What nuns contributed to patient care

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'Health Care', by Chris Johnston

The last time I saw her before she died I was surprised by her desire to live. I had met her doctor at the lifts on the way into the ward. 'I doubt that she'll make it through the week,' she said. The deep red blood in the bag suspended over her bed would turn her parchment skin pink but we knew that the next crisis might be the last. She held my hand and pulled me down to her to kiss me on the cheek.

'I have a feeling that I'll be much better tomorrow,' she said. Tears welled in her eyes. 'I'm very tired though. The blood only lasts a few days and then I'm back to where I started.' A nurse entered the room and adjusted the flow rate of the transfusion. I made my apologies and caught a taxi to the airport.

Fifteen years earlier my mother had died in the same bed and it had been Theresa who met me at the lifts with the news. She was in tears then too. She cried whenever anybody on her haematology ward died but, I liked to believe, she cried especially for my mother.

Theresa was a short woman with an enormous bosom that, through the layers of her habit, had comforted countless crying babies. She had a bad back and held herself stiff and upright. She hosted the weekly Alcoholics Anonymous meetings at the hospital but she drank a sherry each evening and she loved bright and cheerful company.

She was strict but she knew that the younger staff nurses needed latitude and she allowed some innovation and limited democracy. She was tolerant of young medical residents because, having worked with several generations of them, she knew that they usually grew into wiser doctors.

She was prayerful but not pious and the occasional profanity escaped her lips. Her faith was simple but its certainty kept many of us from making the final break with belief. We loved her because she acknowledged that caring for unlovable people was hard: she channelled our anger away from the patients without denying us the right to feel it.

Theresa taught me many things. One day I had told an elderly man that the cancer in his lungs had spread to his bones and I felt that in relating his prognosis I had managed to find the delicate balance between hope and hard reality. Theresa took me aside later that day and told me that the patient felt sorry for me, having witnessed my distress in conveying the bad news to him. 'Remember, this isn't about you,' she told me.

She taught me that it was impossible to tell someone how long they were going to live. Patients put considerable pressure on you to give them a specific time — a mother needs to make plans for her family, an estranged son may wish to reconcile himself with his father — but a number will almost always be wrong. The family of the patient whom you have told has three months to live will resent it when their father dies in three weeks and the patient who lives for six months after being given three may derive false hope of a cure.

Our job, she said, is to prepare patients and families for the weeks and months ahead, to inform them of the likely process of death and, hardest of all to convey humanely, its inevitability.

Then, in one of those commonplace medical ironies, she was diagnosed with an indolent but incurable bone marrow disease. In her last year she was unable to go a week without a blood transfusion.

A few months before she died, she invited me to her convent across the road from the hospital. I had never been past the ground-floor sitting room where the nuns received their visitors. But this day she asked me to follow her up the stairs.

Her tiny room contained a narrow bed, made up with hospital linen and blankets. There was a crucifix above the door and a hand basin in the corner. This was where she had lived for over 30 years. Her window overlooked a back street lined with parked cars but no trees; a draught rushed under the gap between the door and the linoleum floor. We stayed for a minute or two, then she led me out and down the stairs without any discussion.

Today there are almost no nuns left in the hospitals to provide this kind of mentorship, to create a philosophy of practice that is lived, not written down in unread mission statements. Modern hospital management theory recognises the importance of workplace 'culture' but it is singularly unsuccessful in knowing how to create one that works for the sick. We knew how to do it once. But we seem to have forgotten.

LINK:
Catholic Health Australia


Frank Bowden Frank Bowden is an infectious diseases physician and Professor of Medicine at the Australian National University Medical School in Canberra. In addition to his academic writing he is a regular book reviewer for the Canberra Times.

 

 

 

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Existing comments

In Ireland at present, there is a general regret that Religious Sisters are scarce or no longer present in hospitals. Even those who would have little time for the same Religious, are admitting that standards have dropped. There is a bug ... MRSA which is causing a lot of grief. It was never present when hospitals were managed and staffed by Sisters. In those times, hygiene was of a high standard ... which is not necessarily the case now!
Finian Gavin | 16 May 2008


Last week, SBS ran a most distressing program about an orphanage in Bulgaria. Not Angola or Bangladesh but a modern democracy, a member of the EU. Two generations ago, that sad place would have been run by nuns and what a difference it would have made for those children.

I have no doubt that they ran equivalent places in Ireland when I was growing up, but we rarely heard about them. And they received little thanks.

A few years back, these same Irish nuns were cruficied on the basis of dubious stories of remembered cruelty in one of their institutions.

Is it any wonder that today's nuns are hard-nosed, businesslike, almost masculine. I preferred the soft, cuddly, bosomy ones like Frank Bowden remembers.

"Don't it always seem to be
That we don't know what we've got
'Til it's gone ..."
Frank O'Shea | 16 May 2008


Religious communities are declining, but, in my experience, caring women in hospitals, many of them young imaginative nurses, and some of them women of faith, have not disappeared. There is no need to compare former nuns only with current male administrators.

I recall six weeks in a battered old surgical ward of St Vincent's Hospital Melbourne, attached to a drip and forbidden all food and water. On the day when my visiting specialist asked me gently whether I was missing food very badly, I admitted to having hourly fantasies not of food but of drink, not of alcohol, but of chilled lemonade, in a tall glass, frosted, with a black straw.

"I think we may be able to let you have something to drink tomorrow," the doctor replied.

On the following morning, two smiling young nurses appeared at my bedside carrying a tray. On it was a glass of lemonade, a tall frosted glass with a black straw, topped with ice and a little umbrella.
Gwynith Young | 16 May 2008


When I read this article I was transported back to the hospice in Ireland where my father died almost five years ago. He (and the family) were fortunate enough to be cared for by some wonderful nuns and lay nurses.
The contribution of the caring religious philosophy to my father's last days was immeasurably comforting.

I look back now with deep gratitude.
I learnt a lot from them, both about myself (I thought I knew it all being a qualified nurse)and the love and faith I experienced.

Mission statements must be carried in the heart and lived each day.
Angela Wall | 16 May 2008


So many people are still unaware that it was the female religious congregations of Europe in the Middle Ages who were responsible for what we now call nurses. Millions have been assisted by the "urgency of their charity" that Our Lord dispensed using them as vehicles.

In my own case, I can remember as an eight year old child being treated with unbelievable charity for six months by The Little Company of Mary at Lewisham hospital. They not only cared for my physical osteomiolitis, but proceded to teach me lessons that I was missing at school!

Absolutely remarkable women whom we will never see the likes of again I fear.
Brent Egan | 16 May 2008


As a Christian Brother, I work with FOUR religious sisters, FOUR other volunteer chaplains and two priests in the largest (for number of patients) hospital in Melbourne - Monash
Medical Centre.

No amouunt of nostalgic yearning for the past will return us to the "Good old days" (If such a beast ever existed?) - I suggest we stop hankering for tha past and examine the
current reality.

Here at Monash Catholic chaplaincy and the whole department of Pastoral Care work as a valued team in meeting the needs of patients on a daily basis.
Gerard Bennet | 17 May 2008


I do not understand why Br Gerard Bennett begrudges me looking benevolently on a wonderful religious order who did wonderful things. I could say the same about his religious order who didn't educate me in the Catholic faith in the 1970s if it were true.

One axiom that the Presentation of the Blessed Virgin Mary Sisters taught me in PRIMARY school however, was that if you cannot say anything nice about someone, don't say anything at all.
They were and ARE wonderful women whom we will never see the likes of again because of the religious who spawned a faulty generation.
Brent Egan | 17 May 2008


I might add that the "lessons" they taught me were ones of genuine charity, something that went astray in my generation of the 1960s, even from their fellow religious brothers.
Brent Egan | 17 May 2008


Frank Bowden is a great painter of pictures of the past, of compassion and of Christ like values practiced in our Public Hospitals.

I saw this article as a bit of a metaphor for the role of women in the church. The kind compassionate sister, who was wise and caring and deeply committed to her role. Yet this person of great spirit was limited to the hospital. Why wasn't she permitted to minister to a wider community of the faithful? This is a question I still ask about the church, why are women consigned to this narrow definition.

My second issue is we will not find the answers to the questions we face now by looking back we need to make bold decisions about the way society responds to the poor and marginalised to witness the way Theresa did and confront the entrenched viewpoints about who is worthy and who deserves the rich resources of Australia.
Lindsay Gardner (Mr) | 18 May 2008


Thank you so much for the beautiful tribute to Sr Theresa. Would that more nurses were like her today - and would that there were more Sisters to follow her example.
Sr. Marie Gaudry | 01 June 2008


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