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Early one morning, I received a frantic call at home from a fellow nurse in the burn ICU: A woman in her 60s who had been badly burned in a house fire and would need vigilant nursing care for at least the next 24 hours was about to be admitted. Worse, two nurses had called in sick the evening before, so the unit was woefully understaffed.

My colleague didn’t need to say another word — I arrived on the unit within an hour, and just ahead of my new patient.

In the debridement room, we saw the true extent of the woman’s injuries: She had severe burns to the face, chest, abdomen, and extremities, most of which were quite deep, requiring extensive surgery and prolonged hospitalization. Her chances of survival looked remote, at best, and even if she did survive, her quality of life would be minimal.

The attending anesthesiologist delivered this somber news to members of the patient’s extended family who had gathered in the nearby waiting room. Once he left, the woman’s sister, a retired nurse herself, approached me. “Does it really look that bad,” she asked, “or was he just preparing us for the worst?”

Before I could respond, the woman threw her arms around my neck and began sobbing. Perhaps she’d seen the answer on my face. Her sister — a vibrant woman who enjoyed volunteer work and baking cookies with her grandchildren — would most likely die.

Rare request

I offered my condolences and handed a box of tissues to the family, then asked if there was anything, anything at all, I could do to help. The woman’s sister seized on this and asked if I could stand with her family and pray aloud for her sister’s recovery.

I was stunned. Patients’ families often ask me to pray silently for their loved ones, but never aloud. What’s more, the woman wanted the prayer directed at a deity representing a faith in direct conflict with my own, very strong spiritual beliefs.

What’s a nurse to do? I very much wanted to comfort family members in their sorrow, but praying the way the woman wanted just didn’t seem right. Sure, I could go through the motions by standing silently with them as they prayed aloud, but what comfort could my mute presence possibly provide? What if the family asked me to lead the prayer on my own?
If I failed to do so convincingly, I would probably offend them, making a tragic situation even worse. Didn’t my patient’s family deserve the participation of someone who was capable of interacting with vigor, sincerity, and conviction?

Like most nurses, I go above and beyond what I have to do for my patients every day. I do this, not because I want professional reward, but because it’s simply the just and decent thing to do. Praying aloud with this family, however, crossed the line: Why should I have to compromise my own deeply held religious beliefs in carrying out my duties? I asked myself. Aren’t my spiritual beliefs worth considering? In honoring the family’s spiritual needs, I would have felt I was betraying my own. As genuinely touched as I was by this desperate woman’s request, I simply could not do it.

Dilemma resolved

Of course, my primary focus was on helping the family, not on defending my faith. This was neither the time nor the place for theological debate. I smiled and thanked the woman for offering to include me in what surely was an incredibly trying moment in the family’s life — and then suggested calling on the hospital chaplain. The woman eagerly agreed.

We were in luck. The chaplain was just then making rounds in the area and would be available within the hour. Better still, he had a close colleague who shared the family’s beliefs, so he had a good understanding of how to conduct his vigil.

The chaplain hit it off with the family instantly. He prayed aloud with them in the waiting room and at the bedside that day and well into the night, almost without stopping. When I wasn’t busy attending to the patient’s critical health needs, I tried to help out by reducing the volume of alarms, adjusting the lights, clearing surfaces for religious icons, and removing clutter so family members could gather around the bed, hand in hand. These small gestures showed the family that I supported, even encouraged, their religious devotion, even though I couldn’t join in.

The patient died about two weeks later. As the moment drew closer, family members wept, prayed, and sang, their hands resting atop her bandaged body. Moments after her passing, the family filed out of the room and thanked all of us for our efforts.

As the woman’s sister was about to leave the unit for the final time, she turned and said, “God’s work — all of you are doing God’s work here.”

Lloyd Mathew Ohls, RN, BSN, BA, CCRN, is a clinical nurse in the burn unit at the Tampa General Hospital, Tampa.