Caring from a Christian Worldview: the Agape Model

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© Philip Meyer/Shutterstock© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CHAPTER 3 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORCaring SALE OR DISTRIBUTION from a ChristianNOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,Worldview: LLC The© Jones Agape & Bartlett Learning, Model LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Shirlene Newbanks, DNP, RN; Nancy Eckerd, MS, RN; Linda Rieg, PhD, RN, CNE; Tara Stephen, MSN, RN, PHN; and Becky Le, PhD, RN © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC LEARNINGNOT FOR OBJECTIVESSALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

At the end of this chapter, the reader will be able to: 1. Describe the Christian worldview. © Jones & Bartlett2. Acknowledge Learning, the importance LLC of the origin of caring. © Jones & Bartlett Learning, LLC NOT FOR SALE3. Discuss OR howDISTRIBUTION the Fruit of the Spirit may be reflected in nursingNOT care. FOR SALE OR DISTRIBUTION 4. Explore the personal worldview of the nurse dedicated to the Christian faith. 5. Apply the Agape Model.

© Jones & Bartlett Learning,KEY TERMS LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Agape Caritas Imago Dei Agape Model Christian worldview Shalom Calling Fruit of the Spirit Caring Holy Spirit © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION We Are Mirrors Reflecting Him We rest in Him—awaiting His call. He is the Source; we are the “looking” And when placed in His hands, we do glass. His work. He is the Light; we are the mirrors. It is not about us. It’s all about Him. © Jones & BartlettHe sends Learning,the message; we LLC mirror it. ©(Lucado, Jones 2004, & Bartlettp. 32) Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Sarah’s shoulder leaned wearily against the not change, her nursing philosophy did. The doorframe of© the Jones hospital & room; Bartlett her head Learning, too change LLC did not occur due to her ©gradual Jones ma -& Bartlett Learning, LLC slowly acceptedNOT the FOR welcoming SALE support OR asDISTRIBUTION she turity in the profession; instead,NOT nursing FOR be- SALE OR DISTRIBUTION waited for her patient to call her for further came a “calling to serve” as a directive from the assistance. It was during this 11th year of her Creator Himself. nursing practice, while serving as a weekend charge nurse on an oncology unit, that Sarah © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC experienced a transformation in her personal ▸▸ NOTphilosophy FOR SALE of nursing. OR DISTRIBUTION Learning the mechan- NursingNOT as FOR a Spiritual SALE OR DISTRIBUTION ics of the functioning human body and the Calling skills necessary to care for the sick and dis- eased was a major focus as a novice nurse. Historically, many nurses believe that nursing As she grew professionally from a novice to a was founded on Biblical principles and that © Jones & Bartlettcompetent Learning, nurse, LLC there was a strong desire to © earlyJones Christian & Bartlett women feltLearning, called to ministerLLC NOT FOR SALE ORprovide DISTRIBUTION what many perceive to be expert nurs- NOTand FORcare for SALE the needs OR of DISTRIBUTIONothers. In so doing, ing care; however, the increased expectations they demonstrated, or mirrored, the caring of hospital administrators and the introduc- characteristics of Jesus Christ (Newb anks, tion to new technology resulted in less time 2015). Throughout history, there have been at the bedside of the patient, leading to an in- numerous examples of the link between serv- creased dissatisfaction© Jones in & her Bartlett role. Learning,ing LLC God and health care (TABLE 3-1©). OneJones of the & Bartlett Learning, LLC Sarah wasNOT weary FOR of the SALE late and ORlong hoursDISTRIBUTION earliest accounts of nurses demonstratingNOT FOR car- SALE OR DISTRIBUTION of work and the lack of sleep, and she was bat- ing for others is found in Exodus, when mid- tling grief from the recent loss of her husband wives would not kill infant boys, because they from the dreaded disease of cancer. Caring for feared God more than they feared Pharaoh. those who were experiencing the same disease The relationship between faith and health was © Jonesthat was & herBartlett husband’s Learning, demise only LLCintensified foundational with© Jonesthe teachings & Bartlett of Moses Learning,and LLC NOTher FOR numbness. SALE Nursing OR DISTRIBUTION had become a strug- the Levitical laws.NOT At theFOR time, SALE they probably OR DISTRIBUTION gle, a duty—merely tasks to perform and a way seemed to be just rules to follow, but now we to provide a living. That night, however, while understand that the principles of epidemiol- Sarah was assisting her patient, the patient be- ogy, aseptic technique, isolation, and hand came more than just an object of duty. washing were health laws. One of the most © Jones & Bartlett Learning,As a Christian, LLC Sarah’s personal values © well-knownJones & BiblicalBartlett accounts Learning, of caring LLC is the NOT FOR SALE ORand DISTRIBUTIONbeliefs—specifically, the knowledge that NOTparable FOR that SALE Jesus told OR of DISTRIBUTION the Good Samar- God is the Creator of all things and that He itan. In this parable, we discover a man who directed her life’s path—were never a question met the emergent needs of a stranger and rec- in her mind. But that night, they became more ognize the Good Samaritan as reflective of than just “head knowledge.” As she leaned “a neighbor”; understanding the concept of wearily against© Jones the doorframe, & Bartlett Sarah Learning, ques- loving LLC your neighbor as yourself.© The Jones utmost & Bartlett Learning, LLC tioned in herNOT mind, FOR “Why SALE am I doing OR this?”DISTRIBUTION model of caring is in the form of NOTJesus ChristFOR SALE OR DISTRIBUTION Before the thought had completely slipped himself as he ministered to the needs of many away, the Holy Spirit strongly impressed upon in life, and in death. her heart and mind, saying, “This is one of My Caring was also demonstrated as min- created beings and I personally placed this pa- istry by early religious orders as they served © Jonestient under & Bartlett your care.” Learning, Sarah experienced LLC that the sick. St. Benedict© Jones founded & Bartlett the Benedic Learning,- LLC NOTnight FOR what SALE Nightingale OR DISTRIBUTION (1992) and others have tine nursing order.NOT Military, FOR religious,SALE ORand layDISTRIBUTION emphasized as a calling from God. Although orders of men including the Knights Hospi- Sarah’s underlying values as a Christian did talers, the Teutonic Knights, the Knights of

TABLE© Jones 3-1 A History& Bartlett of Caring Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Caring: Contribution to Caring from a Timeline Reflecting Major Reference Biblical/Christian Worldview

Approximately Hebrew Exodus 1 Example of the call to love © Jones & 1450Bartlett B.C. Learning,midwives LLC © JonesGod rather & than Bartlett government Learning, LLC NOT FOR SALE OR DISTRIBUTION NOTauthorities. FOR SALE OR DISTRIBUTION

Approximately Moses/Biblical Leviticus and Links between health laws and 1400 B.C. health laws Deuteronomy prevention—even if the cause wasn’t understood. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION26–30 A.D. Jesus Christ GospelNOT accounts, FOR Luke SALE Call OR for compassion,DISTRIBUTION caring, and 10:25–37 agape love; serving the poor and helpless; Good Samaritan.

30–100 A.D. Early church Matthew 22:36–50; Deacons and deaconesses caring © Jones & Bartlett Learning,Matthew 25;LLC Acts 6; for the widows, orphans,© Jones and sick; & Bartlett Learning, LLC James 1:27 loving God and loving others. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1800s Sisters of Ann Doyle, nursing by Provided care to reflect the love of Charity, Sisters religious orders Christ and call to minister to those of Mercy, whom God loves. Deaconesses © Jones & Bartlett Learning,at Kaiserwerth LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1850–1860 Florence Notes on Nursing, 1860 Presented nursing as a Nightingale calling—a means to demonstrate God’s love.

© Jones & Bartlett Learning,1976–present LLC Sister Callista Roy,© C. (1988).Jones An & BartlettRoy views Learning, human beings LLC as indi- NOT FOR SALE OR DISTRIBUTION Roy explicationNOT ofFOR the phil SALE- viduals OR DISTRIBUTIONin community with a loving osophical assumptions Creator and with others; concept of the Roy adaptation of veritivity. model. Nursing Science “Persons have mutual relationships Quarterly, 1, 26–34 with the world and a God-figure” and “God is intimately revealed in © Jones & Bartlett Learning, LLC the diversity of creation© Jones and is the& Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION common destinyNOT of creation” FOR (Roy, SALE OR DISTRIBUTION 1997, p. 45).

1984 Roach Caring from the heart Roach’s theory of caring brought together aspects of relational eth- © Jones & Bartlett Learning, LLC © Jonesics, spirituality, & Bartlett and components Learning, of LLC NOT FOR SALE OR DISTRIBUTION NOTcaring FOR to inform SALE nursing OR practice DISTRIBUTION

(continues)

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TABLE 3-1© JonesA History &of CaringBartlett Learning, LLC ©(continued) Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Caring: Contribution to Caring from a Timeline Reflecting Major Reference Biblical/Christian Worldview

1994 Ann Bradshaw Lighting the Lamp: The An in-depth study of the spiritual © Jones & Bartlett Learning, LLCSpiritual Dimension of dimension© Jones of human & Bartlett nature and Learning, LLC NOT FOR SALE OR DISTRIBUTIONNursing Care its placeNOT in nursing;FOR SALEpresents theOR DISTRIBUTION Judeo-Christian perspective of a covenant relationship based on love—agape or caritas. Traces the historical development © Jones & Bartlett Learning, LLC © Jones & ofBartlett nursing, with Learning, the increasing LLC ten- sions created by secularization in NOT FOR SALE OR DISTRIBUTION NOT FOR SALEthe profession. OR DISTRIBUTION

1997 Katie Eriksson Multiple publications Presents the concept of caritas from 1997 onward from scripture—agape love—and relates to nursing and caring. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 1998, 2008,NOT FORMary Eliza SALE- ORSpirituality DISTRIBUTION in Nursing: Multiple works that linkNOT the love FOR SALE OR DISTRIBUTION 2011, 2014 beth O’Brien Standing on Holy of Christ with nursing care; spe- Ground cifically, that a nursing encounter is a sacred encounter; using the concept of standing on holy © Jones & Bartlett Learning, LLC ground.© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1999, 2006 Shelly and Called to Care: A Chris- Classical work that compares Miller tian Theology of Nursing nursing concepts as seen through (1st and 2nd editions) a Christian worldview versus post-modern nursing theories. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2004 Cusveller Commitment and Re- Builds on the scriptural principles NOT FOR SALE OR DISTRIBUTION sponsibility inNOT Nursing: FOR A SALEof human OR dignity DISTRIBUTION and the roots of Faith-Based Approach Christian nursing.

2005 Doornbos, Transforming Care: A Responds to the question, “How Groenhout, Christian Vision of does a commitment to the © Jonesand Hotz& BartlettNursing Learning, Practice LLC Christian faith inform the© practice Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION of care?” NOT FOR SALE OR DISTRIBUTION

2013 Campinha- A Biblical Based Model Presents a Biblical-based model for Bacote of Cultural Competence the process of becoming culturally in the Delivery of Health- competent. © Jones & Bartlett Learning, LLCcare Services: Seeing © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONImago Dei NOT FOR SALE OR DISTRIBUTION

St. Lazarus, and the Hospital Brothers of St. of “vocation” as an intrinsic motivating fac- Anthony© Jones provided & nursingBartlett care Learning, during the LLCtor for what motivates a© person Jones to &choose Bartlett Learning, LLC MiddleNOT Ages FOR (Rieg, SALE Newbanks, OR &DISTRIBUTION Sprunger, the profession of nursing NOTand to FORfully under SALE- OR DISTRIBUTION 2018). stand nursing itself. Bradshaw perceived the Florence Nightingale witnessed quality concept of vocation to mean that “Nurses . . . care by observing Catholic nuns, who she said choose to become actualized as a caring per- made better nurses because they were disci- son” (Lundmark, 2007, p. 770). In the 1960s © Jones &plined Bartlett and well Learning, organized; she LLC also spent time and 1970s,© nursingJones turned & Bartlett toward secular Learning, val- LLC NOT FORwith SALE the ProtestantOR DISTRIBUTION deaconesses at Kaiserw- ues; nevertheless,NOT FOR some SALE Christian OR nurse DISTRIBUTION lead- erth, who were well known for caring for the ers advocated a return to the link between destitute and the training school. Nightingale faith, calling, and nursing care (see Table 3-1). highly valued education and advocated rais- Viewing nursing as a caring vocation influ- ing the standard of education for nurses, but ences how one serves the patient and the com- © Jones & Bartlett Learning,she also emphasized LLC nursing as a calling—a© Jones munity & Bartlett in which theLearning, nurse works. LLC NOT FOR SALE OR DISTRIBUTIONvocation: “But more than this, she must NOTbe a FOR LoveSALE and OR charity, DISTRIBUTION or caritas, was origi- religious and devoted woman; she must have nally emphasized as a principal idea in Eriks- a respect for her own calling, because God’s son’s early works (1989, 1997, 2002). Eriksson precious gift of life is often literally placed in held that the human being is fundamentally her hands” (Nightingale, 1860, p. 71). body, soul, and spirit. As such, she asserted The© Jones Latin form & ofBartlett the term vocationLearning, dates LLCthat we are religious beings© Jonesand created & Bartlett in Learning, LLC back NOTto the 1400sFOR and SALE was defined OR DISTRIBUTION as “a sum- God’s image. Therefore, eachNOT person FOR deserves SALE OR DISTRIBUTION mons or strong inclination to a particular state dignity, and nurses must accept the responsi- or course of action; especially: a divine call bility of serving with love and existing for the to the religious life” (“Vocation,” n.d.). As de- sake of others. Although other nurse theorists scribed by Lundmark (2007), the proper title have used this caritas concept, the original © Jones &for Bartlett nursing was Learning, heavily debated LLC by the end of scriptures© and Jones Biblical & understanding Bartlett Learning, of agape LLC NOT FORthe SALE 19th century OR DISTRIBUTION by nursing organizations and love wereNOT not preserved FOR SALE in Eriksson’s OR DISTRIBUTION presen- mainstream nursing—namely, whether nurs- tation. Instead, in collaboration with several ing should be labeled a “vocation” or a “con- theologians, Eriksson developed a subdisci- tract.” Mainstream medical organizations saw pline referred to as caring theology (Lindstrom, nursing as “particularism, scientism, and more Nystrom, & Zetterlund, 2018). © Jones & Bartlett Learning,of a contract LLC rather than a vocation” (p. 768).© Jones &Shelly Bartlett and Miller Learning, (2006), in theirLLC Chris tian NOT FOR SALE OR DISTRIBUTIONThe critical factor for these organizationsNOT FORtheology SALE of caring, OR DISTRIBUTION propose that a Christian was that higher education and certification nurse serves to provide “care for the whole per- provided competent nurses; therefore, they son, in response to God’s grace toward a sinful resisted calling it a vocation, which was per- world, which aims to foster optimum health ceived as a “virtue of obedience to doctors . . . and bring comfort in suffering and death for femininity© Jones and motherhood” & Bartlett (p. Learning,768). LLCanyone in need” (p. 250).© In Jones accepting & Bartlettthis Learning, LLC AlthoughNOT FOR Nightingale SALE valuedOR DISTRIBUTION education worldview, nursing becomesNOT a “calling” FOR to SALE care OR DISTRIBUTION and raising the standard for nursing, it was her for the sick, which cannot be separated from its perception that, in itself, education should not roots of Biblical teachings (Matthew 25:31–46; be the standard by which nurses are measured; Luke 10:33–35; 1 Thessalonians 2:6–8). instead, nurses should be measured by the stan- In 1905, Weber predicted that the ad- © Jones &dard Bartlett of their relationship Learning, with LLC God (Bradshaw, vancement© Jonesof science & andBartlett technology Learning, would LLC NOT FOR1994). SALE Lundmark OR DISTRIBUTION (2007, p. 767) contends that be viewedNOT as progress, FOR SALEand that ORthe epistemol DISTRIBUTION- it is important to use theology-based nurs- ogy would shift such that the religious prin- ing theories so as to understand the concept ciples and “notions of divine authority would

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fade away and disappear completely” (Fowler, not believe every spirit, but test the spirits 2012, p. 5). ©Weber’s Jones prediction & Bartlett is supported Learning, whether LLC they are of God; because© many Jones false & Bartlett Learning, LLC by contemporaryNOT authorsFOR SALE who suggest OR DISTRIBUTION that prophets have gone out into the world”NOT FOR(New SALE OR DISTRIBUTION the Biblical context has been removed from King James Version [NKJV]). In the next sec- nursing over the years and the perception of tion, the Christian worldview is explained what constitutes nursing is changing (Hawke- further within the description of the nursing Eder, 2017; Liaschenko & Peter, 2004; Salladay, metaparadigm. © Jones2000). & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORThe SALEconcern OR of some DISTRIBUTION nurses who hold a NOT FOR SALE OR DISTRIBUTION Christian worldview is that nursing is moving toward becoming an occupation rather ▸▸ The Nursing than a vocation. In addition, the shift of what constitutes a good nurse is moving toward Metaparadigm from a © Jones & Bartlettself-sufficiency, Learning, LLCprofessionalism, and aca- © JonesChristian & Bartlett Worldview Learning, LLC NOT FOR SALE ORdemic DISTRIBUTION knowledge (Hawke-Eder, 2017). “Some NOT FOR SALE OR DISTRIBUTION argue the shift towards academia has left newly Our worldview shapes our responses to life’s qualified nurses ineffective at both performing situations and provides a foundation for our practical tasks and the interpersonal skills of nursing practice. The nursing metaparadigm caring” (Hawke-Eder, 2017, p. 24). This shift serves as a framework that nurses infuse with has been subtle,© Jones and neither & Bartlett obvious nor Learning, easy their LLC personal worldview and use© Jonesto guide & Bartlett Learning, LLC to detect or NOTanalyze. FOR Through SALE the years, OR DISTRIBUTIONnurs- their practice. In this chapter, theNOT concepts FOR SALE OR DISTRIBUTION ing has been somewhat redefined as a “sci- within this metaparadigm are addressed from entific discipline as well as a profession that the Christian worldview, are based on Biblical requires education and national examination truths, and are reflected in the Agape Model for licensure . . . with a flexible boundary that (FIGURE 3-1, TABLE 3-2; Eckerd, 2017). © Jonesis responsive & Bartlett to the changingLearning, needs LLC of society The concept© ofJones “caring &in Bartlettnursing moves Learning, LLC NOTand FOR expanding SALE knowledge OR DISTRIBUTION base of its theoret- the term nurse NOTto the FORverb form, SALE to nurseOR DISTRIBUTIONor ical and scientific domains” (Shelly & Miller, nursing”—one of the components of the nurs- 2006, p. 243; see also Hawke-Eder, 2017). ing metaparadigm (Newbanks, 2015, p. 4). Although education and national examination Tonges and Ray (2011) contend that the concept are essential to the nursing profession, the em- of nursing is the act of nurses “demonstrating © Jones & Bartlettphasis Learning, on the art ofLLC caring has decreased, to the © theyJones care about& Bartlett patients” Learning, and propose LLCit “is as NOT FOR SALE ORpoint DISTRIBUTION that nursing has become more of a finan- NOTimportant FOR toSALE patient OR well-being DISTRIBUTION as caring for cial venture and a source of professional career them through clinical activities such as pre- advancement to many practitioners. venting infection and administering medica- For many who hold a Christian world- tions” (p. 374). If nursing is grounded only in view, this shift may not be apparent or realized normative science, known as logical, ethical, due to either© a Joneslack of understanding & Bartlett of Learning, nurs- and LLC aesthetic ways of thinking, and© does Jones not in -& Bartlett Learning, LLC ing theories NOTof other FOR worldviews SALE or OR a failure DISTRIBUTION clude the concept of caring, it will “likelyNOT depictFOR SALE OR DISTRIBUTION to appreciate the danger of embracing theor- cause-and-effect relationships, depersonaliza- ies that include concepts that are contrary to tion, detachment, and objectification of person” a Christian worldview (Newbanks, Rieg, & (Boykin & Schoenhofer, 2013, pp. 96–97). Schaefer, 2018). For instance, Shelly and Miller Such a view is too narrow to be considered © Jones(2006) & emphasize Bartlett that Learning, some theories LLC might high-quality care© becauseJones it &ignores Bartlett the person Learning, LLC NOT“open FOR the SALE door toOR the DISTRIBUTION spirit world Christians and family andNOT focuses FOR instead SALE on the OR disease DISTRIBUTION are warned against in the Scripture” (p. 51). or the injury, thereby justifying the necessity 1 John 4:1 addresses this point: “Beloved, do for Christ-centered patient care.

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The Nursing Metaparadigm from a Christian Worldview 43

Nurse dedicated © Jones & Bartlett Learning,to Christian LLC faith © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Nurse reflects Fruit of the Nurse continues SpiritNOT at theFOR point SALE of care* OR DISTRIBUTION spiritual NOTand professional FOR SALE OR DISTRIBUTION *Love - joy - peace growth patience - faithfulness gentleness - self-control kindness - goodness © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Patient receives © Jones & Bartlett Learning,Christ-centered LLC care © Jones & Bartlett Learning, LLC FIGURENOT 3-1 FORThe Agape SALE Model. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Reproduced from Eckerd, N. (2017). A nursing practice model based on Christ: The Agape model. Journal of Christian Nursing, 35(2), 124–130. doi:10.1097/CNJ0000000000000417

Another metaparadigm concept is that includes all internal and external conditions, of the environment. In the Agape Model, this circumstances, and influences affecting the © Jones &concept Bartlett is defined Learning, as “the spiritual LLC and physi- person. The© Jones nurse may & playBartlett a major Learning, role in as- LLC NOT FORcal SALE realm whereOR DISTRIBUTION the nurse emulates the agape sisting theNOT patient FOR in adapting SALE toOR internal DISTRIBUTION and love of Christ” (Eckerd, 2017, p. 126). Klef- external environmental stressors that might fel (2013) maintains that the environment affect the individual’s well-being. The nurse

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 44 Chapter 3 Caring from a Christian Worldview: The Agape Model

TABLE 3-2© JonesThe Agape & Model Bartlett Metaparadigm Learning, Concepts LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Human being The recipient of Christ-centered care, inclusive of the patient, patient’s family, peers, and those with whom the nurse comes in contact, both professionally and personally

Environment The spiritual and physical realm where the nurse emulates the agape love of Christ

© JonesHealth & Bartlett TheLearning, optimal system LLC stability and well-being of an individual,© Jones which includes & Bartlett the spiritual, Learning, LLC NOT FOR SALE ORemotional, DISTRIBUTION relational, and physical dimensions of the recipientNOT ofFOR Christ-centered SALE careOR DISTRIBUTION

Nursing The practice of providing care to all humankind, revealing the presence and character of Christ

© Jones & Bartlett ReproducedLearning, from Eckerd, N.LLC (2017). A nursing practice model based on Christ: The© AgapeJones model. Journal & ofBartlett Christian Nursing, Learning, 35(2), 124–130. doi:10.1097 LLC /CNJ0000000000000417 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION reflecting Christ’s caring may be instrumen- and endowed with intellect, free will, and an tal in improving patient outcomes (Leyva, Per- indwelling dignity (Genesis 1:26; Howard, alta, Tejero, & Santos, 2015; Nightingale, Spiby, 2013; Williams, 2013). Williams (2013) con- Sheen, & Slade, 2018). cludes that it comes down to two different con- Health is© the Jones optimal & system Bartlett stability Learning, and cepts: LLC “the image of God is something© Jones about & Bartlett Learning, LLC well-being ofNOT an individual; FOR SALE it includes OR the DISTRIBUTION spir- us, something we are, or the imageNOT of God FOR is SALE OR DISTRIBUTION itual, emotional, relational, and physical dimen- something we do” (p. 11). In other words, ei- sions of the recipient of Christ-centered care ther person is a noun, “something about our (Eckerd, 2017). Holistic health reaches beyond being,” or it is a verb, “an activity we carry out” physical, mental, and social well-being to include (p. 40). Williams (2013) contends: © Jonesthe spiritual & Bartlett dimension. Learning, Research demonstrates LLC © Jones & Bartlett Learning, LLC NOTa FORclose relationship SALE OR between DISTRIBUTION an individual’s spir- This imagingNOT God FOR is serious SALE business, OR DISTRIBUTION itual wellness and the reaction of the immune so serious that it sits at the very heart system function in the healing process (Griffin of the biblical story. The call to be- & Yancey, 2009). Wolterstorff (1994) defined the lieve the gospel is designed to return metaparadigm concept of health from a Biblical us to our first calling, our calling to © Jones & Bartlettstandpoint Learning, and referred LLC to it as Shalom. Accord- © Jonesbear God’s& Bartlett image in Learning,the world. (p. 44)LLC NOT FOR SALE ORing toDISTRIBUTION this author, Shalom is “the human being NOT FOR SALE OR DISTRIBUTION dwelling at peace in all his or her relationships: We not only bear that image but, according to with God, with self, with fellows, with nature” the teachings of scripture, so does every other (p. 251). Shelly and Miller (2006) also support human being. Consequently, we are called to this conceptualization: “Nursing is a ministry of treat others as image bearers deserving of re- compassionate© careJones for the & whole Bartlett person, Learning, in respect LLC and dignity. © Jones & Bartlett Learning, LLC sponse to God’sNOT grace, FOR which SALE aims to OR foster DISTRIBUTION op- Ferngren (2009), an early-churchNOT histoFOR- SALE OR DISTRIBUTION timum health (Shalom) and bring comfort in rian, proposes that the “teachings on imago suffering and death” (p. 68). Dei were formative in shaping Christian views Unlike other worldviews, the Christian of humanity, ethics, and ministry” (p. 94). worldview emphasizes that the metaparadigm Ferngren also maintains that the doctrine © Jonesconcept & ofBartlett person begins Learning, with God LLC as the cre- of Imago Dei ©spurred Jones Christian & Bartlett charity Learning,and LLC NOTator FOR of human SALE beings, OR createdDISTRIBUTION in the image and philanthropy, providedNOT FOR grounds SALE for the OR belief DISTRIBUTION likeness of God (Imago Dei) as physiologi- that human life possesses intrinsic value as a cal, psychological, social, and spiritual beings, bearer of God’s image, gave a new perception

on embodiment and human personality, and Jesus described the relationship of himself formed© theJones basis for & ChristianBartlett compassion Learning, and LLC(the vine) and the disciples© (the Jones branches). & Bartlett In Learning, LLC care forNOT those FOR in need SALE (Newbanks, OR DISTRIBUTION 2015). The John 15:5, he said, “I am theNOT vine; FOR you are SALE the OR DISTRIBUTION metaparadigm concept of human being in this branches. The one who remains in me and I in text is defined as “the recipient of Christ-cen- him produces much fruit, because you can do tered care, inclusive of the patient, patient’s nothing without me” (Christian Standard Bi- family, peers and those with whom the nurse ble [CSB]). This metaphor emphasizes the en- © Jones &comes Bartlett in contact, Learning, both professionally LLC and per- ergy and ©the Jones strength &that Bartlett the branches Learning, receive LLC NOT FORsonally” SALE (Eckerd, OR DISTRIBUTION 2017, p. 126). to produceNOT fruit FOR when SALEconnected OR to DISTRIBUTIONthe vine, When viewed through the lens of a Chris- with the fruit being the Fruit of the Spirit tian worldview, all of these nursing metapara- (Parrott, 2018). digm concepts—nursing, environment, health, As explained by Lundmark (2007), “God’s and person—are systematically linked and in- love must be the value system that nursing care © Jones & Bartlett Learning,terconnected LLC and reflect the source of caring,© Jones is dependent & Bartlett on . . .Learning, when God LLCis in me, I am NOT FOR SALE OR DISTRIBUTIONcaring behaviors, cultural implications, NOTand FORwho SALEI should ORbe” (p. DISTRIBUTION 774). This concept is also Biblical scripture (Newbanks, 2015). The ori- emphasized in 2 Corinthians 5:17: “Therefore gin of caring permeates the framework of the if anyone is in Christ, he is a new creation; old Christian nursing metaparadigm. Just as nurs- things have passed away; behold, all things ing is considered a central concept in the nurs- have become new” (NKJV). A person who is ing metaparadigm,© Jones & soBartlett caring is Learning,considered a LLCin Christ (freed from sin and© Jonescreated anew & Bartlett in Learning, LLC centralNOT concept FOR in nursing. SALE OR DISTRIBUTIONChrist) no longer serves self,NOT but longs FOR to SALEserve OR DISTRIBUTION God and others. “We were made to live a life that says, ‘Look at God.’ People are to look at ▸▸ Origin of Caring us and see not US but the image of our Maker” (Lucado, 2018, p. 22). © Jones &One Bartlett might say Learning, that a Christian LLC worldview is For ©a ChristianJones &nurse, Bartlett the virtuous Learning, be- LLC NOT FORborn SALE through OR the DISTRIBUTION transforming power of the havior ofNOT caring FOR “requires SALE understanding OR DISTRIBUTION of Holy Spirit. Until nurses experience a spir- Agape love” (Campinha-Bacote, 2013, p. 36). itual “awakening” or transformation of the This understanding is not innate, nor does it heart, they will not view their practice from a come from a self-image that promotes pride Christian worldview, reflect evidence of prac- and feeling good about oneself. Instead, Chris- © Jones & Bartlett Learning,ticing the presenceLLC of God, see others through© Jones tian & nurses Bartlett see themselves Learning, in the LLC light of God’s NOT FOR SALE OR DISTRIBUTIONHis eyes, or reflect His characteristics (EzeNOT- FORgrace SALE and forgiveness, OR DISTRIBUTION and their dependency kiel 36:26; 2 Corinthians 5:17). According to upon the renewal of the Holy Spirit allows Grenz and Olson (1996), our spiritual expe- them to be used to “advance His kingdom and riences radically affect our worldview. When bring joy to others” (Hoekema, 1986, p. 110). one considers the Apostle Paul and his expe- As Austgard (2008) shared, “it is only the fruit rience© on Jones the road & to BartlettDamascus (ActsLearning, 9:1–22), LLCof Christian belief that can bring© Jones about the& Bartlettsin- Learning, LLC we seeNOT that hisFOR worldview SALE was OR quickly DISTRIBUTION trans- cere, self-sacrificing love thatNOT can elevateFOR nursSALE- OR DISTRIBUTION formed after his encounter with Jesus. As ing to where it should be . . . without love, Johnson (2008) stated, “Perhaps nurses are nursing is nothing more than a simple craft” born, not made” (p. 21). There may be more (p. 315). truth in this statement than Johnson had in- Because of our fallen nature, humans are © Jones &tended Bartlett or meant. Learning, Jesus told LLCNicodemus, “You not able© to Jonesreflect agape & Bartlett love without Learning, having LLC NOT FORmust SALE be born OR again” DISTRIBUTION (John 3:7, NKJV); in this experiencedNOT reconciliation FOR SALE with OR God DISTRIBUTION and an context, Jesus was referring to a spiritual birth, infilling of the Holy Spirit (Romans 5:5; Gala- or reconciliation to God (Newbanks, 2015). tians 5:22). Agape love is “a love that is selfless,

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 46 Chapter 3 Caring from a Christian Worldview: The Agape Model

John 3:7 You must be born again. 2 Corinthians 5:17 Therefore, if anyone is in Christ, he is a John 15:5 I am the vine; you are new creation. the branches. The one who remains © Jonesin me & and Bartlett I in him produces Learning, much LLC © RoJonesmans 5:5 & This Bartlett hope will noLearning,t LLC NOT FORfruit, because SALE you OR can doDISTRIBUTION nothing NOTdisappoint FOR us, SALE because OR God’ sDISTRIBUTION without me. love has been poured out in our hearts through the Holy Spirt who was given to us. (Christian Standard Bible) © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE ORFIGURE DISTRIBUTION 3-2 Biblical practice points. NOT FOR SALE OR DISTRIBUTION

unconditional, and voluntary loving-kindness” nursing practice—specifically, the presence or (Campinha-Bacote, 2013, p. 36). We can teach lack of caring—is a needed activity that pro- students to care for patients with skills learned motes change. Understanding that the source through educational© Jones strategies. & Bartlett But Learning,as the of LLCcaring is God and recognizing© Joneshow car -& Bartlett Learning, LLC Apostle PaulNOT stressed FOR in RomansSALE 3,OR compas DISTRIBUTION- ing is demonstrated will provide aNOT foundation FOR SALE OR DISTRIBUTION sionate Christian caring, or agape love, comes for incorporating caring within practice (see from the heart as a result of Christ within BOXES 3-1 and 3-2). This reflection may play a us; it is not intrinsic to human nature, but major part in this “awakening” or transforma- rather is a gift from God (Campinha-Bacote, tion process. © Jones2013; &Shelly Bartlett & Miller, Learning, 2006). Competence LLC © Jones & Bartlett Learning, LLC NOTwithout FOR SALEcaring often OR results DISTRIBUTION in robotic, “going NOT FOR SALE OR DISTRIBUTION through the motions” care. In contrast, bear- ▸▸ The Agape Model ing the image of God through caring is something that affects our being and is evidenced in Every nurse dedicated to Christ has a story to the activities we carry out. Selfless caring is re- be told regarding the Holy Spirit’s influence on © Jones & Bartlettflected Learning, as Christian LLC caring. It is who we are, be- © hisJones or her &practice. Bartlett This Learning,Christian faith-based LLC NOT FOR SALE ORcause DISTRIBUTION it is who He is in us (FIGURE 3-2). NOTmodel FOR is applicable SALE ORto the DISTRIBUTION clinical nurse, the “It is important the nurse understand missionary nurse, the school nurse, the com- the origin of his or her caring and the be- munity health practitioner, the nursing educa- haviors that reflect caring, as the capacity tor, the administrator, the advanced practice to demonstrate caring, or lack thereof, is re- nurse, and even the new student nurse. When flected in his© or Jones her nursing & Bartlett practice” Learning,(New- the LLC dedicated nurse commits his ©or Jonesher prac -& Bartlett Learning, LLC banks et al.,NOT 2018, FORp. 160). SALE Bringing OR students DISTRIBUTION tice to the Lord, amazing things happen.NOT FOR The SALE OR DISTRIBUTION to the point of reflecting by way of “reexam- purpose of the Agape Model (Figure 3-1) is not ining, reevaluating [and perhaps even] revis- only to validate this gold standard of care but ing their convictions about God, [themselves], also to encourage the novice nursing student and our world” (Grenz & Olson, 1996, p. 125) to be intentionally bold in his or her practice. © Jonesmay assist& Bartlett them in Learning,their practice LLC and help The application© of Jones this model & toBartlett the dedicated Learning, LLC NOTthem FOR to SALE answer ORthe questionDISTRIBUTION of “why” they nurse is limitless,NOT and FOR consists SALE of the ORhighest DISTRIBUTION do what they do. Providing students with the level of professional, personal, and spiritual opportunity to reflect on their worldview for standards.

BOX© 3-1Jones Research & Bartlett Highlight Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION In 2016, Kim and Patterson wanted to see if caring could be taught in a classroom setting. Data were gathered over a four-year period on a total convenience sample of 238 students in a psychiatric– mental health course in a BSN program. Students engaged in a self-awareness, reflective exercise; data were then gathered on an author-developed questionnaire to see if self-awareness actually influenced © Jones & caringBartlett behaviors. Learning, The findings LLC support that using self-awareness© strategies Jones and & quiet Bartlett time with Learning, silence LLC and reflection did have a positive effect on caring behaviors in nursing students. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Modified from Kim, M. S., & Patterson, K. T. (2016). Teaching and practicing caring in the classroom: Students’ responses to a self-awareness intervention in psychiatric-mental health nursing. Journal of Christian Nursing, 33(2), E23–E26.

In Dr. Newbanks’s (the lead author for this chapter) final project for her doctorate of nursing practice (DNP), she used a critical review of existing literature to develop a middle-range theory on caring from a Christian worldview. Dr. Newbanks discovered that there was a paucity of research on caring from a Biblical© Jones worldview. & ABartlett middle-range Learning, theory on Christian LLC caring could guide Christian© nurses Jones in their & Bartlett Learning, LLC nursing as ministry. Integrative review findings represented by 25 philosophers and nursing theorists showedNOT that FOR “qualitative SALE research OR was DISTRIBUTION most prevalent (27%) with phenomenologicalNOT studies FOR(12%) SALE OR DISTRIBUTION as the second most prevalent type of research study noted” (p. 41), suggesting that caring from a Christian perspective is in its infancy, and that much more research is needed. Characteristics of caring were explored and found to include 15 unique aspects when using a Christian worldview: agape love, accountability, charity, forgiving, faithfulness, generosity, goodness, joy, justness, long-suffering, © Jones & peacefulness,Bartlett Learning, self-control, self-giving, LLC warmth, and willingness. © Jones & Bartlett Learning, LLC NOT FOR SALEThe authorOR DISTRIBUTIONrecommended four areas as ripe for research initiatives:NOT FOR (1) differences SALE in OR DISTRIBUTION perspectives of characteristics of caring, (2) a 360-degree evaluation of the characteristics of caring, (3) patients’ agreement with the study findings, and (4) a Delphi study to confirm the characteristics in this study. Her complete paper on this project is available from ProQuest at the web address listed here. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Modified from Newbanks, R. S. (2015). An integrative critical literature review toward the development of a middle range theory on caring from a biblical NOT FOR SALE OR DISTRIBUTIONChristian worldview (Order No. 10600632). ProQuest DissertationsNOT & Theses FORGlobal: Health SALE & Medicine. OR (1925343218). DISTRIBUTION Retrieved from https://0-search -proquest-com.oak.indwes.edu/docview/1925343218?accountid=6363.

The Agape Model is a tool that describes the least of these brothers and sisters of mine, the development© Jones and& Bartlett the character Learning, of a nurse LLCyou did for me” (Matthew 25:40,© Jones New Interna & Bartlett- Learning, LLC who isNOT dedicated FOR to SALEChrist. It OR is a reflectionDISTRIBUTION of tional Version [NIV]). NOT FOR SALE OR DISTRIBUTION the character of Christ manifesting agape love The Agape Model describes how the nurse, in the nurse’s professional and personal life. enabled by the Holy Spirit, shows respect re- Agape is considered God’s self-sacrificial love, gardless of cultural differences or worldviews. love that is charitable, caring for strangers, and Such a nurse is able to achieve excellence in © Jones &love Bartlett in action Learning, versus purely LLC emotional (Eck- all acts, ©attitudes, Jones behaviors,& Bartlett thoughts, Learning, and LLC NOT FORerd, SALE 2017; OR MacArthur, DISTRIBUTION 2005). Scripture con- deeds. Additionally,NOT FOR the SALE Agape ORModel DISTRIBUTION defines firms the critical nature of this sacrificial love: scriptural guidelines and encourages Christ- “Truly I tell you, whatever you did for one of like qualities that exemplify the excellence of

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the nurse dedicated to Christ in the delivery the highest level of excellence in all of professional© Jonesstandards & of Bartlett care. All core Learning, be- LLCacts, attitudes, behaviors, thoughts© Jones & Bartlett Learning, LLC liefs in this modelNOT are FOR found SALE in the Bible, OR whichDISTRIBUTION and deeds. This commitmentNOT to ex FOR- SALE OR DISTRIBUTION is considered the ultimate authority, support- cellence is viewed as worship and an ing the practice of a nurse dedicated to Christ offering to God. (Eckerd, 2017) (Eckerd, 2017). The dedicated Christian nurse’s practice © Jones & Bartlett Learning, LLC and ministry will© Jonesreflect every & Bartlett aspect of Learning,the LLC NOTStatement FOR SALE of OR Faith DISTRIBUTION Agape Model. TheNOT Model FOR consists SALE of fourOR inDISTRIBUTION- The Agape Model is rooted in a straightfor- tentionally simple constructs (Figure 3-1): ward, Biblically based, nondenominational ■■ The nurse is dedicated to Christian faith. Statement of Faith: ■■ The nurse continues spiritual and © Jones & Bartlett Learning, LLC © Jonesprofessional & Bartlett growth. Learning, LLC God exists in three persons: Father, ■■ The nurse utilizes prayer and spiritual NOT FOR SALE OR SonDISTRIBUTION and Holy Spirit. God created the NOT FORgifts in SALEresponse OR to the DISTRIBUTION Holy Spirit. heavens and earth and all things ex- ■■ The nurse reflects the Fruit of the Spirit ist by and through Him. The Bible is at the point of care. the inerrant, authoritative Word of God, and together with the indwelling of the© HolyJones Spirit, & guidesBartlett all per Learning,- The LLC Nurse Is Dedicated © Jones & Bartlett Learning, LLC sonal andNOT professional FOR SALE conduct OR and DISTRIBUTION NOT FOR SALE OR DISTRIBUTION care provided by the nurse dedicated to Christian Faith to Christian Faith. As an offering to The Agape Model’s main assumption is that God, the dedicated nurse strives for the nurse is dedicated to Christ (FIGURE 3-3). a life reflective of the dedication to © Jones & Bartlett Learning, LLC Becoming a follower© Jones of Christ & requiresBartlett that Learning, the LLC a calling from God and belief in the believer accept Jesus Christ as Lord and Sav- NOT FORcrucifixion SALE and OR resurrection DISTRIBUTION of Jesus ior. Now a disciple,NOT the FOR believer SALE receives OR the inDISTRIBUTION- Christ as Lord and Savior, offering dwelling of the Holy Spirit. It is the Spirit of salvation and eternal life to all who God within the believer that sets the dedicated seek him. (Eckerd, 2017) nurse apart by influencing a lifestyle manifes- tation of the Fruit of the Spirit (Eckerd, 2017). © Jones & BartlettThe Learning, nurse’s dedication LLC to Christ is supported © Jones & Bartlett Learning, LLC NOT FOR SALE ORby the DISTRIBUTION Statement of Ethos: NOT FOR SALE OR DISTRIBUTION The Agape Model is dedicated to a A Accept Christ as Savior lifestyle reflecting the character of Christ in both professional and per- G Grow spiritually and professionally sonal life.© TheJones reflection & Bartlett is visualized Learning, LLC © Jones & Bartlett Learning, LLC through care, incorporating the Fruit NOT FOR SALE OR DISTRIBUTIONA Anticipate Holy Spirit interventionNOT FOR SALE OR DISTRIBUTION of the Spirit (Galatians 5:22–23) and achieved through committed profes- P Prayer and spiritual gifts sional and spiritual growth because of faith, prayer, the use of spiritual gifts E Embrace Fruit of the Spirit © Jonesand & Bartlettthe leading Learning, of the Holy LLCSpirit. © Jones & Bartlett Learning, LLC The nurse dedicated to the Christian NOT FOR SALE OR DISTRIBUTION FIGURE 3-3 The AgapeNOT Model FOR mnemonic. SALE OR DISTRIBUTION Faith is respectful of cultural dif- Reproduced from Eckerd, N. (2017). A nursing practice model based on Christ: The Agape model. ferences and worldviews and offers Journal of Christian Nursing, 35(2), 124–130. doi:10.1097/CNJ0000000000000417

The nurse dedicated to the Christ also The Nurse Utilizes Prayer views© the Jones nursing &practice Bartlett as a calling Learning, or min- LLC © Jones & Bartlett Learning, LLC istry ratherNOT thanFOR a job. SALE Having OR been DISTRIBUTION chosen for and Spiritual Gifts inNOT Response FOR SALE OR DISTRIBUTION the profession of nursing, the dedicated nurse to the Holy Spirit views his or her practice as holy ground (Eck- erd, 2017; O’Brien, 2011). The dedicated nurse Communication with God is often accessed receives Godly instruction from the Holy through prayer. Dedicated nurses frequently © Jones &Spirit, Bartlett allowing Learning, for dedication LLC in service to turn to prayer© Jones in matters & Bartlett of strength Learning, of spirit, LLC NOT FORothers, SALE such OR as DISTRIBUTIONis described in 2 Corinthians guidance,NOT wisdom, FOR knowledge, SALE OR discernment, DISTRIBUTION 5:14–15: “For Christ’s love compels us, because boldness, intervention, and any other petition we are convinced that one died for all . . . that in line with Biblical teaching. Important ele- those who live should no longer live for them- ments include forgiveness, faith, trust, thanks- selves but for him who died for them and was giving, praise, and requests for meeting the © Jones & Bartlett Learning,raised again.” LLC © Jonesspiritual, & Bartlett emotional, Learning, and physical LLC needs of self NOT FOR SALE OR DISTRIBUTION NOT FORand othersSALE (Eckerd, OR DISTRIBUTION 2017). Dedicated nurses consider it an honor to pray for their patients The Nurse Continues Spiritual as an integral element of spiritual care. The Apostle James (5:16) tells us that “the prayer and Professional Growth of a righteous person is powerful and effec- The ©American Jones Nurses & Bartlett Association’s Learning, (ANA) LLCtive.” Nursing research underscores© Jones the & phys Bartlett- Learning, LLC Code NOTof Ethics FOR for SALENurses states, OR DISTRIBUTION“The nurse ical and emotional benefitsNOT of prayer FOR in termsSALE OR DISTRIBUTION owes the same duties to self as to others, in- of a “positive association between prayer and cluding the responsibility to promote health wellbeing” (Hollywell & Walker, 2008). and safety, preserve wholeness of charac- Spiritual gifts are imparted by God Him- ter and integrity, maintain competence and self. Romans 12:68 and 1 Peter 4:10–11 reveal © Jones &continue Bartlett personal Learning, and professional LLC growth” that all Christ-followers© Jones & Bartlett are given atLearning, least one LLC NOT FOR(ANA, SALE 2015, OR p. DISTRIBUTION19). As dedicated nurses com- spiritual NOTgift, handpicked FOR SALE for us, OR matched DISTRIBUTION to mitted to our profession, we must fully un- our specific God-given attributes and abilities derstand the need for continuing education, (Eckerd, 2017). According to Kinghorn (1981), which ensures that we apply the highest and “A spiritual gift is a divine, supernatural abil- best practices in nursing. This practice was en- ity given by God to enable a Christian to serve © Jones & Bartlett Learning,couraged by LLC Florence Nightingale (1860, 1992)© Jones and & to Bartlett minister . . . Learning, a special tool LLC for ministry” NOT FOR SALE OR DISTRIBUTIONin her Notes on Nursing, and it continues todayNOT FOR(p. 8). SALE The nurse OR dedicatedDISTRIBUTION to the Christian through peer-reviewed research and solid, evi- faith is encouraged to periodically complete dence-based practice. a spiritual gifts inventory, such as Kinghorn’s The New Testament of the Bible is rich (1981) Discovering Your Spiritual Gifts. This with instruction for disciples. The nurse type of inventory may increase the awareness dedicated© Jones to Christ & isBartlett encouraged Learning, in Colos- LLCof one’s spiritual gifts, which© can Jones then be & inten Bartlett- Learning, LLC sians NOT3:10–11 FOR to “put SALE on the OR new DISTRIBUTION self, which tionally practiced. The nurseNOT dedicated FOR toSALE the OR DISTRIBUTION is being renewed in knowledge in the im- Christian faith understands that the influence age of its Creator . . . because Christ is all of the Holy Spirit connects the spiritual gift of and is in all.” Through thoughtful, commit- the dedicated nurse to the needs of the patient ted study (2 Timothy 2:15; Romans 12:1–2), at a predetermined spiritual intersection. © Jones &the Bartlett dedicated Learning, nurse turns LLCfrom earthly to The© nurse Jones dedicated & Bartlett to Christ Learning, is guided LLC NOT FORChrist-like SALE OR behavior DISTRIBUTION as an act of worship by God NOTHimself FOR through SALE the Holy OR Spirit.DISTRIBUTION He and under the influence of the Holy Spirit guides us in the spirit of truth, holiness, wis- (Eckerd, 2017). dom, grace, and understanding, and is our

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Godly counselor. The Holy Spirit has chosen worth and unique attributes of every person” to work through© Jones us to reveal & Bartlett the agape Learning,love of (ANA, LLC 2015, p. 1). Application of© the Jones Fruit of & Bartlett Learning, LLC Christ to all.NOT It is through FOR SALEthe presence OR ofDISTRIBUTION the the Spirit, whether in practice orNOT in the FORdedi- SALE OR DISTRIBUTION Holy Spirit in the dedicated nurse’s life that our cated nurse’s personal life, is synonymous with patients experience the love of Christ. excellence in the eyes of God (Eckerd, 2017). The Agape Model offers the highest and best The Nurse Reflects the Fruit care that a nurse dedicated to the Christian © Jones & Bartlett Learning, LLC faith can offer. © Jones & Bartlett Learning, LLC NOTof FOR the SALESpirit atOR the DISTRIBUTION Point of Care NOT FOR SALE OR DISTRIBUTION Because The Agape Model’s focus is on In Galatians 5:22–23, Paul summarizes the at- the character of the nurse, it benefits all tributes of Christ in nine characteristics: love, aspects of patient care. The freshness joy, peace, patience, kindness, goodness, faith- of approach and delivery will serve to fulness, gentleness, and self-control. Once © Jones & Bartlett Learning, LLC © Jonesfurther & elevateBartlett the nursingLearning, profession LLC believers accept Christ as their Lord and Sav- as a gold standard of care, while setting NOT FOR SALE ORior, theyDISTRIBUTION are enabled, through the Holy Spirit, NOT FOR SALE OR DISTRIBUTION an example of excellence. Although the to reflect the character of Christ in their ac- primary goal of The Agape Model is tions, attitudes, behaviors, thoughts, and deeds for the nurse to emulate the character (Eckerd, 2017). All nurses dedicated to the of Christ, the secondary goal will result Christian faith possess all elements of the Fruit © Jones & Bartlett Learning, LLCin elevated patient satisfaction ©and Jones out- & Bartlett Learning, LLC of the Spirit. As we are conformed to the image comes. (Eckerd, 2017) of Christ, theNOT Fruit FOR of the SALESpirit is ORmore DISTRIBUTION fully NOT FOR SALE OR DISTRIBUTION evidenced and demonstrated by the nurse’s life, reflecting the agape love of Christ to all persons. By implementing the Agape Model, the ▸▸ Application of the © Jonesimmediate & Bartlett benefit to Learning, the nursing LLCprofession Agape© Model Jones & Bartlett Learning, LLC becomes a Biblically defined view of compas- NOTsionate FOR care,SALE such OR as that DISTRIBUTION demonstrated by Je- The use of the AgapeNOT Model FOR in SALE practice ORis appli DISTRIBUTION- sus in Mathew 14:14: “When Jesus went out He cable to multigenerational nurses who practice saw a great multitude; and He was moved with in every healthcare setting. Dedicated nurses compassion for them and healed their sick.” should stand out in their personal, profes- Additionally, by offering such Christ-inspired sional, and spiritual life by reflecting ev- © Jones & Bartlettcare, Learning, the Code of LLC Ethics for Nurses, Provision © eryJones aspect & of Bartlett this model Learning, within their LLC daily NOT FOR SALE OR1, is DISTRIBUTIONfulfilled: “The nurse practices with com- NOTlives, FOR because SALE it represents OR DISTRIBUTION their life in Christ passion and respect for the inherent dignity, (CASE STUDY 3-1). Just as Christians are recognized

CASE© JonesSTUDY & 3-1Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION You arrive on your medical–surgical unit and receive the shift report from the outgoing nurse. The nurse provides a comprehensive report of the patient in room 326, including the patient’s physical diagnosis and current assessment data. The patient, Ms. Chase, is a 62-year-old widowed female who lives alone and was admitted yesterday for an exacerbation of chronic obstructive pulmonary © Jonesdisease & Bartlett(COPD). She Learning, has a history of LLC bipolar disorder and diabetes mellitus© Jones type 2. &The Bartlett patient is a Learning, LLC NOT FORfull code, SALE and her OR oxygen DISTRIBUTION saturation level is stable at 95% on 2 liters ofNOT oxygen FOR per nasal SALE cannula. OR DISTRIBUTION

Her© vital Jones signs are & as Bartlett follows: blood Learning, pressure, 138/84 LLC mm Hg; heart rate, 76 beats ©per Jones minute—rate & Bartlett Learning, LLC is regular with no abnormal heart sound auscultated; respiratory rate, 18 breaths per minute and unlaboredNOT withFOR no SALEabnormal OR lung DISTRIBUTION sounds auscultated. Oral temperature is 98.8°F.NOT The patient FOR SALE OR DISTRIBUTION denies pain, with a reported pain level of 0/10. The remainder of the report, including lab values, is unremarkable, except that the night shift nurse adds that the patient has been noncompliant with breathing treatments and the incentive spirometer. The nurse goes on to state, “She is a pretty miserable. If I were you, I would try to stay out of her room as much as possible. She likes to be © Jones & leftBartlett alone.” Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEPrior OR to arriving DISTRIBUTION for each scheduled shift, you undergo a greatNOT deal FOR of preparation SALE both OR DISTRIBUTION mentally and physically. You don the proper attire and equipment; you anticipate the events of the day and mentally prepare to face the challenges. Equally as important as preparing yourself physically and emotionally, as a nurse dedicated to the Christian faith, you prepare for the shift by asking the Holy Spirit to guide you through each and every encounter with patients, family, and © Jones & Bartlett Learning,coworkers. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONQuestions NOT FOR SALE OR DISTRIBUTION 1. As a nurse dedicated to the Christian faith, what steps would you take to prepare yourself prior to arriving for your shift each day? 2. As you prepare to enter the patient’s room to meet and assess Ms. Chase, how would you anticipate the Holy Spirit guiding you in demonstrating the Fruit of the Spirit (TABLE 3-3) in © deliveringJones compassionate& Bartlett careLearning, for this patient? LLC Explain your answer. © Jones & Bartlett Learning, LLC NOTUpon FOR assessment, SALE you ORnote thatDISTRIBUTION Ms. Chase’s oxygen saturation has dropped intoNOT the lowFOR 90s SALE OR DISTRIBUTION and her respirations have increased to 22 breaths per minute and are labored. You notice that her nasal cannula is on the bed. While you are reapplying and adjusting her nasal cannula, Ms. Chase suddenly tears it from her face and asks, “Why is this happening to me? Is God punishing me for all of the bad things that I have done in my life?” © Jones & Bartlett3. After addressing Learning, the patient’s LLC physical needs and ensuring© adequate Jones oxygenation & Bartlett and stabilization Learning, LLC of her vital signs, how would you approach applying the Agape Model to provide comfort for this NOT FOR SALEpatient OR inDISTRIBUTION light of her previous question about God and HisNOT perceived FOR punishment? SALE OR DISTRIBUTION

Additional resources for case study: NCFI Spiritual Care Materials, https://ncf-jcn.org/resources/spiritual-care-resources

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC for their fruit, nurses dedicated to the Christian setting the expectation for every nurse to pro- NOT FOR SALE OR DISTRIBUTIONfaith will bear fruit in their practice that willNOT be FORvide Christ-centered,SALE OR DISTRIBUTION evidence-based care. evident to surrounding constituents. Dedicated nurses (BOX 3-3) should inte- grate Biblical principles, as described in the ▸▸ Conclusion Agape© Model, Jones into & every Bartlett moment Learning, of every day, LLC © Jones & Bartlett Learning, LLC as they interact with their patient as well as with This chapter has highlighted the historical coworkersNOT and FOR others. SALE Furthermore, OR DISTRIBUTION Christian journey of caring from a ChristianNOT FOR worldview, SALE OR DISTRIBUTION faculty within faith-based universities should to enable the nurse to appreciate the roots of consider integrating the Agape Model into their Biblical-based caring. The Agape Model was curriculum. Christian nursing faculty have an introduced as a framework for providing com- © Jones &obligation Bartlett to mentorLearning, nursing LLC students and to passionate© care.Jones The challenge& Bartlett for each Learning, nurse is LLC model the likeness of Christ. The Agape Model to personally reflect on the origin or source of NOT FORoffers SALE the ORframework DISTRIBUTION to do just that, while his or herNOT caring. FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 52 Chapter 3 Caring from a Christian Worldview: The Agape Model

BOX 3-3 ©Outstanding Jones & Nurse Bartlett Leader: Learning, Jennifer Scott, LLC RN © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION There is no better feeling in my nursing practice than to reflect the heart and character of Christ. I am more than privileged to have been picked by God to represent Him in the field of nursing. The Holy Spirit is the catalyst that took me from a © Jones & Bartlett Learning, LLCconventional nurse to a kingdom© nurse. Jones By allowing & Bartlett the Holy Learning, LLC Spirit to lead me in my personal life and nursing practice, I feel NOT FOR SALE OR DISTRIBUTIONso much more love, guidance, calmness,NOT andFOR comfort. SALE I know OR DISTRIBUTION

Jennifer Scott God’s plan for me is to be a Christ-centered nurse, and I rely on the Holy Spirit to guide me. Just looking into someone’s eyes or using a simple touch, I will sense the prompting of the Holy Spirit and know in my spirit how God wants me to help people physically, spiritually, or mentally. © Jones & Bartlett Learning,Practicing in Canada,LLC I regularly assess the spiritual© needsJones of my & patients Bartlett and their Learning, families. My desireLLC NOT FOR SALE ORis toDISTRIBUTION provide the best care possible for them by showingNOT them FOR the agape SALE love ORof Christ. DISTRIBUTION By allowing the Holy Spirit to guide me, I can actually feel the difference in the connection I have with my patient. Every life situation and patient circumstance is different, and I learn from each one of them. By studying the Bible and worshiping God, I’m growing in my faith and desire to become more focused on my profession. I am able to love more, care more, forgive more. By applying my professional instincts, knowledge,© Jones and & training, Bartlett and integrating Learning, my faith LLC and the guidance of the Holy Spirit,© Jones I am & Bartlett Learning, LLC sharing the agape love of Christ. I believeNOT that prayer FOR is soSALE important OR in everydayDISTRIBUTION life and have come to realize that my nursingNOT FOR SALE OR DISTRIBUTION practice is a calling. I am doing God’s work. I am serving as a conduit to provide excellent care to all, regardless of the circumstances. When you thank God for your blessings and ask God for guidance by embracing the Fruit of Spirit, you are emulating the love of Christ, providing patients with exceptional care focused on their individual needs. This can be demonstrated by a simple touch or look, or the way © Jonesyou perform& Bartlett a nursing Learning, intervention. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

TABLE 3-3 Fruit of the Spirit Manifested in the Nurse Dedicated to the Christian Faith © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Love The highest expression of dedication and appreciation Matthew 7:12; NOT FOR SALE OR DISTRIBUTIONfor the sacrifice of Christ; it requiresNOT doing noFOR harm SALE OR RomansDISTRIBUTION 13:10; 1 (nonmaleficence), a core element of healthcare oaths and Corinthians 13:4–5, nursing morality (ANA, 2015). The Holy Spirit influences the 13; Colossians 3:14 nurse dedicated to Christian faith in anticipating actions and motives, working to keep the patient free from actual or © Jonespotential & harm. Bartlett As an act Learning, of worship, the LLCnurse dedicated to © Jones & Bartlett Learning, LLC NOTChristian FOR faith SALE displays OR caring DISTRIBUTION that goes beyond reasonable, NOT FOR SALE OR DISTRIBUTION acceptable nursing care, acting as a willing vessel allowing patients to experience God’s love and care.

Joy Unlike human happiness, true joy comes from Christ and is John 16:24; Romans © Jones & Bartlettpresent Learning, regardless ofLLC circumstances. Supernatural joy serves© Jones 12:15, & Bartlett 15:13; 1 Learning, LLC as an insulator and helps provide confident service in the Corinthians 9:22 NOT FOR SALE ORface ofDISTRIBUTION undesirable situations. The nurse dedicated to NOT FOR SALE OR DISTRIBUTION Christian faith has confidence that prayer produces divine results and joy in that God controls all circumstances.

Peace© Jones Internal& Bartlett calmness Learning, received from GodLLC that can be passed to John© Jones 14:27; & Bartlett Learning, LLC NOT FORan SALEanxious patient; OR DISTRIBUTION reflected as confidence in the outcome, RomansNOT 15:13;FOR SALE OR DISTRIBUTION regardless of the situation. There are no earthly limits on Philippians 4:4–8; Godly peace. A peaceful spirit protects the nurse as well as 2 Thessalonians 3:16 the patient from a sense of chaos. This peace reflects Shalom and secures composure, dissolves fear, and maintains harmony (MacArthur, 2005). Perfect peace comes from God © Jones & Bartlett Learning,and is often coupledLLC with joy. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Patience Calm acceptance of people or circumstances results in Psalms 75:2; respect and high regard for others. Combined with prayer, Ephesians 4:2; patience allows the dedicated nurse’s anxiety to be replaced Philippians 4:6 with focus and confidence and may help diffuse patient © Jones & Bartlett Learning, LLC anxiety. The nurse dedicated© to Jones Christian &faith Bartlett waits on Learning, LLC NOT FOR SALE OR DISTRIBUTIONGod and the prompting of NOTthe Holy FOR Spirit andSALE responds OR DISTRIBUTION accordingly. The reward is endurance, renewed strength, and divine support, providing the patient with freshness in the delivery of care.

Kindness© Jones Treating& Bartlett others as Learning, God has treated LLC us. The nurse dedicated to Proverbs© Jones 31:26; & Bartlett Learning, LLC Christian faith approaches the patient with knowledgeable, Ephesians 4:31–32 NOT FORprofessional SALE ORconfidence DISTRIBUTION and uses tenderness in words and NOT FOR SALE OR DISTRIBUTION actions. The dedicated nurse’s character reveals tenderness generalized to all mankind.

Goodness Generosity that springs from kindness. Beneficence, an Romans 15:14; © Jones & Bartlett Learning,ethical principle, LLC focuses on the desire to help and© Jones advocate & BartlettGalatians 6:10; Learning, LLC NOT FOR SALE OR DISTRIBUTIONfor others (ANA, 2015). The nurse dedicated to ChristianNOT FOR faith SALE1 Timothy OR 6:18 DISTRIBUTION elevates this virtue to a spiritual level by demonstrating the goodness of Christ to others.

Faithfulness The framework required for love and grace flowing from Luke 16:10–12; © Jones & Bartlett Learning, LLC God to the patient. The nurse© Jonesdedicated & to BartlettChristian faith Learning, Romans LLC 12:2; remains confident and faithful that the Holy Spirit will 2 Corinthians 5:7; NOT FOR SALE OR DISTRIBUTIONdirect steps, thoughts, andNOT actions. FOR Daily renewalSALE of OR the DISTRIBUTION1 John 1:3 mind and heart is nurtured through scripture and prayer, leaning on God’s revelation through the Holy Spirit for understanding.

Gentleness© Jones Gentleness& Bartlett allows Learning, the nurse dedicated LLC to Christian faith Colossians© Jones 3:14; & Bartlett Learning, LLC NOT FORto temperSALE aggressiveness OR DISTRIBUTION in a calm, respectful, and 1NOT Peter 3:15; FOR SALE OR DISTRIBUTION nonthreatening manner. The nurse dedicated to Christian James 3:17 faith invites the Holy Spirit’s oversight in striving for gentleness.

© Jones & Self-controlBartlett Learning,Provides the LLC discipline necessary to be above reproach© Jones in & Bartlett1 Corinthians Learning, LLC NOT FOR SALE OR DISTRIBUTIONcharacter, diligently remaining on task and focusingNOT on FOR the SALE9:24–27; OR 2 Timothy DISTRIBUTION well-being of the patient. 1:7; Titus 1:8

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 54 Chapter 3 Caring from a Christian Worldview: The Agape Model

TABLE 3-4© JonesApplying &the Bartlett Agape Model: Learning, Biblical Practice LLC Points © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ■■ Pray before every ■■ Identify spiritual distress in ■■ Identify and develop your interaction with your your patients. God-given spiritual gifts. patient. ■■ Implement individualized ■■ The results may reflect ■■ Be intentional to nursing interventions. improved patient © Jonesdemonstrate & Bartlett the Learning,Fruit LLC © Jonesoutcomes. & Bartlett Learning, LLC of the Spirit in your NOT FORpractice. SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett▸▸ Learning,Clinical LLCReasoning © ofJones the Spirit. & BartlettYou are also Learning, familiar with LLC iden- NOT FOR SALE OR DISTRIBUTION NOTtifying FOR spiritual SALE distress OR and DISTRIBUTION regularly use evidence-based nursing interventions to assist Exercises the patient. Explore the Agape Model website and arti- 1. What else can you do to ensure that cles at https://agapenursingmodel.com/. Use your nursing practice is based on the your Bible as© aJones reference & whileBartlett reading Learning, and LLC © Jones & Bartlett Learning, LLC agape love of Christ? learning. NOT FOR SALE OR DISTRIBUTION2. Are you familiar with yourNOT own FOR SALE OR DISTRIBUTION 1. Discuss the Agape Model with another spiritual gifts? nursing student in a group setting. 3. Do you believe that your spiritual gifts 2. Read Exodus 3:4–5. Why is the nurse– can lead to change in your approach to © Jones &patient Bartlett encounter Learning, considered LLC holy patient care© Jones and may &influence Bartlett patient Learning, LLC ground? outcomes? If so, how? NOT FOR3. From SALE a Christian OR DISTRIBUTION worldview, NOT FOR SALE OR DISTRIBUTION discuss what is considered a sacred encounter. References 4. How does this apply to you and to your American Nurses Association (ANA). (2015). Code of patient? ethics for nurses with interpretive statements. Silver © Jones & Bartlett Learning, LLC © JonesSpring, MD:& Bartlett Author. Learning, LLC Austgard, K. (2008). What characterizes nursing care? A NOT FOR SALE OR DISTRIBUTION NOThermeneutical FOR SALE philosophical OR DISTRIBUTION inquiry. Scandinavian Journal of Caring Sciences, 22(2), 314–319. ▸▸ Personal Reflection Boykin, A., & Schoenhofer, S. (2013). Reframing outcomes: Enhancing personhood. In W. Cody (Ed.), Exercises Philosophical and theoretical perspectives for advanced © Jones & Bartlett Learning, LLCnursing practice (5th ed., pp. 132–144).© JonesBurlington, & Bartlett Learning, LLC You have prepared yourself physically, emo- MA: Jones & Bartlett Learning. tionally, and NOTspiritually FOR to careSALE for your OR clients, DISTRIBUTION Bradshaw, A. (1994). Lighting the lamp: TheNOT spiritual FOR di- SALE OR DISTRIBUTION including Ms. Chase (Case Study 3-1). You mension of nursing care. Middlesex, UK: Scutari Press. Campinha-Bacote, J. (2013). A Biblically based model of have educated yourself on the Agape Model cultural competence in the delivery of healthcare ser- (TABLE 3-4) and understand the importance vices: Seeing Imago Dei. Cincinnati, OH: Transcultural © Jonesof displaying & Bartlett the characteristics Learning, of LLC the Fruit C.A.R.E. Associates.© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Eckerd, N. (2017). A nursing practice model based on Lindstrom, U. A., Nystrom, L. L., & Zetterlund, J. E. Christ:© Jones The Agape &model. Bartlett Journal of ChristianLearning, Nursing, LLC (2018). Theory of caritative© caring. Jones In M. &R. BartlettAlli- Learning, LLC 35(2), 124–130. doi:10.1097/CNJ0000000000000417 good (Ed.), Nursing theorists and their work (9th ed., Eriksson,NOT K. (1989). FOR Caring SALE paradigms: OR A studyDISTRIBUTION of the ori- pp. 140–163). St. Louis, MO: NOTElsevier. FOR SALE OR DISTRIBUTION gins and the development of caring paradigms among Lucado, M. (2004). It’s not about me. Nashville, TN: nursing students. Scandinavian Journal of Caring Thomas Nelson. Sciences, 3(4), 169–176. Lucado, M. (2018). Unshakeable hope. Nashville, TN: Eriksson, K. (1997). Caring, spirituality, and suffering. In Thomas Nelson. © Jones & BartlettM. S. Roach (Ed.),Learning, Caring from LLCthe heart: The conver- Lundmark, ©M. Jones (2007). Vocation & Bartlett in theology-based Learning, nurs- LLC gence between caring and spirituality (pp. 68–84). New ing theories. Nursing Ethics, 14(6). doi:10.1177/096973 NOT FOR SALEYork, NY: OR Paulist DISTRIBUTION Press. 3007082117NOT FOR SALE OR DISTRIBUTION Eriksson, K. (2002). Caring science in a new key. Nursing MacArthur, J. (2005). MacArthur Bible commentary. Science Quarterly, 15(1), 61–64. Nashville, TN: Thomas Nelson. Ferngren, G. (2009). Medicine and health care in early Newbanks, R. S. (2015). An integrative critical literature Christianity. Baltimore, MD: The John Hopkins review toward the development of a middle range the- © Jones & Bartlett Learning,University LLC Press. © Jones &ory Bartletton caring from Learning, a biblical Christian LLC worldview (Or- Fowler, M. (2012). Religion and nursing. In M. Fowler, S. der No. 10600632). ProQuest Dissertations & Theses NOT FOR SALE OR DISTRIBUTIONReimer-Kirkham, R. Sawatzky, & E. Johnston Taylor,NOT FORGlobal: SALE Health OR & Medicine. DISTRIBUTION (1925343218). Retrieved Religion, religious ethics, and nursing (pp. 1–26). New from https://0-search-proquest-com.oak.indwes.edu York, NY: Springer. /docview/1925343218?accountid=6363 Grenz, S., & Olson, R. (1996). Who needs theology? Down- Newbanks, R. S., Rieg, L., & Schaefer, B. (2018). What is ers Grove, IL: InterVarsity Press. caring in nursing? Sorting out humanistic and Chris- Griffin, A. & Yancey, V. (2009). Spiritual dimensions of tian perspectives. Journal of Christian Nursing, 35(3), the© perioperative Jones &experience. Bartlett AORN Learning, Journal, 89(5), LLC 160–167. doi:10.1097/CNJ.0000000000000441© Jones & Bartlett Learning, LLC 875–882.NOT doi:10.1016/j.aorn.2009.01.024 FOR SALE OR DISTRIBUTIONNightingale, F. (1860). Notes on NOTnursing: WhatFOR it is,SALE and OR DISTRIBUTION Hawke-Eder, S. (2017). Can caring be taught? Kai Tiaki: what it is not. New York, NY: D. Appleton. Nursing New Zealand, 23(3), 23–25, 46. Nightingale, F. (1992). Notes on nursing. Philadelphia, PA: Hoekema, A. (1986). Created in God’s image. Grand Lippincott. Rapids, MI: William B. Eerdmans. Nightingale, S., Spiby, H., Sheen, K., & Slade, P. (2018). The Hollywell, C., & Walker, J. (2008). Private prayer as a impact of emotional intelligence in health care profes- © Jones & Bartlettsuitable intervention Learning, for hospitalized LLC patients: A sionals© on Jonescaring behavior & Bartlett towards patients Learning, in clinical LLC NOT FOR SALEcritical reviewOR DISTRIBUTIONof the literature. Journal of Clinical and long-termNOT careFOR settings: SALE Findings OR from DISTRIBUTION an integra- Nursing, 18(1), 637–651. tive review. International Journal of Nursing Studies, 80, Howard, T. (2013). Imago Dei. Washington, DC: Catholic 106–117. doi:10.1016/j.ijnurstu.2018.01.006 University of America Press. O’Brien, M. (2011). Servant leadership in nursing: Spiritu- Johnson, M. (2008). Can compassion be taught? Nursing ality and practice in contemporary healthcare. Sudbury, Standard, 23(11), 19–21. MA: Jones and Bartlett. © Jones & Bartlett Learning,Kinghorn, K. LLC (1981). Discovering your spiritual ©gifts. Jones Parrott, & BartlettL. (2018). Love Learning, like that. Nashville, LLC TN: Thomas Grand Rapids, MI: Zondervan. Nelson. NOT FOR SALE OR DISTRIBUTIONKleffel, D. (2013). Environmental paradigms: MovingNOT FORRieg, L.SALE S., Newbanks, OR R. DISTRIBUTION S., & Sprunger, R. (2018). Caring toward an ecocentric perspective. In W. Cody, Philo- from a Christian worldview: Exploring nurses’ source sophical and theoretical perspectives for advanced nurs- of caring, faith practices, and view of nursing. Jour- ing practice (5th ed., pp. 168–181). Burlington, MA: nal of Christian Nursing, 35(3), 168–173. doi:10.1097 Jones & Bartlett Learning. /CNJ.0000000000000474 Leyva, ©E. A.,Jones Peralta, A.& B., Bartlett Tejero, L. S., Learning, & Santos, M. A. LLCRoy, C. (1997). Future of the Roy ©model: Jones Challenge & toBartlett re- Learning, LLC (2015). Global perspectives of caring: An integrative define adaptation. Nursing Science Quarterly, 10(1), review.NOT International FOR SALEJournal for ORHuman DISTRIBUTION Caring, 19(4), 42–48. NOT FOR SALE OR DISTRIBUTION 7–29. Salladay, S. (2000). Healing is believing: Postmodernism im- Liaschenko, J., & Peter, E. (2004). Nursing ethics and pacts nursing. The Scientific Review of Alternative Med- conceptualizations of nursing: Profession, practice and icine, 4(1), 39–46. Retrieved from http://www.sram.org work. Journal of Advanced Nursing, 46(5), 488–495. /media/documents/uploads/article_pdfs/4-1-09. © Jones & Bartlettdoi:10.1111/j.1365-2648.2004.03011.x Learning, LLC Salladay.pdf© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning,© Jones LLC & Bartlett Learning LLC, an Ascend Learning© Jones Company. & NOT Bartlett FOR SALE Learning, OR DISTRIBUTION. LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 56 Chapter 3 Caring from a Christian Worldview: The Agape Model

Shelly, J., & Miller, A. (2006). Called to care: A Christian Cusveller, B. (2004). Commitment and responsibility in worldview ©for nursingJones (2nd & ed.). Bartlett Downers Grove, Learning, IL: LLCnursing: A faith-based approach. Sioux© JonesCenter, IA: & Bartlett Learning, LLC InterVarsity Press. Dordt College Press. Tonges, M., & NOTRay, J. (2011).FOR Translating SALE caringOR DISTRIBUTIONtheory Deloughery, G. L. (1977). History and trendsNOT of professional FOR SALE OR DISTRIBUTION into practice: The Carolina care model. Journal of nursing. Saint Louis, MO: C. V. Mosby. Nursing Administration, 41(9), 374–381. doi:10.1097 Doornbos, M. M., Groenhout, R. R., & Hotz, K. G. (2005). /NNA.0b013e31822a732c Transforming care: A Christian vision of nursing prac- Vocation. (n.d.). In Merriam-Webster. Retrieved from https:// tice. Grand Rapids, MI: Eerdmans. © Joneswww.merriam-webster.com/dictionary/vocation & Bartlett Learning, LLC Eriksson, K. (1997).© Understanding Jones & the Bartlett world of the Learning, pa- LLC Williams, M. (2013). First calling: The Imago Dei and the tient, the suffering human being: The new clinical NOT FORorder ofSALE creation: ORPart I. DISTRIBUTIONPresbyterian, 39(1), 30–44. paradigm fromNOT nursing FORto caring. SALE Advanced OR Practice DISTRIBUTION Wolterstorff, N. (1994). For justice in Shalom. In W. G. Nursing Quarterly, 3(1), 8–13. Boulton, T. D. Kennedy, & A. Verhey (Eds.), From Eriksson, K. (2006). The suffering human being. Chicago, Christ to the world: Introductory readings in Christian IL: Nordic Studies Press. ethics (p. 251). Grand Rapids, MI: Eerdmans. Eriksson, K. (2007). The theory of caritative caring: A vision. Nursing Science Quarterly, 20(3), 201–202. © Jones & Bartlett Learning, LLC © O’Brien,Jones M. &E. Bartlett(2008). A sacred Learning, covenant: The LLC spiritual NOT FOR SALE OR DISTRIBUTION NOTministry FOR of SALE nursing. Sudbury, OR DISTRIBUTION MA: Jones and Bartlett. Recommended Readings O’Brien, M. E. (2011). Servant leadership in nursing: Bradshaw, A. (1994). Lighting the lamp: The spiritual di- Spirituality and practice in contemporary health care. mension of nursing care. Middlesex, UK: Scutari Press. Sudbury, MA: Jones and Bartlett. Bradshaw, A. (2001). The nurse apprentice, 1860–1977. O’Brien, M. E. (2014). Spirituality in nursing: Standing on London, UK: Routledge Press. holy ground (5th ed.). Burlington, MA: Jones & Bartlett Campinha-Bacote,© JonesJ. (2013). A& Biblically Bartlett based Learning,model of LLCLearning. © Jones & Bartlett Learning, LLC cultural competenceNOT FORin the delivery SALE of healthcareOR DISTRIBUTION ser- Roach, S. (1997). Caring from the heart: TheNOT convergence FOR SALE OR DISTRIBUTION vices: Seeing Imago Dei. Cincinnati, OH: Transcultural of caring and spirituality. Mahwah, NJ: Paulist Press. Associates. Shelly, J. A., & Miller A. B. (2006). Called to care: A Chris- Chapman, E. (2009). Sacred work: Planting cultures of tian theology of nursing (2nd ed.). Downers Grove, IL: radical loving care in America. Nashville, TN: Baptist InterVarsity Press. Healing Trust. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION