cancer, Christianity, death & dying, nursing, spiritual care



  1. Mills, Deborah Stephens
  2. Flynn, Kathleen T.


ABSTRACT: Nurses frequently care for dying patients and their families. For Christian nurses, the issue of dying patients' relationship with God has been a long standing concern. This case study, first published in 1985, relays this struggle. The responses of spiritual care experts and nurses promote offering individualized spiritual care based on patient needs, not prescribed religious formulas.


Article Content

Jerry was twenty-three years old. His enemy was leukemia, now accompanied by pneumonia too fierce to control. I had known Jerry for two years, watching him progress and regress, in roller coaster fashion, through good days and bad. As a clinical specialist in cancer nursing, I had coordinated his care in and out of the hospital. But this time Jerry wouldn't be going home.

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The staff nurses knew Jerry well; he had been hospitalized several times before. When the staff nurses were with Jerry, they filled their time with tasks, giving him drugs to keep him alive and trying to keep him comfortable


Leaning over the side rails at the head of his bed, which was raised to help him breathe, I watched Jerry. Pneumonia filled his chest, making him work hard to get enough oxygen. With his breathing labored and fast, Jerry couldn't talk much. Nonetheless, he tried.


"How's it going?" That was Jerry's usual opening.


"Okay," I said. "How's it going with you?" I knew the answer but didn't know how else to respond. My smile must have looked weak, if he noticed it at all.


"Hanging in there," he said, too sick to smile, but wrinkling his forehead with a nod. I thought he was trying to convince me he wasn't as sick as he looked. Maybe if he convinced me, he could convince himself. It had worked in the past.


"We're hanging in with you, too, Jerry." I felt as if I had just lied to him somehow. I touched his shoulder, then busied myself with checking his IV lines as his nurse hung another antibiotic. I envied her ability to be absorbed by activity. Once a staff nurse myself, I knew tasks don't remove the sadness, but they do fill a need to be doing something. Words seemed so inadequate and out of place. I couldn't think of anything relevant to say, much less anything profound.


I believe that when someone nears the end of life, the most important issue continues to be what that person's relationship is with God. That day, as I stood with Jerry, I was distressed by not knowing.


In a troubled time, David [Ancient King of Israel] wrote about God's mercy: "I will be glad and rejoice in thy mercy: for thou hast considered my trouble; thou hast known my soul in adversities; and hast not shut me up into the hand of the enemy" (Psalm 31:7-8, KJV).


Did Jerry know God's mercy? I would never be sure. During his extended treatments he never talked about having or desiring a spiritual relationship or identity. When I met with Jerry, we talked about changes in his therapy, new symptoms or family problems. Occasionally, when appropriate, I tried to move the discussion in the direction of his spiritual needs. But he'd shrug his shoulders uncomfortably and mutter that he needed to be getting back to work. I had talked to his grandfather, who shared my concern for Jerry and his relationship with God. Now, before any of us were ready, Jerry was dying.

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1. How should Christian nurses understand their role in carrying out Christ's commission, "Go into all the world and preach the gospel to the whole creation" (Mark 16:15)? Does their role differ from other Christians? How?


2. What principles should guide nurses in talking about the gospel with patients?


3. Deborah hopes Jerry will have eternal life, and believes it is related to having a relationship with Christ in this life. What might she have said or done earlier when Jerry shrugged off her attempts to discuss his spiritual needs? What should she say or do now while he is dying?