Security & Significance

I heard a sermon today that mentioned, in passing, that people are always looking for security & significance. This is the motivation behind people's ambitions, fears, standards, and goals: establishing some form of security and significance. This wasn't the point of the sermon, but in typical-Jenn-fashion, I managed to hear this one line and have it transport me immediately to my patients. I thought about it on a personal level, too, and quickly came up with a list of a dozen fears and goals motivated by gaining security and significance for myself. But I mostly thought about how often I recognize this in my patients, and how often I unknowingly try to appease or appeal to this motivation.

One of my favorite parts of working in an ICU is that I feel like I see people at a very raw state-- totally scared of a diagnosis, totally grateful for a treatment option, etc. In the rest of my world, people express emotions on a more muted scale, not wanting to be over-dramatic in fear or appear to be gloating in joy. But that veil doesn't appear in the ICU-- there's no energy for it. People leave the "socially accepted approach to sharing emotions" at the automated doors of the ER. What's left is a near-raw form of a human, untainted by learned social boundaries. And seeing a sliver of the population in a raw state sheds light on the rest of the population with whom I engage. My patients show a desperate yearning for security and significance, which is no different from "regular" people... it's just more obvious. EVERYONE is seeking security and significance.

(I'm not saying it's wrong to seek these things... I'm not even hinting towards that. The sermon just made the point that what determines how you define security & significance is what will harm or heal you.)

People seeking significance is easy to see in everyday life: wanting to be treated respectfully; not wanting to be just "a number" or "a statistic"; wanting to be unique and admired among colleagues and peers. And it's easiest to spot this desire when it is being threatened-- someone being rude to you and how you respond indignantly; people staying in jobs they detest for the coveted title or opportunity to leave a legacy; even titles like "best friend" or "one true love" indicate ways we appeal to people's desire to be stand out apart from others.

People seeking security is sometimes harder to identify. These ways are kept more subtle, not wanting to "show our cards" for fear of losing their value. But it's there, nonetheless: in how we save or spend money; in which relationships we keep or let fizzle away; even in how we fill up our schedules or claim our free time and hold it tightly. The primary motivation may be difficult to obviously see, but it's deeply there.

If in the real world people's motivation for significance is more obvious but their desire for security is less pronounced, how interesting that it seems to be the opposite for me in the hospital. I recognize both motivations in my patients, but the difficulty in soothing the fears related to losing significance is far harder than soothing the fears related to losing security. Let me show you.

Security: I can reassure my patient that my ICU is exceptional in caring for critically ill patients. I can assure them that we know how to identify issues and how to respond to them appropriately. I can declare that, even when the doctors and I aren't in their room, we are often doing a lot of work related to helping them move towards their health and comfort goals. I can promise them that I care deeply about their pain and relieving it; I can promise to return after 30 minutes to assess how their pain is responding to medications I've given; I can promise that my knowledge of pain management is extensive and that I have many safe methods of pain relief available to them. I can promise to explain things to them to the best of my ability, using videos and pictures, to ensure their understanding. I can pledge to take every reasonable precaution against exposing them to infections or allowing them to accidentally fall, to prevent allergic reactions or causing unnecessary pain. I can guarantee families that I'll call them with updates if anything changes, and I'll promise to be equally diligent in my care, even if they aren't at the bedside "reminding" me.

Significance: Oh dear. I don't even know where to start! This is where people want to stand apart form others and have unique value. I can promise my patients that, during my shift, they are my foremost priority. But the reality is: when my shift ends, so does my compulsion towards them. The reality is: whether that patient dies or improves enough to be discharged, there will soon be another patient in Room 4126 who will become my priority, and another patient after that, and another after that. I will care for, on average, 10-18 different patients per month. So, when my patient seeking to have significance is assigned to me, they are my priority... until 7pm shows its face or that patient evacuates my room. That seems to be a pretty short-lived significance.

Just because they stop being my assignment doesn't mean I never think of them... of course I do! This blog proves it: interactions stay with me, episodes of raw emotions are burned in my memory, and miraculous healings or devastating downturns remain with me longer than I'd like, at times. I remember names and faces and quirks about many of my patients. But how do I assure them of that, without naming a dozen other patients that have significance to me? Telling someone s/he is significant by identifying my hefty list of other "significant" people belittles the designation.

I have no fears that I actually consider patients insignificant. That is ingrained in me, so deep that I can't really identify where I got the notion, but the weight with which I respond to that notion testifies to how fundamental it is in me. Let me show you again.

While I was in nursing school, I had a conversation with a few friends about the eccentricities of being a nurse. One girl, another Christian in the nursing school, made the comment, "What good is it to help these people if we can't preach to them about the Gospel? Why bother helping their physical bodies if we can't help their souls?" I was disgusted. DISGUSTED. Why bother?? Because everybody is valuable, that's why! People don't deserve my attention because I can "save their soul"-- they deserve my attention because they have a soul! The image of God in all of us; the fact that every good thing comes from God whether the recipient believes that or not; the truth that Grace is offered to everyone, not just those who will accept it or those to "earn" it... these are things that are common to everyone, just like the yearning for security and significance. And because of that, because His imprint and His gifts are distributed to everyone, we are called to love everyone. People aren't projects-- they're image-bearers. And there is innate significance from that fact alone.

But how do I show that to my patients? How do I show them that I love them because they merely exist and are in my presence?

One thing I do know is that I can prioritize recognizing their significance over asserting my own significance because my significance rests securely in Christ: I don't have to assert it 24/7. I can strive to offer security by honoring my promises, and by continuing to love and care for and forgive people despite their faults. But I also know that my significance doesn't come from my ability (or, more often, inability) to keep these promises perfectly. Nor is that the source of my security. My security and significance come from promises that have already been fulfilled and other promises He will faithfully keep. As long as I try to remember that Truth, I can try to help others recognize it for themselves, too.

In the meantime, I guess I'll do the only thing I know how to do for my patients: give them my full attention. That's what everybody deserves, afterall.