Presentation on theme: "Grace J. Tazelaar MS, RN Missions Director Nurses Christian Fellowship"— Presentation transcript:
1Grace J. Tazelaar MS, RN Missions Director Nurses Christian Fellowship Things They Didn’t Teach in Nursing School: Preparing for Missionary NursingGrace J. Tazelaar MS, RNMissions DirectorNurses Christian FellowshipDescribe the differences between a scientific/medical understanding of Health and Illness and those of other cultures.Appreciate that the gospel message is interpreted through a cultural worldview.Identify tensions that often occur between cultures.Present the basic spiritual needs that all people have and ways to provide spiritual care to meet identified spiritual needs.Differentiate between professional education, competency based education for given tasks, and health education necessary for changing behaviors.
2Topics for Missionary Nursing Cultures/WorldviewSpiritual CareHow to teach
3Culture/WorldviewWorldview – “culturally agreed upon perception of reality, in other words worldview bridges the gap between objective reality and a person’s perception of it”Lane, Patty. A Beginners Guide to Crossing Cultures. Downers Grove, IL.: InterVarsity PressRead story from Patty LaneLiving in Uganda – never could totally understand UgandaFlorence Muindi in Louisville – perception of missionaries.
4Culture/WorldviewValues and BeliefsWorldviewWhat we do or Practice
5Culture/Worldview HEALTH AND ILLNESS Nursing grew out of a Christian worldviewHistorically nursing practice is based in the scientific/medical understanding of health and illnessGerm theorySystems theoryEvidence based practice
6HEALTH AND ILLNESSHost cultures may have a different understanding of health and illnessIllness may be:Considered normal – everyone suffers from this problemCaused by a broken relationshipRelated to a curseAnne Fadiman When the Spirit catches You and You Fall Down
7HEALTH AND ILLNESS John 9:1- 7 1 As he went along, he saw a man blind from birth.2 His disciples asked him, "Rabbi, who sinned, this man or his parents, that he was born blind?"3 "Neither this man nor his parents sinned," said Jesus, "but this happened so that the work of God might be displayed in his life.4 As long as it is day, we must do the work of him who sent me. Night is coming, when no one can work.5 While I am in the world, I am the light of the world."6 Having said this, he spit on the ground, made some mud with the saliva, and put it on the man's eyes.7 "Go," he told him, "wash in the Pool of Siloam" (this word means Sent). So the man went and washed, and came home seeing.How do the disciples see this man born blind?Disciples’ WorldviewIllness is caused by sinSomeone caused this illnessSimilar to animistic cultures today – ancestors, curses, broken relationships cause illnessHow does Jesus see him?Biblical worldviewThe “Why” of illness and suffering leads to a decision toDraw closer to GodBlame someone – self, others, GodMay or may not be the result of sin
8Culture/Worldview Understanding of the Gospel message Jackie and Bill are developing a relationship with Luc and Li. The have been drawn together because their third grad children have become best friends. Luc and his family are first generation immigrants from Vietnam. They have been in the United States for six years and during that time have developed good English communication skills. Jackie and Bill consciously work at bringing up spiritual matters with Luc and Li. They all seem to be in agreement about the importance of knowing Jesus, and Luc and Li have prayed to receive Jesus.You can imagine their surprise when their daughter came home telling about the altar set up to Luc’s ancestors with real food on it! They did not understand this custom nor did they know what to say to their daughter. After prayer and talking with their minister, Jackie and Bill went to visit Luc and Li. They saw for themselves the altar and began asking questions about its meaning.Luc explained the Vietnamese tradition of ancestor veneration. He believed it was important for him to pray to and honor his ancestors in order to secure their protection and blessing for himself and his family. In addition, Luc had a responsibility to honor his dead relatives so that they could be happy in their new lives. He explained that this tradition had been carried on in his family for hundreds of years.Bill wanted to laugh. How could anyone believe such nonsense? But he refrained from commenting and began instead to ask Questions about Luc’s faith in Jesus. It soon became obvious that Luc saw no problem with believing in Jesus and venerating his ancestors.Jackie began to talk to him and to Li, trying to explain how their ancestors had no power to effect their lives. She alos emphasized that Luc had no ability to secure a happier life for people who were already dead. She went on to share how their faith in Jesus was all they needed. They could pray to him and he would help them. The ancestors were dead and there was nothing they could do for them now. This prompted Luc’s questions, “Does this mean that my ancestors are in hell?” Sadly Jackie told him that if they had not believed in Jesus they would not be with him in heaven he died. Luc immediately said he would not believe in Jesus then because he could not be responsible for his parent and grandparents being in hell. All efforts to persuade him that what he believed would have no bearing on the final destination of anyone but himself were futile. The visit cam to an end and the two couples said a sad goodbye.Opini – polygamy – “What else did the missionaries tell us that was wrong?”The Missionary and the Diviner: Contending Theologies of Christian and African Religions (Paperback) by Michael C. Kirwen (Author)
9Cultural tensions Lingenfelter, Sherwood G. & Mayers, Marvin K Cultural tensions Lingenfelter, Sherwood G. & Mayers, Marvin K. Ministering Cross-Culturally: An Incarnational Model for Personal Relationships. Grand Rapids, MI.: Baker Books. 1997Tensions about TimeTensions in JudgmentTensions in Handling CrisisTensions over GoalsTensions about Self-WorthTensions regarding VulnerabilityBalancing act between the tensions outlined. One not better than the other (not a moral judgment); but we need to appreciate the other viewpoint.
10II. Spiritual Care Assessing Spiritual Needs Personal Relationship with GodView of GodView of ManView of JesusMeaning and PurposeLove and BelongingForgiveness
11The Person Providing Spiritual Assistance Should have their own spiritual needs metNot get ahead of God and do in our own strengthNot get behind and miss opportunitiesIn tune with GodWe need to carefully examine our motives for providing spiritual assistance.Because we are not perfect, we sometimes get ahead of God and try to provide spiritual assistance on our own. Sometimes we use helping others to meet our own spiritual needs. We may find our identity and meaning in life as a spiritual person. Or we may seek to find favor with God by “doing” His work. Other times, we may drag our feet and miss opportunities that God has given us to provide spiritual assistance.To prevent these failings that ultimately hinder God’s work from occurring, we need to carefully examine our motives for providing spiritual assistance. Is it because this is something God is prompting us to do? Or is it something we feel that we should or ought to do because of expectations that have been placed on us by ourselves or others? There is a tendency to think that without us, “the world would go to hell in a hand basket.” We get so caught up in the “doing” that we forget that the reason that God created us was to have a personal relationship with Him. We forget that He desires us to become all that He has created us to be. We fail to take the time to just “Be” and fellowship with God. This is not saying that we should all live hermitlike lifestyles. God created us for work in His Kingdom. However, doing only those things that God has called us to and gifted us for is freeing. We are not responsible to meet all the needs of everyone in the world. That’s God’s job. We are not fixers but facilitators.We are only required to be obedient in the things He has given us to do. He has promised us that He will provide the resources that we need to do those things. “Therefore you do not lack any spiritual gift as you eagerly wait for our Lord Jesus Christ to be revealed. He will keep you strong to the end, so that you will be blameless on the day of our Lord Jesus Christ. God, who has called you into fellowship with his Son Jesus Christ our Lord, is faithful.” (I Corinthians 1:7-9) It is also comforting to know that our God is a redeeming God. He can and does use us in spite of our weaknesses and failures.
12The Person Providing Spiritual Assistance MotivationMeet the spiritual need of the person for whom you are caring?Meet your need to share the gospel?
13The Person Providing Spiritual Assistance Be obedientDo only the work God has given us to doDon’t try to do the work of the Holy SpiritGod often uses our weak areasGlory goes to God
14The Ministry of Presence Being Christ in a person’s life.Comfortable in silenceTherapeutic communication skillsExcerpt from The Last Thing We Talk Aboutoriginally published as A View From the Hearse“I was sitting, torn by grief. Someone came and talked to me of God’s dealings, of why it happened, of hope beyond the grave. He talked constantly, he said things I knew were true.I was unmoved, except to wish he’d go away. He finally did.Another came and sat beside me. He didn’t talk. He didn’t ask leading questions. He just sat beside me for an hour and more, listened when I said something, answered briefly, prayed simply, left.I was moved. I was comforted. I hated to see him go.” Bayly, Joseph. The Last Thing We Talk About. Elgin, IL, David C. Cook, 1970
15Meeting Spiritual Needs Through Scripture Personal study of the Bible prerequisiteUsing scriptureMeet the identified spiritual needPerson is agreeable to the ideaNot using scriptureInappropriate applicationPersons with acute mental illnessInappropriate application -- exhorting an anxious person with “Do not be anxious about anything,” (Philippians 4:6) is probably not going to relieve the anxiety.Persons with acute mental illness can view scripture in a magical or confused way.
16Meeting Spiritual Needs Through Prayer Not magicPersonal prayerFor othersWith their permissionApart from the person on their behalfNot magic – research into effectiveness of prayer determined by desired outcomes puts God in our box.Personal prayer“Prayer is intimate conversation between us and God. It is our response to God’s initiative. Prayer is recognition of our human limitations and our need for God…True prayer is a dialog.”Lord’s prayer as a model – ACTSSpiritual warfareFor othersWith their permissionA known comforting prayer – the Lord’s prayerPray short, simple prayers that present the hopes, fears, and needs to the Lord. Acknowledge God’s ability to meet these needs. If the need is not well articulated or understood, we can tell God that in prayer.Apart from the person on their behalf – intercession Shelley, Judith A., and Fish, Sharon. Spiritual Care: The Nurse’s Role 3rd edition. Downers Grove, IL: InterVarsity Press p. 107.
17Meeting Spiritual Needs Through the Church The Body of ChristEach has unique gifts to bring to the tableEach person is a work in progress – in need of graceEveryone is neededThe Body of ChristEach has unique gifts to bring to the tableEach person is a work in progress – in need of graceEveryone is neededUnity – the message of the gospelCan’t be jealous of others giftsBy the love we have for one another, others will see Christ.Don’t neglect the Church in our priorities.
18Meeting Spiritual Needs Through the Church Unity – the message of the gospelCan’t be jealous of others giftsBy the love we have for one another, others will see Christ.Don’t neglect the Church in our priorities.
19How to Teach Most educators Aim at the cognitive domain Focus on providing informationTend to teach the way we have been taught.
20How to teach Health education should Aim at the practice domain Focus on changed behaviorUse methodology appropriate for adult learners
21Adult Education Theory Implications 1. Adults are capable of learning throughout their lives1. Everyone should be given opportunity2. Adults are the agents of their own education2. Emphasis is on learning; not teaching3. Adults have a wide experience and have learned much from life3. Begin with what they know4. As adults grow older their memories may get weaker but their powers of observation and reasoning often grow stronger4. Don’t emphasize facts as much as present concepts5. Adults have a sense of personal dignity5. Treat them with respect
22Adult Education People Remember: 20% of what they hear 40% of what they hear and see80% of what they discover for themselves
23Adult Education Problem Posing method Presents a problem (without offering a solution)
24Adult Education Presenting the Problem Starters/Codes Songs Pictures DramasStoriesGames/Riddles
25Adult Education Qualities of Good Starters/Codes (5 Ss) Short Simple SpecificSensitiveSolvable
26Adult Education SHOWeD See Happening Our Why Do What did you see or hear?HappeningWhat is happening?OurDoes this happen in our community?Give examplesWhyWhy does it happen?eDoWhat can we do about it?How? Who? When? Where?
27Curriculum Development ProfessionalBody of knowledgeRegulated practice – LicenseBuilt on foundation of arts and sciencesLack of nurse educators is worldwide – both in the US and in other countriesLots of missions opportunities for nurse educators.
28Curriculum Development Competency/MasteryPrepares person for a task/jobFocus is on skill/job performanceInformation is limited to what is necessary to learn the skillCommunity health workersCertified nursing assistantsPhysicians assistants
29Develop a list of skills What knowledge does the health worker need to do this task?What would be nice to knowWhat would be good to knowWhat is essential to knowMalaria educationProfessional education would teach the life cycle of the mosquito, pathophysiology, signs and symptoms of disease, laboratory tests, diagnosis, treatment, evaluation. Might include means of prevention.Competency/mastery would teach how malaria is spread, how to diagnose and treat malaria, and how to prevent it.
30Develop a list of skills What attitude does the health worker need to do this task well?Attitude is key to practicing the skill well.
31Develop a list of skills What practical skills does the health worker need to do this task?CommunicationProblem solvingManual
32Knowledge, Attitude, Practice Learning has not taken place until it is put into practiceHead knowledge passes through values/beliefs before being acted uponSmokers continue to smoke even though they know it is detrimental to their healthDistance between heaven and hell is distance between head and heart
33Adult EducationWhat we do or PracticeValues and BeliefsWorldview