James 1:27 and the Training of the Modern Nurse

In the increasingly pluralistic campus classroom, one might expect the primary texts of the world’s religions not to resonate with modern students, especially the career-minded ones. However, I am convinced that these texts—James 1:27 being a case-in-point—continue to have tremendous, and deeply interdisciplinary, value.  This semester, I am teaching “Theology of Death and Dying” at the University of St. Francis, an institution founded by the Sisters of St. Francis of Mary Immaculate in Joliet in 1920. My students are Catholic, Protestant, and—according to one—“pagan.” Several of them have career interests in nursing and gerontology. We’re concluding, therefore, with the work of Sr. Mary Elizabeth O’Brien on servant leadership in nursing and the work of Sr. Helen Prejean on spiritual advisors.

My students are following in the tradition of the women religious who broke into the nursing field during the Civil War and performed sacraments upon request for Christian and non-Christian soldiers. Modern nurses will find that their corporal acts of mercy resonate with the ordained widows tending widows and orphans in Article 9 of the Mennonite Confession at Dordrecht in 1632. Before the ordained widows, contemporary caregivers can look to the Christian institution of the Orphanotropheion and the inspiration figure of Saint Zotikos, priest and orphanotrophos. And, of course, this notion that it is the care of orphans and widows that constitutes the true prize and trophy of a religion can be traced further back still. This is the definition of faith given in James 1:27.

Widows and Orphans in James

While isolating a biblical verse from its context is often a notoriously perilous enterprise, James 1:27 functions as the conclusion to the preceding argument of chapter 1, a transition to the next point of chapter 2, and, quite possibly, a maxim. The verse itself reads:

Religion that is pure and undefiled before God and the Father is this: to care for orphans and widows in their affliction and to keep oneself unstained by the world.

James expands upon his previous exhortation that each person must fight their own battles against temptations and achieve their own victory over their own passions. Unlike Paul, who sets God in charge of the moral arena in which Christians are tested, James presents a God who waits for people to overcome their corrupting desires in order to award the faithful with a crown of immortality. This discipline involves a proactive gathering in of those on the margins of life, a population with which nurses and social workers routinely work.

For James, those furthest on the margins are not the lepers, the tax-collectors, or those overcome by bandits. Rather, James focuses on the members of society who have dealt with death itself, the widows and orphans who have outlived their loved ones and now must go on as best they can without them. As O’Brien has noted, Jesus’ healing ministry exemplified how to love one’s neighbor. Some of the healing miracles involve a triumph over death, like the cure of the royal official’s son (John 4:46-54). Others, like the cure of the bent-over woman (Luke 13:10-17), remove illness and disability from individual bodies. Jesus must teach his community that suffering is not the product of a sin by the sufferer or his or her parents. Instead, sin points to the fallen, imperfect nature of the world, which can only be restored to its intended glory by God.  Jesus’ role as a physician is a role only God can sustain.  The nurse serves as a modern guide on how to sustain life in the face of the eventual illness and death that await us all.

James as a Guide for the Modern Nurse

In grouping widows and orphans, James privileges the classic example set in Exodus 22:22, where the command “You will not afflict the widow or orphan” invites its refugee audience to reflect on their solidarity with those who have narrowly escaped death themselves. (James’ identification of his audience with the tribes of Israel in dispersion allows him to not need to extend protection to strangers, as does Deut. 10:18.) The words orphanos and chēra do not occur elsewhere in James, and they function here to provide concrete examples of how Christians can be victorious over temptation and yet not become ethically implicated in the corrupt moral economy of the Roman Empire. Like the ancient individual who trains to perfect his or her character and receives the crown of a good and impartial God, the nurse uses his or her skills to provide the support system for those losing their fight with illness and those losing their loved ones.

Part of helping someone is identifying with them. In a hospital, this is achieved by dressing everyone in flimsy fabric, whether scrubs or hospital gowns. Within the wards, nurses have the opportunity to live out James 2, where James quotes the scripture “You shall love your neighbor as yourself.” The letter decries the divisions in the community caused by the attention given to distinctions of physical appearance, particularly those achieved by means of the display of gold rings and expensive fabrics. For James, love of neighbor implies that one will not care about the jewelry that advertised equestrian rank or the cloth that suggested mercantile success in the Roman Empire. Nurses’ basic scrubs place them closer to the hospital gown of the patient, allowing the nurse to empathize with the patient more naturally than the white coat of the physician that sets the physician apart. Without the status inversion of clowning like Patch Adams, the nurse nonetheless manages to relate to the patient.

As patients and their families encounter illness and death, a nurse must help them navigate their feelings in order to accept certain treatments. Due to the existential nature of nursing, organizations such as the American Association of Colleges of Nursing recommend that nurses receive spiritual training. Nurses are often able to augment the role of the hospital chaplain, particularly in situations in which a patient may not feel comfortable sharing concerns with the chaplain. Male patients with breast cancer may need a male nurse to complement a female hospital chaplain. Female patients with ovarian cancer may wish to speak with a female nurse as well as a male hospital chaplain. Among the training topics for nurses are:

• Sufficient time to build rapport
• Fear of imposing spirituality on patients
• Deference to the role of hospital chaplains

Using the definition of James 1:27, nurses may find a way to maintain a New Testament ethic in a pluralistic and neutral way. Both nurse and patient may define religion as based on a principle of love of neighbor and care within community. The nursing students in my own class supplied examples from Game of Thrones, but James 1:27 can be compared universally in a manner that is helpful to those who need to serve the spiritual needs of Christians, pagans, and atheists alike. The nurse undertakes a spiritual role that complements the hospital chaplain without duplicating or replacing it.

Hospitals, Hospice, and Hospitality

The nurse and the social worker in a theology course have a vocational opportunity to serve as an example of ideal religion. For James, ideal faith presents itself not in the often rote recitation of creeds in contemporary services; rather, true religion is a religion of service to the most vulnerable of human society, putting the “kith” in the phrase “kith and kin.” Whereas many theologians want to privilege the role of Jesus as physician and healer, the nurse and the social worker find a voice in the James’ solicitude for those around the dying and those whose lives have been permanently touched by an encounter with illness. James 1:27 commends itself to those in the health professions and those in social services.

Photo Credit: “Medical/Surgical Operative Photography” by Phalinn Ooi— CC by 2.0

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