongoing grief, but either way, healing can happen.
Our modern western medical/health care system does not know what to do about suffering. Suffering can’t be seen on a CT scan. It can’t be fixed with a pharmaceutical. And when something can’t be measured or fixed, it’s ignored because it makes our fix-it mentality uncomfortable. An article in The Journal of the American Medical Association acknowledged that Western Medicine has no model to help people through their suffering. That’s an astonishing statement, that Western Medicine has no model to help people through their suffering. In fact, from what I’ve seen, our modern systems often add to suffering.
          Enter the church. Religion is supposed to be the place where we grapple with the big questions of life, love, suffering and death. Good religion doesn’t provide easy answers but a container in which we acknowledge the questions and wrestle with the mystery. This is called spirituality and spirituality is gets short shrift in Western Medicine and our health care system. Spiritual care departments in hospitals and care centres have been cut by more than half, and I’d say almost to nothing. Spiritual care is seen as an unnecessary frill in today’s tight budgets.
          The health care system is a reflection of our North American society. We don’t want to deal with suffering. We don’t want to be out of control and suffering is being out of control. Dame Cecily Saunders is the founder of the modern day Hospice movement. Her observation was that spirituality is the most overlooked factor relieving pain and suffering. I agree with that 100%.
          Don’t get me wrong. If I’m sick, take me to the hospital. Give me skilled medical staff and medications or medical treatments to cure me or ease my symptoms. But please, send someone to companion me while I’m in there, to pray with me and remind me of God’s presence. That’s soul medicine.
          A Parish Nurse can be such a companion, as can a minister, a pastoral care worker or volunteer, a friend, a neighbour, a family member, or indeed, a compassionate health care worker. God’s spirit is not left kicking her heels in the hospital parking lot. She moves and heals in surprising ways and in unexpected places.
          Our health and wholeness is not just impacted by the state of our physical health and abilities. If, as a nurse, I am listening to hearts and attending to suffering, I am a witness to the tragic gap. The tragic gap is where suffering arises. Let me explain.
The tragic gap occurs when we have a circumstance that causes us pain and there doesn’t seem to be any way we can fix it. We have the ideal or how we want things to be on the one hand and the reality on the other and there is no way we can see those two coming together. There is a tragic gap. 
I recently bumped into one in my own life. I considered strategies that might help or miraculously fix things but that only made me more anxious in feeling I could and should do something. And then one morning I woke up with this crystal clear thought. “My love cannot save anyone.” I experienced the tragic gap. And it was a humble, painful and profound moment.
Families are full of tragic gaps. Life is full of tragic gaps. I’m sure you can think of one of your own. Sure, we can work at solving problems but eventually we run into a situation where we don’t know what to do, or accept that there is nothing we can do. But what does this have to do with Parish Nursing? Well, over the years, I’ve bumped into many situations of suffering that can’t be fixed. As a nurse, that’s frustrating. We try to fix everything. But what I have noticed, is that sharing our stories and having our hearts listened to can give us the courage to step into, or, more likely fall into, the unknown, into that tragic gap and find that God is there, not only holding us, but holding the situation much better than we can. And we start to have hope, and we start to heal. God moves and heals in surprising ways and in unexpected places.
Our reading today in Peter tells us that bad things happen to good people but there is a hope in us despite that. In John, Jesus reminds us that he will never abandon us and says “you are in me just as I am in you.” That is the Spirit that is at work in our healing.
It is because I love the depth and vastness and mystery of the spiritual life that I love Parish Nursing. Hippocrates, the ancient father of modern medicine said if the suffering person ever begins to attend to soul, the soul responds a thousand fold. We need companions on that soul journey. That’s why I’m here. I’m here for you. And I thank you and this church for the gift of that. It is truly a gift to me.

 Thanks be to God.

During the time of community prayer, Cathy invited those listening into a little ritual, in which she invited them to hold out their hands on either side of them, saying, "When I learned of the idea of the tragic gap at a conference, we learned a simple ritual that I invite you to try now as we pray. Think of a circumstance that for you has a tragic gap, that seems impossible and unfixable and is causing suffering. In one of your hands, hold the situation in its idea, and in the other hand, hold the situation in its reality. During our prayer we will bring our hands together and hold them over our hearts."

What a beautiful way to pray! Today I hold two tragic gaps -- those of Richard and Ruthie -- in my hands as I pray, remembering how God holds us all...

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