Teaching Life Listening

St. Ambrose Associate Professor of Nursing Shelley-Rae Pehler learned the lesson of a lifetime 20 years ago in a hospital pediatrics ward. She was caring for a four-year-old patient, but Timmy* wasn't going to get better, at least not physically.

Timmy had a brain tumor that was no longer responding to chemotherapy. It was crushing his optic nerve and causing blindness. He could no longer see the TV or his toys or his parents. He could no longer play or interact much with anyone.

As they stood near the bed, helpless, his parents sagged with sorrow. And then Timmy suddenly seemed as if he was looking at something. He asked, "Who's that man in the funny looking robes standing in the corner?"

Tears still well in Pehler's eyes as she shares the story. She tells it to her nursing students each spring as she teaches the pediatric nursing course because she believes it's what the ministry of nursing is all about.

"Timmy's physician said his vision was caused by low hemoglobin," she says. "But his parents were changed after his vision. They felt that he wouldn't be alone when he died. In that moment, their spirits were at peace."
Thanks to Timmy, his parents and others like them, Pehler began to understand the importance of spiritual healing in health care. So when she returned to graduate school several years later, she decided to pursue the study of caring for the whole child-body, mind and spirit.

"My research helped show how to assess and care for children's spiritual needs," she says. "If children say bedtime prayers at home, for example, we help them pray at the hospital. We encourage them to draw pictures and play with dolls in order to communicate their feelings. We listen."

Pehler models the listening she speaks of in her nursing classroom at St. Ambrose. Her voice is gentle and calm yet clear. She makes eye contact with each student. If someone looks confused, she makes sure she has been understood.

"How else can you respond to a child's spiritual needs?" she asks the class. "You can move painful procedures, when possible, to another room in order to maintain a sense of safety in the children's own rooms. You can make sure they don't believe their illnesses are the result of bad behavior. Listen to them, and listen to their parents. If parents are less anxious, children will be less anxious."

She relates Timmy's experience in illustration. When his parents relaxed, she says, they changed the mood of the entire room.

"In pediatrics, we often cannot separate out parents and children," Pehler tells her students. "They respond to one another's anxiety levels. When one relaxes, the other does too."

Adolescent patients need to be listened to as well, Pehler notes. "In my doctoral research on teens who had Duchenne Muscular Dystrophy, they continued to see meaning in life," she says. "They never asked, Why me? But they need to share what they are feeling. When we take time to be present to them, to listen, they will open up. Many times they will say they miss their friends, or being out in nature. We can and should do something about that. It's part of treating the whole person. It's part of caring for the spirit, which is healing."

Pehler says her former students, now nurses in various health care settings, have thanked her for her emphasis on spiritual healing. They say it has helped them to more deeply understand and respond to their patients. It has helped them develop as holistic healers, the reason they chose a career in health care in the first place.

And it has helped them-and their patients-experience peace.

*Timmy is not his real name.