THE gin-swigging and rough-handed character Sarah Gamp, in Charles Dickens’s novel Martin Chuzzlewit, was instantly recognised by his early Victorian readers. She was entirely believable — and typical of nurses of her time.
In 1848, four years after Gamp was invented, Professor Robert Bentley Todd, of Kings’ College Hospital, London, was so alarmed by the low status and appalling hygiene of those who were looking after the patients in London’s hospitals (including religious Sisters, they were largely untrained) that he proposed the organisation of nursing as a profession along the lines of a religious order.
Thus was founded that year the Community of St John the Divine, a lay Anglican nursing order in which Sisters received two years’ training in nursing and hospital management. Many years later, the successors of those first Sisters provided the inspiration for the popular BBC drama Call the Midwife.
Nursing as a Christian vocation, however, goes back to the Early Church, the Christian Medical Fellowship’s connections manager, Steve Fouch, says. “When plague struck the Roman world in the third century, it was Christians who tended the sick and dying, often at great personal cost. Their self-sacrifice and dedication made a profound impression on Roman society.” Centuries later, in medieval Europe, it was the monastic orders that provided health care.
Florence Nightingale takes much of the credit for establishing the modern profession of nursing and its structures of training. She hugely improved standards of care for wounded and dying soldiers during the Crimean War (1853-56), and, later, adapted the same approach for civilian hospitals. Although medical science has advanced since her time, the basic ethos of nursing care remains today close to Nightingale’s vision.
For this reason, International Nurses’ Day, every 12 May, was instituted by the International Council of Nurses in 1965. “The day celebrates the birthday of Florence Nightingale, and is used to challenge perceptions and misconceptions about the profession,” a spokesperson for the Royal College of Nursing said.
“This year, we are focusing on highlighting the many forms that the profession can take. It’s not just about hospital wards, but the many innovative ways nurses work today.”
istockphotoA statue of Florence Nightingale: part of the Guards’ Crimean War Memorial in Waterloo Place, central London
NURSING is frequently described as a vocation, and it is one to which many Christians find they are called.
Nightingale wrote of being “called” by God, after having had a vivid religious conversion as a teenager. Writing in February 1837, she stated: “God has spoken to me and called me to His service.” Four years before going to Crimea, she visited and studied at a Lutheran religious community in Germany which had been set up to train deaconesses in medical skills, nursing, and theology; many of the ideas that Nightingale adopted for her nurses came from observing and working with the deaconesses.
The author of Florence Nightingale: The woman and her legend (Penguin, 2008), Mark Bostridge, says that the Community of St John the Divine also influenced her understanding of nursing as a Christian vocation in its own right, not just “as part of the process of saving souls”.
The training programmes that she devised 150 years ago were not solely devoted to secular medical science, however. Student nurses were required to attend chapel, and nurses to read prayers in the wards. She wrote many letters of spiritual encouragement to her students and former students. To one, she wrote that Christ considered it an “honour to serve the poorest and the meanest. . . He will not give his crown except to those who have borne his cross. . . Enduring hardship is what he encourages and rewards.”
Of all the professions, nursing has one of the strongest claims to being rooted in the gospel. As recently as the 1970s, when training as a nurse at St Thomas’ Hospital, in London, the Revd Laura Garnham, from Chelmsford diocese, recalls that each shift started with prayers. “One Sister insisted we all kneel. The patients all took it in their stride. I remember being with a patient who was close to death in a side room, when suddenly the sound of prayers came over the Tannoy. At Christmas, too, I recall wheeling beds to the hospital chapel.”
Modern nursing is very distant in its language, theory, and philosophy from Christianity, Mr Fouch says. “It is seen as a job or career.” But “the legacy of its Christian origins remain. In times of crisis, most care workers will work over their hours — going, in the biblical phrase, ‘the extra mile’.”
Even in secular quarters, some still speak of nursing as a calling or vocation. In September 2015, the Nursing Times published an interview with a registered care-manager at a rehabilitation charity for blind veterans. It challenged others that “Nursing is a vocation, it’s not just a job.”
Only a generation or two ago, nursing, for many women, was their calling and life. As “Sisters” they used a monastic term to describe their job, not the modern term “charge nurse”. Many never married.
Mr Fouch, a former community and palliative-care nurse, says that as a religious vocation, caring can be seen as worship: “Caring for our patients: as if physically caring for Jesus himself. Our nursing practice grows out of, and in direct response to, our relationship with God.”
“The uniqueness of Christ-inspired nursing lies in its emphasis on caring for the whole person as embodied, respecting each person as created in the image of God. It is both a science and an art, but primarily it is a response to God’s grace and a reflection of his character,” the American nurse and former editor of the Journal of Christian Nursing, Judith Allen Shelly, wrote in Called to Care: A Christian worldview for nursing, with Arlene B. Miller (IVP Academic, 2006).
istockphotoA nurse comforts a patient
THE Bishop of London, the Rt Revd Sarah Mullally, trained and worked as a nurse before being appointed to senior positions in the Health Service. She was Chief Nursing Officer for England between 1999 to 2004.
Ordination was not open to women when she was young, and she was drawn to nursing as an expression of her faith. “I became a Christian as a teenager, and wanted to follow Christ with my whole life. Rather than having two careers, I have had one vocation: to follow Jesus Christ, to know him, and to make him known,” she says.
While modern nursing is a graduate profession, and much of modern practice is scientific and technical, nurses remain responsible for patients’ intimate care. And Christ’s model of service — “seeking to serve others and value them”, Bishop Mullally says — is relevant to every expression of vocation.
“Washing feet is a powerful image which has shaped my vocation. As a nurse, the way we wash feet affords dignity, respect, and value. As a priest, I am called to model Jesus Christ, who took off his outer garments and washed his disciples’ feet. As Bishop, [I am] consecrated to be the shepherd of the flock and committed to those in my care.”
Christian nurses implicitly witness to Christ in caring for others. But there have been several high-profile cases of nurses’ being accused of making Christianity too explicit, in what is a secular health service.
In 2016, after 15 years in the profession, a nursing sister in Kent, Sarah Kuteh, was sacked on the grounds of gross misconduct (News, 16 December 2016). One complainant said that Mrs Kuteh held his hand tightly, said a long and intense prayer over him, and asked him to sing Psalm 23.
Mrs Kuteh claimed that the dismissal was “a hugely disproportionate punishment”, but the employment tribunal sided with her employers. “How could it ever be harmful to tell someone about Jesus?” Mrs Kuteh had asked when she launched her legal action. But the Dartford and Gravesham NHS Trust maintained that the case was never about religion. “It related to professional nursing responsibilities, behaviour and conduct in a . . . position of trust.”
“A nurse is in a position of power, and should not proselytise,” Mr Fouch says. He quotes 1 Peter 3.15, which advises speaking about faith only in response to somebody else’s enquiry: “Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have.” And “do this with gentleness and respect.”
Tash Bale, who is 25, is a student midwife currently studying at City University, in London, and working at Homerton Hospital. She worships at St Helen’s, Bishopsgate. She has delivered 32 babies so far: some straightforward, and some less so. “Caring is a form of worship. I work with patients of all faiths; I pray for patients privately, and have the faith that God will equip me with the right words at the right time when I need them.”
Opportunities for Christian nurses to work in jobs where they are permitted — even encouraged — to spread their faith include working as medical missionaries, and as parish nurses. But the majority continue to work within the NHS, often under increasing pressure and stress.
One in ten nurses leaves the NHS in England every year, and even those with a strong sense of Christian calling can wilt. “I am not sure I would have what it takes to nurse today,” Bishop Mullally admits, “with 12-hour shifts, increased dependency of patients — you have to be far sicker to be in hospital these days — changing public expectation, and less time for clinical supervision.”
Both Bishop Mullally and Mr Fouch acknowledge the contribution that other Christians can make to support those working in the health service, through prayer and practical support. In this way, everyone can be involved in supporting nursing as a Christian vocation.
Bishop Mullally speaks about “the joy of caring . . . asking for nothing in return”, of her time in nursing. Nightingale once paraphrased the words of St Matthew’s Gospel, “I was sick and you visited me” to read: “I was sick and you nursed me.”
“Jesus made it clear that . . . we are called to get involved, to get our hands dirty helping those who are suffering,” Mr Fouch says.