As of today, I am not one of the 2350 men who will get breast cancer this year. The only man that I have seen who had breast cancer was a heavy marijuana user (not a risk factor they tell you about in Colorado.) Yet I have been affected by this illness. A non-English speaking woman asked me to attend her weekly chemo treatments when she was getting substandard care. Several friends have been affected as well. So what does this type of experience cause me to write about- the spirituality which surrounds this disease.
I mean real spirituality not the hallmark card type of spirituality that you see on TV. In those shows, breast cancer patients are spiritual giants, unfazed by death, and caregivers have all the time in the world. Reality is much messier and interesting.
During the weekly chemo treatments I attended, I noticed that it was easy for nurses to slip into a business as usual mode where each chemotherapy patient merged into another. It was clear that it took an effort to treat patients as individuals with their own demands and frustrations. A nurse's normal everyday tasks are once in a lifetime occurrences for our patients. Being able to keep this patient perspective in mind, despite the thousand little tasks we do every day, is made possible only by a spiritual attitude. Caregivers have a variety of ways to express spirituality-prayer, meditation, reading and journaling all help us to quiet our busy mind. The nurses who were able to care for my friend, not as another chemo patient but as a person, all seemed to have this spiritual attitude in common. It was both a credit to our profession and challenge to me.
A friend of mine, in the middle of her chemo therapy regime, made it a point to ask me about my family. She was genuinely interested in what was happening in my life despite all that was happening in hers. I have had similar experiences with other breast cancer patients. Somehow, they were not so fixated on their life that they could not be interested in my mundane life. It was as if being unselfish somehow made their pain easier to bear. Hmm, an interesting thought occurs to me. Maybe I have been trying to do the same with my whole nursing career.
What have been your real experiences with spirituality and breast cancer?
Defining spirituality can be done in such a way that it does not raise controversy. If I define spirituality as "Whatever is not the mind and the body", everyone could agree on this definition but it would be totally useless and frankly silly.
Spirituality is important. Therefore, as with anything important, definition creates controversy. For some, spirituality is centered on a place, like Mecca, or a book, like the Torah. Some reject organized religion or a deity and look for a definition inside themselves. For researchers, spirituality must be measured. How often do you go to church? How often do you pray? For others, measuring spirituality kills it.
In the nursing literature some have argued that health care occurs in a public space that is particularly secular and that all the effects of spirituality can be explained with psychology. Others argue for a Christian Western perspective linking spirituality to a particular religion. Others argue that we must honor diversity and not mention religion, as if spirituality excludes religion.
All these points of view come to bear when you attempt to define spirituality. As soon as you put one definition forward, someone will say "What about this?"
But let me give it a shot. An old story about nurses helped me define spirituality. The Nurse Midwives in Exodus Chapter 1, Shipporah and Puah, successfully resisted Pharaoh's Command to commit genocide because of their "Fear of God."
The original word used for Fear of God is "Yirah." Yirah can be translated as "God's Perspective". These Nurse Midwives saw their problem from God's Perspective and used this point of view to engage and work through an insoluble problem. For me, spirituality has two characteristics -perspective and engagement which flow from a relationship with a Supreme Being. I define spirituality as that which enables me to see the world from God's Perspective and gives me the courage and hope to use that perspective to work through the insoluble problems I face as a nurse.
My definition gives me enough confidence to accept and encourage diverse opinions and yet still be able to use spirituality in my practice without timidity. While I don't have a blood test for spirituality, I have seen its effects in patients and co-workers and think this definition accounts for what I have seen.
Spirituality is best discovered through story. Share a story with us that illustrates your definition of spirituality.
What the first thing you think about when you hear the word spirituality? When I ask nurses about integrating spirituality into their practice, I hear many reactions including
- It's all fluff
- I am too busy
- Or the best one "Are you asking me to go and knock on some strangers door and ask them to go to church?"
Despite all the misconceptions we have about spirituality, it is full of untapped potential. I would propose that the most important question is: How can we use spirituality effectively to help our patients? As I have tried to integrate spirituality into my practice I have run into many challenges, some interesting, some funny, some downright strange. Some the most memorable questions (and their short answers) include:
- Can spirituality actually improve health? (Yes it can.)
- Is there a definition of spirituality? (Yes there are several and therein lies the effectiveness of spirituality)
- Won't using spirituality offend people? (I have attempted to use spirituality for 20 years and have not offended any patients.)
- What about my own spiritual beliefs, aren't they are important as those of the patient? (Yup, bring 'me along. Diversity of spiritual beliefs is a strength.)
- What does the research show about spirituality? Can you even do research into spirituality? (Yes you can research spirituality and the preponderance of research shows it can have beneficial effects on health especially health behaviors)
- Can I learn to integrate spirituality into healthcare, especially my practice? (Yes.)
These series of blogs will be dedicated to exploring these questions. I will try and offer objective helpful information but will also offer my own thoughts and experiences. I am not a theologian. I am a nurse only; ADN trained but current in school for my FNP. I learned about spirituality from my patients.
When I was working at the alcohol and drug recovery center, a number of years ago, I saw people come and go. Many addicts would leave the center bright eyed and bushy tailed only to come back a week later with a nose full of cocaine, a blood stream full of alcohol or both. A few would come back clean and sober to help those who were still suffering. Every one of the recovered addicts would tell me they owed their sobriety to a relationship with a higher power and a mature spirituality. I realized there must be something to spirituality. Nurses witness the power of spiritualty in all areas- from the cancer patient who finds strength to the hospice patient who graciously accepts death to the person with a chronic illness who survives every day.
As nurse, if we are to care for body mind AND spirit, then an exploration of spirituality and its use in our daily work is worth our time. I would welcome your thoughts. When have you seen spirituality make a difference in the life of one of your patients or in your own practice?