Discussion: Suffering

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Elizabeth Peterson, DMin, RN, is
Professor and Department Chair of
Nursing, at Bethel University, St. Paul,
Minnesota. She teaches Psychiatric-
Mental Health Nursing, Nursing Care
of the Elderly, Foundations of Health

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Ministry, and Curriculum and Instruction in Nursing
Education.

DOI:10.1097/CNJ.0b013e31822b6f5e

Suffering
When

Takes a Toll
We may silently struggle with questions

about who God is and how he can
be trusted when painful

things happen.

218 JCN/Volume 28, Number 4 journalofchristiannursing.com

Copyright © 2011 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited.

http://www.journalofchristiannursing.com

tunately, cumulative encounters with suffering can take a toll
on nurses. This commitment to help suffering people can
easily become overwhelming as nurses face pain they cannot
alleviate, needs they cannot meet, and suffering they cannot
explain or understand. Stephen Wright (2002) recognizes
the personal challenge of dealing with suffering in nursing
practice, saying, “With each nursing moment we may be
challenged to face our own sense of mortality, the meaning
and purpose of suffering, and to draw upon the deepest
resources to support ourselves in the often difficult world
of nursing” (p. 709). He suggests dealing with suffering
requires that nurses have a means for dealing with some of

the complicated and often personal issues
surrounding suffering, adding, “Questions
about who and what we are, how we deal
with distress and suffering, why things
happen to us, and so on, can be hard to
answer, especially if as nurses we have
uncertainties about the answers to such
questions ourselves” (p. 709).

Sometimes dealing with suffering can
be even more difficult for nurses who are
Christians because the occurrence of suffer-
ing causes us to ask hard questions that can
challenge our beliefs about the goodness and
power of God. Even as we try to alleviate
suffering, we may silently struggle with
questions about who God is and how he can
be trusted when such painful things happen.

In struggling with questions about suffer-
ing, we are in good company. Epicurus, the
famous Greek philosopher (341–270 B.C.), is
attributed with this oft-quoted observation:

Is God willing to prevent evil, but not able?
Then he is not omnipotent.
Is he able, but not willing?
Then he is malevolent.
Is he both able and willing?
Then whence cometh evil?
Is he neither able nor willing?
Then why call him God? (Barnes, 2010, p. 92)

Apart from personally knowing God, this is
how the secular world frequently views suffering.

As Christians we turn to Scripture to try and understand
difficult issues, including suffering. Unfortunately, as most
experts agree, the Bible does not provide definitive answers
about why suffering occurs. Yet, Scripture has a great deal to
say about suffering. Grappling with what the Bible says is part
of the process of personal spiritual as well as professional
growth in preparation for dealing with suffering in others.

AbstrAct: Observing and trying to cope with
suffering is an integral part of nursing practice. Yet,
there are times when this can take a toll on nurses,
even leading to struggles with faith as nurses try to
understand how a God who is good and all powerful
can allow people to suffer. This article looks at a
biblical understanding of suffering and discusses ways
nurses can cope with caring for suffering people.

KEY WOrDs: nursing, self-care, suffering,

A
few years ago while working
for a home care agency, I was
asked to make a mental health
assessment on a family whose
17-year-old son was paralyzed

as a result of a motor vehicle accident.
When I arrived, I discovered the father
of the family, who was in his early 40s,
was paralyzed as the result of a stroke
2 years earlier. Because of the father’s
disability, the mother, who had been a
homemaker since her children were
born, had to return to work. The family
was already challenged because of this
situation, and the son’s accident and
need for ongoing care was overwhelm-
ing to both parents. As we talked, I
learned this family had a deep faith.
The family was dealing with all of these
circumstances as best they could, but
one of the hardest issues for them was
why God had allowed all of this to
happen. When I left their home, I
realized that I was struggling with the
same question. I found myself wonder-
ing why one family should have to deal
with so much, and I wondered why
God would have let it happen. I even
started to wonder if I could trust God
in my own life.

SUFFERING: PART OF NURSING
According to nurse author Lorraine Wright (2005),

“Nurses form relationships with individuals, families,
and communities to promote health and alleviate or
diminish suffering. Indeed…the very heart or essence
of nursing is the encounter with suffering” (p. xviii).
Probably most individuals enter the nursing profession
because of their desire to help suffering people. Unfor-

By Elizabeth Peterson

journalofchristiannursing.com JCN/October-December 2011 219

Copyright © 2011 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited.

http://www.journalofchristiannursing.com

that should have been ours…The
Servant of the Lord has taken on
himself those very sufferings of his
people. Not only does he know what
it is like—he actually experiences
our sufferings with us. (p. 81)

What does it mean to humans who
are suffering that God experienced
pain, abandonment, rejection, shame,
humiliation, loneliness, and countless
other horrors? Certainly, it does not
remove the pain of suffering, but it does
provide a presence and with that, a
hope. Human suffering is not a solitary
experience because the God of the
universe has experienced and under-
stands the depth of human suffering.
When God, who has experienced
greater pain and suffering than any
human could ever know, promises to
be present in the suffering of humans,
there is a basis for real hope. This hope
comes from knowing that the infinitely
powerful God loves and walks with his
children, and will lead them through
their pain and suffering. Author, poet,
and hymn-writer Marjorie Clarkson
(1984) explains,

Hope does not mean that we will
avoid or be able to ignore suffering,
of course. Indeed, hope born of faith
becomes matured and purified through
difficulty. The surprise that we experience
in hope, then, is not that, unexpect-
edly, things turn out better than
expected. For even when they do not,
we can still have a keen hope. The
basis of our hope has to do with the
One who is stronger than life and
suffering. Faith opens us up to God’s
sustaining, healing presence. A person
in difficulty can trust because of a
belief that something else is possible.
To trust is to allow for hope. (p. 63)

Good Can Come Out of Suffering.
This is rarely the perspective of someone
anticipating or experiencing suffering,
but it often becomes the response of
someone after suffering. Clarkson (1984)
again offers insight:

The suffering that is part of our
life is not a cruel, senseless waste. For

There are at least four important compo-
nents to a biblical understanding of
suffering that offer a beginning perspec-
tive: suffering is real and inevitable;
God himself experienced suffering;
good can come out of suffering; and
only in eternity will complete under-
standing of suffering occur.

BIBlIcAl PERSPEcTIvES
ON SUFFERING

Suffering is Real and Inevitable.
Some contemporary Christian teachers
suggest that suffering is somehow
foreign to a life of faith and that having
enough or the right kind of faith
prevents us from experiencing suffer-
ing. Yet, it probably is not necessary to
read beyond the book of Genesis to
see that after the “Fall” when Adam
and Eve disobeyed God and sin entered
the world (Genesis 3), suffering became
real and inevitable. Over and over again
Scripture addresses suffering and makes
clear that suffering takes place in both
followers of God and nonfollowers,
sometimes as a result of wrong doing,
and often in situations of apparent
innocence. In fact, suffering was a part
of the experience of most people whose
stories are included in the Bible. Not
only do biblical accounts recognize the
existence of suffering, they also describe
the experience of suffering. Because the
experience of suffering is frequently
so personal and painful that words are
inadequate, the Bible can be helpful
putting into words what suffering is
like. The stories and teachings of the
Bible give individuals permission and
ways to describe the reality of suffering.
“I cry out to you, O God, but you do
not answer; I stand up, but you merely
look at me….The churning inside me
never stops; days of suffering confront
me” ( Job 30:20, 27, NIV).

Not only do the Scriptures give
permission to talk about the reality of
suffering, the Bible teaches suffering is
inevitable. The Apostle Paul makes it
very clear, “For it has been granted to
you on behalf of Christ not only to
believe on him, but also to suffer for
him” (Philippians 1:29, NIV). Some-
times it seems the Scriptures are more
vocal about the inevitability of suffering

than many contemporary churches and
teachers. Walter Brueggemann (1984)
reflected on this tendency to avoid
talking about suffering by suggesting
that in most churches we prefer to read
psalms of praise and victory rather than
of lament. Brueggemann goes so far as
to call it a denial of the real world:

Such a denial and cover-up, which
I take it to be, is an odd inclination
for passionate Bible users, given the
large number of psalms that are songs
of lament, protest, and complaint
about the incoherence that is
experienced in the world. At least it
is clear that a church that goes on
singing “happy songs” in the face of
raw reality is doing something very
different from what the Bible itself
does. …Serious use of the lament
psalms has been minimal because we
have believed that faith does not mean
to acknowledge and embrace negativity.
We have thought that acknowledg-
ment of negativity was somehow an
act of unfaith, as though the very
speech about it conceded too much
about God’s “loss of control.” (p. 54)

When we acknowledge the reality
and inevitability of suffering, we avoid
creating unnecessary dissonance, since,
in fact, the Scriptures teach that suffering
will happen and should not be a cause
for surprise.

God Knows and Understands the
Experience of Suffering. God’s nature
is a loving, Trinitarian relationship
consisting of the Father, Son, and Holy
Spirit. It is in the context of this
Trinitarian relationship that God
experienced suffering when Jesus
Christ died on the cross, and it is out
of that relationship that God reaches
out to his creation. Not only did God
experience suffering, but he was com-
pletely innocent in the process. The
Trinitarian God suffered the agonies of
the crucifixion. Brueggemann (1984)
comments:

Isaiah 53 states Christ not only
can sympathize, but he has carried
our griefs and sorrows. This means
more than he took the punishment

220 JCN/Volume 28, Number 4 journalofchristiannursing.com

Copyright © 2011 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited.

http://www.journalofchristiannursing.com

make them hope for the remainder,
and, hoping for that, they “in patience
do wait for that.” And it is because
of this, that St. Paul can say with
such confidence that, he “reckons that
the sufferings of this present time are
not worthy to be compared with the
glory which shall be revealed in us.”
Though he lives in the present it is
clear that the Christian, according to
St. Paul, is meant to live for the
future. (Lloyd-Jones, 1994, p. 113)

Scripture makes it clear that the
ultimate hope for suffering is found in
eternity. This means that the outcome
of understanding the biblical perspec-
tive on suffering is the realization that
the mystery of suffering will not be
completely understood and cannot
completely be explained until eternity
in heaven. At the same time, though,
suffering can provide the means for
spiritual growth in the here and now.
Suffering helps to clarify purpose in
life, provides a perspective on the future,
and gives a deeper understanding of
God’s nature and plans. The Apostle
Paul, again, provides insight into this
life-changing link between suffering and
transformation as he assures believers
that, “Our light momentary troubles
are achieving for us an eternal glory
that far outweighs them all. So we fix
our eyes not on what is seen, but on
what is unseen. For what is seen is
temporary, but what is unseen is eternal”
(2 Corinthians 4:17-18, NIV).

DEAlING wITh SUFFERING
As nurses, when we awake in the

middle of the night reliving the suffering
of a patient or his or her family and
try to make sense out of it, how can a
biblical perspective on suffering help?
Before answering that question we first
need to recognize that for a biblical
perspective to help us at the point of
our struggles with suffering it needs to
impact our thinking, emotions, and
our spirits. To be impacted by a biblical
perspective on suffering we need to
proceed intentionally.

To be intentional we first need to
acknowledge the reality of our struggle
with the suffering we have seen.

the Christian, it has profound meaning.
By it, God is refining us and
working for us an eternal weight of
glory—the glory of being like Jesus
Christ and living with him forever.
Through the very pain by which
Satan seeks to destroy us, God is
changing our sinful humanity into
Christ’s image, triumphing over
Satan in us. (p. 65)

Heilie Lee (1996) suggests that we
learn to experience God’s love through
suffering, saying:

When we have identified, entered,
and embraced the suffering of Christ,
we will be more able to experience
the love of God in a full way. We
will be more and more like him day
by day. The preaching of the gospel
will be real and effective because we
really understand the love of God; the
love that Christ had when he suffered
and died on the cross for us.” (p. 22)

This echoes what the New Testament
authors say about suffering. The Apostle
Paul describes the growth that can take
place as a result of suffering. “We also
rejoice in our sufferings, because we
know that suffering produces persever-
ance; perseverance, character; and
character, hope” (Romans 5:3, NIV).
He later shares his deep desire to
experience suffering in order to come
to know Christ more fully, but also
recognizes this would cause both
hardship and profound spiritual
growth, “I want to know Christ and

the power of his resurrection and the
fellowship of sharing in his sufferings,
becoming like him in his death”
(Philippians 3:10, NIV).

Only in Eternity Will We Fully
Understand Suffering. One criticism
of Christianity is that it takes a “pie in
the sky by and by” approach to life.
If this means we don’t face the reality
of suffering or don’t try to alleviate it,
then the criticism is probably fair. But
the Bible makes it clear that this life is
not all there is. The faith and hope we
have is not limited to our earthly
experience, and, in fact, it won’t be
fulfilled on earth. JonTal Murphree
suggests, “All life on earth is only a
fleeting moment in the span of eternity.
The sufferings here are little more than
a passing dream in light of the reality
of eternal joy” (1981, p. 124).

Martyn Lloyd-Jones (1899–1981),
minister of Westminster Abby in London
and one of the foremost ministers of his
day, speaks in even stronger language
about the future hope of Christians as
he discusses Romans 8:

Christians according to St. Paul
are “heirs.” They have not yet inherited
fully, they are waiting, they are expecting.
There is “glory which is waiting to
be revealed,” and they look forward
to it. They are “waiting for the adoption,
to wit, the redemption of the body.”
They have not gathered in the great
harvest, but they have received the
“first-fruits.” They have not yet seen
fully their great inheritance, but they
have seen and known sufficient to

When we acknowledge the reality and

inevitability of suffering, we avoid creating

unnecessary dissonance.

journalofchristiannursing.com JCN/October-December 2011 221

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chAllENGING YET ENRIchING
Dealing with suffering may be one

of the greatest challenges of nursing
practice. It is challenging, not only
because of the suffering experienced by
others, but potentially it may challenge
our sense of well-being and under-
standing of life itself. On the flip side,
suffering also has the potential to be
one of the most enriching aspects of
our practice, for ourselves and for those
receiving our care. However, that potential
can only be reached as we enter into
our suffering as well as that of others.
The anguish and dissonance that can
result from suffering is to be guarded
and protected, not avoided or prevented.
Facing the pain of suffering can result in
richness and growth found in no other
way. Not only can we grow, but we may
help others grow as well. Writing about
the impact nurses can have on helping
patients who suffer, Lorraine Wright
concludes:

Under the blows of mortal
experience, those who suffer from
serious illness, loss, or disability need
comfort, hope, and, above all, the
knowledge and reassurance that they
are still cherished. This kind of
practice is indeed spiritual and one
that offers a great opportunity and
blessing for all health professionals.
(2005, p. 215)

Barnes, H. B. (2010). Understanding religion and science:
Introducing the debate. London, UK: Continuum International.

Brueggemann, W. (1984). The message of the Psalms.
Minneapolis, MN: Augsburg.

Clarkson, M. (1984). Destined for glory: The meaning of
suffering. Grand Rapids, MI: Eerdmans.

Katongole, E., & Rice, C. (2008). Reconciling all things: A
Christian vision for justice, peace, and healing. Downers
Grove, IL: InterVarsity.

Lee, H. (1996). The merits of suffering. Grand Rapids, MI:
Eerdmans.

Lloyd-Jones, M. (1994). Why does God allow suffering?
Wheaton, IL: Crossway.

Murphree, J. (1981). A loving God and a suffering world.
Downers Grove, IL: InterVarsity.

Wicks, R. (2006). Overcoming secondary stress in medical
and nursing practice. New York, NY: Oxford.

Wright, L. M. (2005). Spirituality, suffering, and illness:
Ideas for healing. Philadelphia, PA: F. A. Davis.

Wright, S. (2002). Examining the impact of spirituality
on nurses and healthcare provision. Professional Nurse,
17(12), 709–711.

Sometimes as nurses we feel we
must be able to handle anything, and
when we struggle with something like
suffering, we are demonstrating personal
and professional weakness. The reality is
we do struggle with the painful situations
we see daily in nursing practice: a child
run over by a school bus, a woman
miscarrying a much wanted child, a
college student becoming incapacitated
with mental illness, a young father learning
he has cancer, an elderly person dying
alone, or a family who has lost their
health insurance and are being refused
care. To acknowledge our struggle with
difficult situations is to acknowledge our
humanness. When we face circumstances
that are beyond our ability to change or
to understand, lamenting, as described
earlier by Brueggemann, might be a
fitting response. Katongole and Rice
describe lament. “Lament is not despair.
It is not whining.…Lament is a cry
directed to God” (2008, p. 78). Lament
is the recognition that if God is not
there, there will be no hope, no good,
and no meaning in the situation.
Sometimes we need to allow ourselves
to recognize the reality of the suffering
around us and express our anguish to
God, and sometimes a part of that
process is to acknowledge our own
suffering and anguish. By doing so
we can experience comfort and hope
in knowing God understands our
anguish—he too has experienced
suffering. As we cry out to God, we
can find freedom from a false sense of
responsibility or guilt over our inability
to ease or eliminate the suffering of

our patients, and recognize that in some
circumstances only God can intervene.

Second, we need to seek support from
others in the Christian community. We
need people with whom we can discuss
experiences with suffering to gain new
perspectives and understanding. Some
support can only come from fellow
nurses who understand the challenges
of nursing practice. However, equally
important is support from people who
do not know the intricacies of nursing
practice and who approach suffering
from a totally different perspective. We
need people with whom we can bare
our souls, and we need to have people
who we know are praying for us. There
are few things in life that we can truly
handle by ourselves; without a doubt
suffering is not on that list.

Third, we need to take time for
personal renewal and growth. Dealing
with suffering can be emotionally,
physically, and spiritually exhausting.
Robert Wicks (2006) remarks, “Health
care is one of the few professions where
it is socially acceptable to ignore your
family, your non-work life, yourself ”
(p. 113). He suggests that self-care involves
anything from taking a quiet walk, to
having friends or family over for dinner,
to having a hobby, to journaling, to
asking oneself profound questions such
as “what really gives value to my life”
(p. 113). Taking time for activities such
as reading the Bible and other helpful
books, praying, attending church,
participating in small groups, or other
religious practices helps give meaning
to life and restore one’s inner self.

“Though he lives in the present it is clear that

the Christian, according to St. Paul, is meant

to live for the future.” Martyn Lloyd-Jones.

222 JCN/Volume 28, Number 4 journalofchristiannursing.com

Copyright © 2011 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited.

http://www.journalofchristiannursing.com

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