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Whole Person Care: Tools for Incorporating Spiritual Care in a Busy Practice

Dr. Iris Mamier Dr. Wichit Srikureja
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Spiritual care is an important part of whole person care but is difficult to incorporate into a busy practice. Drs. Mamier and Srikureja share principles that can be applied in many clinical settings.

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  • May 12, 2017
    9:15 AM
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Our Father in heaven we're grateful for this time that we can learn and interact and teen new thoughts of ways to minister to our patients and we pray to you and bless the presentation this morning in well my name can you hear me. My name is which is so we graze Yeah I'm actually just say just a husband to a beautiful wife and just a father to three beautiful children and it's just. I'm very humbled that Michael had asked me to chair something with UN It's also a great joy actually to have a very good friend to do this with. And in a bit I will introduce her who's who's actually will be taking the majority portion of the talk here we want this talk or this session to be ass interactive as much as possible. And but before we begin I really enjoyed the elders that Stanton's a lecture because there's really nothing that we can share if you don't have it we don't believe in it if you don't. Believe that we have something that is wonderful we will never ever want to share I mean it's just like boy who finally found a cookie jar can stop telling about it to his friends or to his siblings and he weighed one of the most important thing that has Chait what I do in terms of caring spiritually for my patients as dates back all the way when I was actually a young child and let me give you this testimony before we luncheon to the presentation and that is when I. Was a little boy I the. Grew up to be an Adventist I was actually a Sikh. And my father have the opportunity through God's leading to be in an Adventist school he graduated at the Adventists school in Bangkok Thailand and after his graduation he became one of the first Sikh Adventists in this community as a result it was not very easy for him as a result he faced a lot of first persecutions and especially after his graduation he joined business with his father my grandfather and it was not very easy to actually operate the business and take Sabbath Ross Nobody understands that in business world at least at that time Sundays a regular business day anyway slowly but surely he slipped back. Stopped going to church stopped reading his Bible stopped having a prayer life and very soon he has forgotten God. Until he came back from a business a business trip in India from India and when he came back he was gravely ill I can still remember that at this time in my life I saw my father who was deeply jaundice back from India lying on the bed and in fact he couldn't even climbed up the stairs to his bedroom we have to get the bed down into the living room for him to stay at and it was at that time when he was it was quite heal his doctor said we don't know exactly what had happened and we don't know whether he will live or not. The word got around to a very compassionate pastor at the church at the Adventist Church at that time and I was the work of that compassionate pastor. That actually I believe saved my father's life he began to visit him. What. Pastor do medically really nothing except to offer a prayer and he does that he did that he came faithfully every day. Spent time at by my father's bedside prayed with him and as a result of that prayer my father actually was healed and he was alive but it was a door that opened in our home because of that compassionate work of that pastor. There began a branch Sabbath school at our home inviting not only me and my siblings my cousins but some of the neighbors' kids we began to have Sabbath school their. School there and. With that came the knowledge of God in my life and with that all of our family actually became and happened to us so it compassion and prayer of a minister led my father back to God and open the door for God in our lives so I truly believe that that that from that moment on I I really viewed God's who work in health care very very very distinctly especially as I became a physician because I know that illnesses happens in this world some people get healed some people died but I think in the process of it all God is that work trying to reach not only that individual but also to reach people around that individual your and my onus is can be a door not only to your salvation but to salvation of other people around you and as health care professional as ministers we are basically Gaunts homeworker to show compassion. To the ones who are suffering and to the ones who are sick. I remember the story of the day Monny act that cries healed and if you look at the conclusion of it all after he was healed the money eg really that guy really wanted to follow Jesus get onto the boat and get on being close to usis but Christ imparting word to him is this and it's found in Mark chapter five worst nineteen and I think we can take time to read that together OK So Mark Chapter five. Nineteen And this is what Christ said to him in red letters go home to your friends and tell them what great things the Lord has done for you and how he has had compassion on you there are two components here one is the telling. Of what God is did and the love of God and the only way that you can tell is not only by speaking but also by showing the love of God And so there are two things here that we can do as we share we can talk but we can also show compassion we can also show without even saying a word of what God's love it by your love they may know who God is and always my joy and privilege actually to introduce Iris Mimir and Dr MIA as as is her title is she's actually a an associate professor in the School of Nursing at Loma Linda University and she has really been tasked to develop whole person care at the university there at least in the school of nursing he she has done quite an extensive research and spirituality spiritual care. Where the nurse is not only at Loma Linda but also in the United States and also internationally and I would like to welcome Dr Mimir And again you will find that we want this interaction to be very interactive we want to have you share and talk to me thank you to think you're crazy. And I think in this audience I'm Iris and and that that's just plain I'm very thankful to be here with you it's. It's difference to come together in this type of. An audience Adventist health care professional. Health Ministry workers. Fellow believers. Who care about that call that God has on our lives who help ministry. I think it is one of those. Though the special. Call of that God has laid on this church to see to move the Gospel forward through two major means one is health care. And the other is if you cases and I continue to marvel about the fact that God didn't ask angels to do the work I often find that they would be so much more equipped. They do it perfectly right. And we often feel our imperfections. But going back to the story that which it just. Read to us again. When you think about the demoniac. You had an experience with a lot. Argh. And remember he was so excited that in his desperateness in his obviousness the Lord had met him and had liberated him from the ties. Of sin and obsession. And his one desire was. To. Go with Jesus to follow him. And what did Jesus do. You object to right. Why in the world that you object he called others and said Follow me follow me follow me why did he object in this way. Absolutely I'm repeating a Jesus knew that this man had a story to tell. And it is based on that story. That we do our ministry as teachers as health care providers wherever as Christians have been his Christian is wherever the Lord has with us. So I'd like to do something very different with you this morning I'm not going to take a scholarly approach. I'm going to take an experiential approach with you I would like to invite you to engage in to come and first of all I'd like you to move closer I feel like we are very very much. Spread apart in this room and if you're comfortable Why don't you just move a little bit closer and then secondly which it is going to distribute a little index card and I'm going to do something ask you something. Different to I want you to write. A love note. So Jesus. Telling him. What he was thankful for. What has he done in your life. How has he met you in your despair and your brokenness in your darkest moments. And it's personal it's just for you. What I wonder was to set the stage by reflecting for a moment. On that story what has God done for you what has he done for me. To meet me. In my darkest moments. My brokenness and how has he. Thank you for taking the time to put this reflection is there anyone who does want to give it. And Express in this round what God has done for you and. I know we have been doing that very often in the way. You have been with me always even when I didn't know you you protected me and even even when bad things happened you cured me through when my father mother rejected me you adopted me my heart rejoice because I have you for there is no one no one but you may be trying to face our good. But I have you. Two not your eyes to me because we hold my joy my own. He knew. I was. Your forgiveness even when you don't leave. Because I I like to inquire in your home with them. Thank you for sharing. Anyone else who wants to express gratitude to God. Thank you for this opportunity like you say we don't do it as often as we'd like to. But I became acquainted with Jesus when I was a teenager. And so I just wrote the song out to him. Just a note too that you know how grateful I am that you are in my life through the years I have so valued and treasured your wisdom your mercy and your listening ear and I needed to unburden. From the time we met and became acquainted you have always been there for me I've never had to worry or Fred because you were right there to take whatever it was and deal with it for me or with me thank you. Men Thank you. You brought me out of darkness into your marvelous light you supplied on my needs you bring me peace and I saw you surround me with your powerful grace and you fill me with your joy. Like to argue. That this is the fabric. Of. Human experience and story. That angels don't have. But fallen human beings who have experienced the reality of Jesus Christ. Coming into our lives. Loving us at our worst. Except thing us. Putting his robe of writers Nazir round our shoulders. And saying no my beloved. Beloved daughter. In law. And the Lord. Wants to work through us. As health care providers as Atlantis Christians based on our own story of broken. It gives meaning to that brokenness. And it's not about impressing anybody. But it is about what God. Is doing has been doing and continues to do. And it is really one beggar telling another where the cookie jar is right. Because we have found. That the more distrust worthy. He truly does love us that he truly does forgive sin. And that faces. We can encourage another that is broken. We've been encouraged those warning to take serious the the law. Discipleship. And our church has. Set up countless hospital. I think and the North American division there are not quite one hundred but somewhere in the ninety hospital. And many many schools. And yet. The question is. Are we in embracing that whole notion. Of. Health care. And why is that still relevant some of us have concluded as medicine got from high tech to higher tech. We have lost our way. We like to argue. That our society is changing dramatically. And like to argue that. As many people are on church have never been church. Live secular lives. Find. I don't stew feel that sacred who are in themselves right that is the yearning for meaning and purpose and engaged in that that trip of. Feeling that God space with other things. As they are far away from God The health care is in fact an opportunity for us to me people of all walks of life. Right Way. And we do so from a trusted position. In fact I'd like to argue we earn the right. To speak truth to them. By the way we conduct ourselves as Christians is ask Christian us by the way we walk alongside. And as they experience that. We. Have advice to share that is conducive for their lives they start trusting. And we may have interact. Actions that we might not have. In the church and harm and I agree I think we have to change the way we think church. Are we ready. To open our church doors for those that are broken. That are not living the holy life that we believe in. That may have a lifestyle that we don't even approve of. And often the gap of where they are. And where the church is is so big. That we can hardly bridge it would you agree with me and health care. Is an opportunity. To minister to people right where they are and they come with their felt needs the pain here in the tummy or something that is my fatigue whatever symptom it is. And as they experience that. You and I. Are compassionate in listening to their felt needs and minister to them and open possibly a door. To allow. Also for a spiritual ministry so we already said one foundation of this is. Our own personal experience another foundation for this type of ministry is. Being intentional about our walk with God about our relationship. I would like to also suggests to be free of any and and. I think when we feel. That we have to perform or achieve something. It's getting it's getting uncomfortable. Rather it is. As I give my life to God in the morning it is about and the movie Lord. Need me through the Holy Spirit opened my eyes to the realities of this child of yours. And give me the words right so we we made ourselves available to the Lord and that is a work that that is in union with the Holy Spirit because in our humanness we can do it right. I would like to know a little bit about who you are at this point. First of all. Coming from Melinda I am curious. Any longer Linda graduates here in this room. Get up use the opportunity to stand up for a moment. That is beautiful. Praise the Lord and thank you then let me ask Are there any health ministry workers in this room. In your church in your local church. That made you come viewed of all thank You that is very nice to see are right are there any nurses in this room. Are very nice beautiful. How about physicians. There are a number of physicians in wonderful wonderful. How about dieticians and dieticians in this room yes. Look at this this is. Very nice and diverse group. What about physical therapists. Yes wonder how glad you're here you're representing your profession beautiful What about P A's. We have an E.P.A. Sia Yes we do know you would have our thank you and chaplains and Pastor. Pastor back. There are a few wonderful wonderful. Bowser the believers right right arm of the Gospel beautiful. Teachers. Have teachers into wonderful. That's that's beautiful and that is the diversity that that we want to see because no profession alone has it all right we need need each other and in that diversity. Our experience with two uses. And and and. The truth about God and who he is I think that's the foundation. For what we call whole person care. I'd like to ask a little more out there who of you works for a faith based institution your day job and up again yeah. Good number of you that work in a faith based institution who have you work for an Adventist institution. And if you yes very nice so that is interesting because it was being. That many of you have left the sole traders and that's a good thing right because we need to be. It while it is true that our Adventist institutions need people who understand the Sion and who embrace it. It is quite a beautiful thing that. Many of our professional as teachers as doctors and nurses were also in secular institutions when we work in faith based institutions there is often a. Greater amount of buy in for the spiritual dimension. When we work in secular institutions we may think. That we have to be extra careful in the way we approach the spiritual I would like to argue however this morning that I think either way. We want to take a respectful and professional. Approach to approaching the spiritual. But. We will go more into detail in just a minute. I would like to know from you how many of you typically routinely address spiritual. Matters in your patient encounters would you stand up how many of you do this. Quite a number of you. And. How many of you. Take it when you work. In a real hurry way with patients how many of you take a spiritual history or do some spiritual screening. Routinely patients. Because. How many of you would like to engage. The spiritual more in your patient interaction. A I think why did that beautiful. One more question how many of you. When it when it seems appropriate. Of a prayer your patient. OK that is that is quite a few OK very nice Well I think at this point I'd like to get you engaged again. And here are a few questions I'd like you to address. When you do it spiritual history with patients. What kind of questions do you typically ask. Write down. There is also. An additional paper here in your you write down. With. The kinds of questions. That you find useful in asking patients. To get a feeling where they are in their spiritual experience you know. So that is the first questions question. If you. And second question is if you typically do not. Address spirituality. Or assess what are you mainly use in. Doing main reasons for not. Stepping into this virtual. Well ma'am. And. The third question is. If you pray with patients how do you typically. Invite prayer. How do you typically invite prayer in the context of patient care. If you do it. But take a few moments to address these three questions. What questions do you use to assess patient spirituality number two if you don't what are the main reasons that hold you back from doing it number three. If you pray. How do you invite. OK. I would like to hear from you at this point. And we have the first question was. Questions that you have found useful to assess patient spirituality who would like to see where. Your pet questions and if you have found to work well. It may seem a little of brought up but I just ask patients do you believe in God. You try to I usually know that quite yet do you have a church family you specially if they're lonely you know social connection you know. Just where you had spiritual OK thank you very much are there variations. Of this wording. Well question that was modeled for me and that I find works well is actually five not familiar the patient is asking with their source of strength in. And frequently patients will. Sometimes also to God and sometimes it will be their cat or plant in their family and they'll be like oh and of course God if that's a string of them I think the next one. And the beauty of that question is. That the patient can really take it in whatever direction they want right it doesn't leave anyone out I think spirits that Loma Linda when we ask straight to the face do you believe in God Is that a requirement here to get good care you know. It could take people to a point where they feel like OK Is that something I ought to. But I think for people who have that faith background it's a good question because it allows them to to do respond in the affirmative. And to express their faith which boils down to God is my source of strength that is what helps me get through this situation so maybe. An alternative word game could be. And I'm not saying that the that you can't use that one but Oh you did did you have a religious hearing. That would open it up a little bit more do you have a religious heritage or face heritage. Big How was it allows also for those who were raised in a faith background but has have less to this safe background to say Yes way back so if you ask a present they would maybe say no. I'm not sure. Whether God exists. But if you ask do you have a faith background it they might tell new. Their religion where their religious heritage is which gives us an idea of OK even if that. May not be so relevant for them right now or whether they are reconsidering. How what it means to them there is something in the past and. With. This is a side to the society being the way it is nowadays we can not always assume that people believe in God that church is a meaningful institution to them and that they. Find. That helpful and I think that would be also a good follow up question you know how helpful is it. For even your belonging to a church how helpful is that for you right now. I think the question that was suggested about are you do you belong to any faith community. Probes into also the question do they have social support. That's one of the links that has been very very much established by research that people who belong to a faith community often have. A better social network that helps them to go through through hard times and so for healthcare professionals to know whether someone is connected or eyes allayed it is a very important information to have so all of these are very good questions Are there others that. There's a practitioner in the state I suppose a lot of people assume would know him. Who has been for at least thirty years hiring many many physicians mainly physicians and the newest thing I'm talking about here is of course a wide range of practitioners and aside for their them having appropriate training in his field the big issue is would they be comfortable asking every patient before. A procedure is done. Would it be alright if I prayed. And that's the century the that's the opening that every one of his practitioners uses I've never heard of anybody feeling. Uncomfortable with that they some of them say no most people. And most of these are surgeries not all of the procedures of surgeries but most are. Are very happy to have a physician a good I pray before I. Work with very interesting he's been going on for years he has about ten clinics on paranoid when. Yes. And yet what we also have to approach is the power differential between this issue and. Who hold. Much of even the physical body in his hand. And. A medical a patient. So you are coming in in a critical situation and when you look at the look I tried be the discussion. Is all about the ethics. You don't want you you really when you offer a prayer and that brings us to the other question. Can you one the patient to be in a genuine position to turn you down. Because let's face it. You have prayed in the morning God is with you no. But you are all can to share this edition of blessing with a patient that is well we see. It should never be the agenda of the health care provider. The drives it. So one way for example to accomplish that is my mentor Dr Harvey elder he would always lower his seat when he asks that position you would be intentional that it's rather him looking up to the patient rather than. With you like me to pray with you. And if that's what you're comfortable and I'm to I want to point that out because particularly those of you who practice in a secular environment if you have nonbelievers if you have a patient complaining about you and you have nonbelievers judging over you. Whether what you did was professional. And ethical. There will be two things. That will help you cover it yourself and that is the not imposing part. And having assessed. To ask that question cold turkey without having any idea where the patient is it at least. If you meet the wrong person if you need a die hard atheist that hate effect. That health Christians in health care bring in their faith. It could get you into a difficult. Get you into a difficult situation doesn't very often probably not but I want to point that out to you. The discussion is there. And. I think to the degree that we are very intentional and been very careful about how we approach it to where we avoid even the appearance of using our dominant position to impose anything on a patient the better it is. So. To have a few questions that will help us to see kind of screen where is the patient spiritually. And. To consent the patient before you prayed with them. Are helpful practices for you. To be also professionally says' and I would like to suggest to you those of you who are her mother tend. To assess to screen for spirituality routinely and to offer prayer routinely part of your reservation may be that you don't want to be perceived as unprofessional that you're not sure how your employer sees you. Assessing the spirituality and addressing the spiritual dimension and so what could be helpful are tools. Which you can draw on with which are professional tools where you can say OK this is professional practice and the patient has consented and at that point when it's driven by patient me by patient these liars when it's helpful to the patient. It's legitimate and I would like to argue at the. Point a Christian health care provider is an added bonus because you have something to offer. That a secular health care provider wouldn't write. Because they wouldn't be comfortable my research with nurses on spirituality and spiritual care shows very clearly. That it's the nurses own spirituality that drives spiritual care practice. There is a link. Between nurse spirituality in that those nurses who drowned see themselves as spiritual have a very most spiritual care practice school and if you went to Europe that would even be worse I think it is it's probably would be to the ones that. Inclined those physicians who are inclined to pray often have a faith background it's a no brainer but we have to be. Practicing on the basis of assessment establishing patient need and consenting the patient at that point we have covered our grounds to make the case of why this was appropriate. As normal and up we. Have actually used the wording after a brutal interaction where we say not can I pray with you but would it be helpful if I prayed with you before me. And you might find that is a curious way of wording. Would it be helpful to you. Asks. Not. It you see the emphasis is with. Patient. Yes it would be helpful to be or no I don't think so. The problem is this turning down when you are just about to put your. Life into the hands of doctors recall Razer. Is not easy you don't want to offend him because you still want him to do a good job on you right. So. If you say would it be helpful to you that's different than turning down a well mean offer I'm making clear. That. This is driven by me by patients need it under whining so that might be a wording for you to to keep in mind would it be helpful to you if I prayed with you and then if you even if you avoid also aid positioning. That looks down but talk and I love all or as Dr Elders the just even walking up to the patient I think you make it very very clear that this is not a power thing where you are imposing anything and I thought I was saying these things because I so much desire. For Christians who really. Make themselves available to the Lord and boldly step into the spiritual realm why because patients are crying out for it because they need their souls to be touched right. I want this to be a good experience for you I never want you to be in a position that you are accused on professional grounds for doing anything and that's why I'm and giving these suggestions to our nurses as well as our other health care providers. So that you can practice backed up. What the evidence based literature says. OK I want to share with you real quick it is you would open those who mean at this point for me then I. Can show you these questions and if maybe if you help us would at this point. Distribute my. My questions these are questions that we have used successfully have been there and I would we have used them in the professional teams at spiritual care conferences. In this context of our spiritual care conferences at Loma Linda. We have gone within the professional teams. To the unit and when you come with teams of medical students and nursing students and ph students or whoever joins. You have to make it clear that we are not part of the treatment team OK So we are coming in to invite a spiritual dialogue I'm sharing with you Weston's that we have found very helpful in inviting a spiritual conversation. And the first question is a low key entry question How long have you had this illness. And we have made transparent that we're not. We have no access to the electronic health record but the question allows the patient to say something initially about. What this illness has meant to them what it has done to them it has. They have. Taken them totally from being well to being extremely ill it may have discouraged them and may have cost him her in fear and whatever. And the second question flows logically from it and I think it is an important question for health care providers because it probes into the lament. Of the state of the soul what about it concerns you most. I'd like to share with you an experience that we have had. Seeing a young man who. Hand received. Had been shot into his. Knee or into his his leg. The day before and it was so messed up that they had to amputate him below the knee. And when you look at that as a health care provider you think you know what it means but when we asked him the question what about it concerns you most. We were shocked to learn. That his most pressing need was killed. He had shot and someone else had shot him. And at this point. The Holy Spirit was working on his heart. And he was wondering whether God could be in. For as it was an eye opening experience which as I said we were not part of the treatment tree team and probably. None. Of the physicians and nurses that were involved in his case asked that question. They were concerned about the wound and you know the change in body image the implications of a young man losing part of his leg and what leg and what it would mean for him to continue to live and be rehabilitated his answer was a spiritual one could God forgive him if you allow her such a question you allow the patient to all the lament. You are not assuming that you already know. But you give an opportunity. For the patient to frame. What this means. Then comes the question that you have suggested what is your source of strength. And that's a very good one because the patient can take it in whatever direction they want. Often if they don't feel safe they will say well my husband is very supportive or my children and I need to be well for them again. And if they don't volunteer the notion of God at that point this could be a very very good follow up question is God at all. And. What other sources there are. Now one of the deeper probing questions is. How. Has this illness affected the way you see yourself. When you have taken care. Of musculo looking. Strong. Tall Man. All of us that. Curled up in a bed in pain. You know. That illness affect us right there is an illness we experience ourselves in a manner ability in a way we have not experienced ourselves. And that cuts through our self-sufficiency there are guys. Where everything is based on performance and all of us that here we are weak. Need of. Their ego. Goes very deep this question wides them to share. And. Particularly with serious illness. There is also a having to come to terms. That sometimes. Terrible things happen. And where is God made. So you are opening the door. For the patient if he or she wants to to share. How the illness experience has been processed spiritually. I'd like to suggest to you this morning you are liberal rated from having to achieve anything. You can just ask simple questions like this as time allows. And you listen. And while you listen the Holy Spirit has an opportunity. To speak to your heart. And if you feel he is prompting you. Allow him to do that. You know. But I guarantee you say one thing and that has been experientially true as I work with. Medical and nursing students on the unit. Just the fact that someone came. And took a genuine interest. Is there a future in. Sometimes we don't have to be fixed and answers we don't have to even rescue God and explain. Why you allow tragedy. We can't allow to do what Jesus did. And it doesn't you know you are not emotionally so inclined that's OK too but we can express. What you share that that must have been hard for you to affirm to validate the patients experience. Oh I will leave these questions with you and invite you to. Possibly try them out you don't have to try to get to try them out all simultaneously but what I would like to encourage you. To find a wording and and questions that you are comfortable to ask. And that probe into this into the spiritual domain and to try them out and to liberate you from any pressure and just learn to listen and people who feel that you have genuinely. And. Often also Reese receptive. To hearing a word of healing and comfort and validation and encouragement. And there is someone that I know that is committed to doing that. And I think at this point I would like to invite. You did not this week or raise or to share a little bit from your experience that if you have. Found ways to. Routinely address spirituality now I understand you were going to fast paced environment you have procedures that are scheduled and most of the time your patients are then asleep while while you work on them so there are sometimes only small windows of opportunity how do you. Manage to bring in the spiritual in a busy. Day full of procedures. Well I'll be brief because I know our time is running short but. Before coming here I was at Loma Linda and have little and I feel very much liberated to talk about God because is that Adventists institution being an Adventist I can share whatever I need to. However coming up here and looking at private practices that the foremost concerns that I have is how will that affect how would my new work. Affect the way I can share with my patient. And so just like that physician recruit a physician who are comparable being able to pray with a patient I wasn't sure if an organization that I will join with will be comparable for me to share my spiritual or a said. Patient spirituality or even offer. A prayer for the patient. And so when I came and started work here. One of the questions I asked. My interview is was the are there any objections if I incorporated. Spiritual history of prayer or in my practice and the answer is absolutely not there's really no objection at all doctor you feel free to share what is best in your judgment with your patient. And so I took that as as a liberation to to incorporate that spirituality in in my practice you know I'm I'm a gastroenterologist and. Anyone who has been to a G.I. doctor know that they are busy. Spend lots of hours there procedures are stacked up and it's a fast pace just like many other medical professions are and so the challenge always is how do I within split seconds of meeting a patients who I may never see them again because they just came in for a routine colonoscopy or routine and DA Skippy How do I make an impact on them. And I think after five years I think I learned that it actually takes a whole village to do that it is not my endeavor alone it is the whole village and by that I mean even though I practice in a non Adventist institution even though some of my coworkers do not really share the same believe that I do I thing it has come to the point where they know that doctors are recurs or will always pray and take time to pray with their patients and I agree in. I had a permission a consent from the patient is very necessary. And routinely we would do that begins with with a nurse who actually does the intake history preparing the patient starting an I.V. that nurse knows that this is a patient of doctors or equation and she will drop a line and says you know that you know that doctors are equation. Will ask you about whether you want to pray with your with whether you would want to pray with them or not and that questions then sink into the patients mind they have time to think it over and by the time I see them we go over the benefits and risks of the procedures and such and and and that by that time I think they have warmed up to to the idea that I can offer them more than just a diagnostic or a screening colonoscopy and that I'm a little more interested in their spiritual life and the prayers offered at that time. The most important thing is is and that is the prayer that we offer to the patient is really not not only for patients sake but also for my sake because many a times if you're in the medical field if you're doing procedures there can be things that can go wrong and even if the patient declines I will always say a prayer. Where they're in front of the may not be in front of the patient and so in that ways that that's how I have come to in corporate practicing spirituality and if I end up seeing the patient back again in the clinic there will always be follow up conversation there goes a little deeper into their spiritual. One of the things that you also shared with me and I know we have to wrap this up is indeed often visits when you see people on and on. Going basis. How do you keep that threat of conversation conversation about spirituality. Well you know it's very interesting because there are many patients that I see in the clinic that have issues that relates to that got that doesn't come from the gut. It has roots and neither depression or anxiety you were there are social factors that are more pressing but the manifestation of sash phenomenon actually is physical rather than. Emotional or otherwise and so getting to the root of that becomes a very very crucial in managing them and one of the way that we or that I have done is keep a log I mean night I think. Has been suggestion that as you listen to them you find key words key phrases you can jot them down from follow them up during their next visit but I always think that I'm not there to convert them I'm there to help them to be open and be receptive to the work of the Holy Spirit I am there as a link I am just a small link I have all I can do is open their hearts to God for a prayer God can take from there and open heart to another person to another person to another person to find to make sure that that person can find their way back to him so I am just a little small link in the whole chain so that's why it is takes a whole villages takes a whole church just takes the ministers takes away members' takes it takes everyone to be actively involved because I can't do it alone and these patients who sees me with a sliver of time that I have. All I can do is one tiny little intervention one tiny whole length but that tiny a link is enough for guard if there's a door that is a jar God can open it God can always use that door and open. All right I think our time is up I invite us for a word of prayer to wrap this up dear lord. Thank you so much for the call that you have on our lives. Already you still care about this world you have never left this world and you have never walked off this but you are intimately involved for the healing. And Lord as we see a generation that is so far away from you. That doesn't know your name. I pray Lori that you draw our hearts and new to you. That we might know you. That we might experience you on a daily basis that we might be filled with the Holy Spirit. To be empowered to. Minister to those. Into whose life you have placed us whether that is students. Whether that is patients. Whoever it is whether it is our community our neighborhood whether it is in our church we want to be available to you and we pray for your continued blessing. Lives. Fashion only private lives. Our church our community we thank you for. This media was brought to you by audio voice a website dedicated to spreading God's word through free sermon audio and my. If you would like to know more about. This. Or.

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