There is a tangible toll on those who are daily immersed in the suffering of others.

Hospitalization is rarely a result of planned procedures. Trauma and sickness are never convenient. Nurses arrive to work with the opportunity to walk with patients and families as they face uncertainty and emotional turmoil. Nurses bear the anxiety that proliferates with every poorly trending lab value or vital sign; they mediate family dynamics and pain that present themselves in crisis; they fight for the wellbeing of the lives in their care.

Some patients and families are grateful. Others are not.

The darkness of human nature is quickly revealed in times of fear and loss of control. Patients are at the expense of medical intervention and their time to the flow of hospital procedures. Too often entitled and inappropriate behavior dominate the day. Entering a room may open the door to objectifying language and reaching hands; to screams of obscenities over something of no consequence; to family members whose actions may uncover motives that are beyond ethically gray.

One patient will trigger the weight of countless hard experiences. Upon discharge, a homeless woman will need insulin, a high-risk medication if administered incorrectly. She is encouraged to use some of her 2,000 dollars, collected every month from social security and disability, to buy a prepaid cell phone that could be used for emergencies. This advice is ridiculous in the eyes of the woman; she demands the hospital pays for her cell phone. A married man – as soon as his wife exits the room – continually tells the bedside nurse that he should come home with her and take her husband’s place. A young patient with an infection in his heart is found crushing narcotic pills and secretly flushing them through his intravenous catheter, undoubtedly making his infection worse. This young patient, having left the hospital against medical advice the week before, leaves again – likely to continue his known drug habit and return to the hospital in worse condition. An old woman lay in the hospital bed, her breathing apneic; she could die between any breath. The old woman’s daughter refuses to put her on hospice and be made comfortable, stating: “I just need her to live until next month so I can get her social security check. When I was a child, she never had compassion for me when I was in pain. Now she knows what that feels like.”

These memories wear on hearts and minds. It is much easier to remember appalling situations than those that are considered polite and acceptable. These memories grow like wild blackberry shoots which are difficult to eradicate or even suppress. Its brambles begin to choke out good and beautiful memories. It becomes easier to treat the illness and not the person. It also becomes easier for caregivers to avoid their own heart.  

The confrontation with human depravity is not just seen in the hearts of others, but can be reflected in the heart of the caregiver. The simplest way to cope is for front-line staff to become numb to the suffering they engage. Patients can become tasks; the temptation is to check off isolated cares and treat diagnoses without having to think and feel the weight of how it is affecting each individual person’s life.

The greatest toll on those that are daily immersed in others’ suffering is to see the weakness and complacency her own heart. It creeps up unexpectedly and deconstructs the idealistic framework that believes – with the right ethical principles – humans can engage perfectly every single time. While this realization is exhausting, it is perhaps the most beautiful. Service should never be out of self-mustered strength. It is not out of labels of being the “wisest” or “most compassionate.” It is because of Christ and His work in broken hearts: “And I am sure of this, that he who began a good work in you will bring it to completion at the day of Jesus Christ.” (Philippians 1:6).

Christian scholar, Nancy Pearcey writes:

“The problem is that many people treat morality as a list of rules. But in reality, every moral system rests on a worldview. In every decision we make, we are not just deciding what we want to do. We are expressing our view of the purpose of human life.”

For followers of Christ, patient care must be informed by a Christian worldview if there is any hope of escaping either burn-out or cynicism.  

The Gospel shows how cherished human life is. Each person has intrinsic dignity and worth because they are made in the image of God. Jesus’ example of deep love, service, and sacrifice prompts those same actions to others.

When confronted with the reality of human hearts, the only answer is to cling to Christ. Only He can permeate broken hearts to fully engage this world. Often it is easy for beliefs to remain strong intellectually but not lived out in the day-to-day mess.

His work is the balm to burnout. He gives life to love well; to not just see the diagnosis and lists of tasks, but to see the person, who – regardless of voiced thank yous or screamed obscenities – was created by the God who made all life and offers salvation to all life through His own sacrifice.

For those that feel tension and toll between heart and mind, it should be an encouragement. It demonstrates that coping is not through sheer numbness.

Cling to truth and through Christ’s strength do each task remembering the personhood of each patient. With Him, there will be fruit amidst thistles.

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“‘My grace is sufficient for you, for my power is made perfect in weakness.’ Therefore I will boast all the more gladly of my weakness, so that the power of Christ may rest upon me. For the sake of Christ, then, I am content with my weakness, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong” (2 Corinthians 12:9-10).