NURS 502 Week 5 Discussion Board Forum 1 on Persons, Health and a Christian Worldview Example

Discussion Board Forum 1: The Person and Health in a Christian Worldview for Nursing

NURS 502 Nursing Theory and Advanced Practice, Discussion Board Forum 1

Thread by [Student Name]

The classmates replied to are composites written for a model discussion.

Last month a patient in our clinic with type 2 diabetes, early kidney disease and a stable heart rhythm told me, "I am the healthiest I have been in years." By any laboratory measure the patient has three chronic diseases. Yet the statement was not denial; the patient had stopped drinking, reconciled with an estranged child and was attending church again. Which definition of health makes sense of that claim?

The World Health Organization (1946) defined health as a state of complete physical, mental and social well-being and added that being free of disease or infirmity does not by itself amount to health. That definition deserves credit. It refused to reduce health to the absence of disease, and it named mental and social well-being when much of medicine ignored them. But by its standard almost no one is healthy, and certainly not my patient, because "complete" well-being is a standard few people with chronic illness can meet. The definition also has no place for the spiritual dimension that the patient named as the center of the recovery.

A Christian worldview offers a different starting point. Shelly and Miller (2006) describe the person as a unity created by God, body and spirit together, in relationship with God, others and the created world, and they describe sin and illness as distortions of those relationships rather than the final word about a person. The biblical idea of shalom, often translated as peace, carries the sense of wholeness and right relationship. On that view, a person can move toward health while still carrying disease, because health is measured by wholeness of relationship as well as by the function of organs. The prophet's vision is of a people who "shall not labor in vain or bear children for calamity" (English Standard Version Bible, 2001/2016, Isaiah 65:23), a picture of flourishing that includes but goes beyond freedom from illness.

This view is close to the holism in the theory I am using for my exemplar paper. Erickson et al. (1983) describe the person as a whole of body, mind and spirit and define health as a dynamic equilibrium that can coexist with disease, which leaves room for my patient's claim.

In practice, holding this view changes what I assess and what I count as progress. I ask about relationships, meaning and faith as part of the history, not as an afterthought, and I document gains such as reconciliation or renewed purpose as part of the patient's health. It also changes how I care for patients who will not be cured: the goal becomes wholeness and peace as far as they can be reached, not only control of numbers.

Reply to Rebecca

Rebecca, I agree that a spiritual assessment belongs in every admission, and your point that many nurses skip it because they feel unprepared is honest. One way to lower that barrier is to begin with questions about meaning and support rather than religion, so that patients of any faith or none can answer. The holistic view in Modeling and Role-Modeling suggests asking what the patient believes is happening and what would help (Erickson et al., 1983), and those questions often open the spiritual conversation naturally, because people answer them in terms of hope, fear and relationship. Your idea of a short list of three questions on the admission form is practical, and I would add a fourth: "Is there anyone you would like us to call for support?" That question respects the patient's community as part of their care. Paul's encouragement to "rejoice with those who rejoice, weep with those who weep" (English Standard Version Bible, 2001/2016, Romans 12:15) describes what the assessment makes possible, which is entering the patient's situation instead of standing outside it. Have you seen nurses on your unit refer patients to chaplains more often since your hospital added spiritual screening? I would be interested to know whether referrals rose or whether the questions mostly prompted nurses to stay and listen themselves.

Reply to Daniel

Daniel, your example of the hospice patient who said the last months were the best of their marriage illustrates the distinction between healing and cure that the readings drew. I think your argument could go one step further. If health is wholeness in relationship, then a nurse's work at the end of life is not a retreat from health care but one of its most direct forms. McEwen and Wills (2014) point out that a theory's definition of health shapes what nurses do, and a definition that allows healing without cure gives hospice nursing a positive goal rather than a defensive one. Jesus' words that he came so that people "may have life and have it abundantly" (English Standard Version Bible, 2001/2016, John 10:10) are about more than length of life. Your patient's last months are a picture of that abundance under very hard conditions. I wonder whether your hospice team documents these relational goals anywhere in the plan of care, or whether they live only in conversations at the bedside. Capturing them in the record could help new team members see what the patient and family most want protected.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Prentice-Hall.

McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Wolters Kluwer Health.

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). IVP Academic.

World Health Organization. (1946). Constitution of the World Health Organization. https://www.who.int/about/governance/constitution