1. Hanna, Kimberly Joyce

Article Content

Self-esteem, how we see ourselves, changes throughout our lives. I grew up feeling secure and with a developing faith. However, my self-confidence decreased as I grew into adulthood. As a young nurse working on an oncology unit, I faced life and death situations. I struggled emotionally and mentally with caring for my terminally ill patients. I began to focus my self-worth and energy on my career, my nursing skills, and higher education. The transition from caring for critical patients into academia did not ease my struggles with self-esteem. Balancing the daily grind of classroom and clinical teaching, serving on committees, and completing scholarly work challenged my abilities to perform well. Attempting to cope, my attention turned to perseverance and survival, instead of Christ.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

In the academic setting, I see nursing students and colleagues struggling with issues of low self-esteem. I find myself pondering the role of self-esteem regarding health and spiritual care. How many times has self-esteem been shaken by mistakes, insecurities, or by the words or actions of others? How often have communications and actions impacted others' self-confidence? Satan wants "to steal, and kill, and destroy" (John 10:10, NIV), and that includes self-esteem secure in Christ.


Jesus taught that we are to "Love your neighbor as yourself" (Matthew 22:39, NIV). If you do not love yourself, how can you love your neighbor? Loving the "Lord your God with all your heart, with all your soul, and with all your mind" (Matthew 22:37, NIV) is the "first and greatest commandment" (verse 38). Loving God first is basic to love yourself, and self-love is basic to loving others. Healthy self-esteem and nurture of one's self-image, and others' self-esteem, is essential in fulfilling God's commands to love yourself and others.


The apostle Paul emphasized the importance of good thinking. Our thoughts and self-talk influence our image of self. "Do not be conformed to this world, but be transformed by the renewal of your mind" (Romans 12:2, ESV). "Be renewed in the spirit of your minds" (Ephesians 4:23, ESV). Paul affirmed this unifying concept of self-esteem. "Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves. Each of you should look not only to your own interests, but also to the interests of others" (Philippians 2:3-4, NIV). Christ calls us to humble ourselves by esteeming the interests of others, to benefit the whole body and serve as he did.


A health crisis can lead patients to question their self-worth, especially if they had previously struggled with a disordered self-concept. From a Christian nursing perspective, how can we assess for low self-esteem? How can we intervene? While listening to your patients (or colleagues), consider the following key points:


* Actively listen and show compassionate presence. Pray for wisdom and to see the patient in front of you as God sees him or her.


* Is the patient exhibiting evidence of low self-esteem? What does she say (i.e., negative or pessimistic comments about self?) How does his behavior (i.e., withdrawal, easily offended) suggest he might be struggling with low self-esteem?


* What seems to be the source of the patient's self-esteem?


* If the patient believes in, and consents to discussion about, God, encourage her to see herself as loved by God. Does the patient recognize that low self-esteem stems, in part, from failing to accept and appreciate the way God created him/her?



Healthy self-esteem is rooted with Christ as my confidence (Proverbs 3:26; 1 John 5:14). I need to believe "I can do everything through him who gives me strength" (Philippians 4:13, NIV). I pray God will give me the strength and faith necessary to possess Christ-like love for myself and for others. Rather than nibbling away at self-esteem, we are told to build others up. "Therefore encourage one another and build each other up, just as in fact you are doing" (1 Thessalonians 5:11, NIV).


As nurses concerned about health, let's be models of healthy, godly self-esteem, correctly rooted in our relationship with God. May we sense, "The LORD your God is with you, he is mighty to save. He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing" (Zephaniah 3:17, NIV).