[NP-Clinical] Clinical Spirituality- article from the Medical Journal of Australia

[np at c-zone.net]

Spirituality and Health

Religion, spirituality and medicine in Australia: research and clinical
practice

Harold G Koenig,  MJA 2007; 186 (10): S45-S46
Studies demonstrating health benefits of religion are many and growing in
number, and some claim the results are ripe for application in clinical
settings.1,2 However, others argue that the research is not nearly as good
or consistent as portrayed, and caution against acting rashly on
inconclusive evidence.3,4 The goal of this supplement is to determine what
this growing body of research means for Australian practitioners and
patients.
Religion involves beliefs and practices related to the sacred, where the
sacred is defined as God, the numinous (mystical or supernatural) or
ultimate truth. Religion is a unique construct, different from other
psychological and social phenomena. Spirituality, on the other hand, is
more difficult to define, as its definition today has changed — from one
based in religion to a more diffuse concept, self-defined by each
individual. The result is that there is no widespread agreement on what
spirituality means, producing a real challenge when trying to measure it.
Attempts to measure spirituality have taken two approaches:
Asking questions about religious involvement;

Asking questions about positive psychological characteristics, such as
meaning and purpose in life, connectedness to others, peacefulness and
high personal values.

There are two problems with the latter way of defining and measuring
spirituality. The first is that atheists might claim that they are neither
religious nor spiritual — yet argue, rightly, that their lives have
purpose and meaning, that they experience connection with others, and that
they maintain high personal values.
The second problem with defining spirituality in terms of positive
psychological characteristics is that doing so produces a construct that
is really a quasi-indicator of mental health. This makes it difficult or
impossible to interpret research on the relationship between spirituality
and health, especially mental health. Correlating a construct defined by
indicators of mental health (spirituality) with another mental health
construct (eg, wellbeing, life satisfaction, depression or anxiety) will
always lead to an association between the two. Such an approach could also
lead to false relationships between spirituality and physical health,
given the strong links between mental and physical health.
The word spirituality, when used in research, should be restricted to
those things that have something to do with the sacred (as defined above).
If there is no connection with the sacred, then it should not be referred
to as spiritual or spirituality. We already have psychological and social
terms to deal with concepts that all humans have in common, regardless of
belief, and I think we should keep these concepts distinct from religious
terms. I realise that many others in both the United States and Australia
will not share this opinion, including a number of authors who have
contributed to this supplement. From a purely scientific standpoint, if we
are to study the relationships between religion, spirituality and health,
it is essential to have constructs that are clear and non-overlapping.
For these reasons, I refer mainly to religion when discussing
relationships with mental and physical health. My definition of religion,
however, is quite broad and means a lot more than just institutional
religion or religious affiliation. Another reason for using religious
language when discussing the research is that most published research has
really been examining religion, even if it is presented and discussed in
terms of spirituality.
However, when talking with patients in clinical practice, there are good
reasons for using the word spirituality, rather than religion. Research
shows that, while many patients do not distinguish between being religious
or spiritual,5 others feel alienated from institutional religion and see
themselves more as spiritual than as religious. This may be particularly
true for patients in Australia. The term spirituality is vague enough to
allow patients themselves to define the playing field.
Why should religion and health be connected? The argument is a rational
one. If religious people have a world view that gives hope and meaning in
the face of stress and loss, if they have social support from other
members of the religious community, and if they live healthier lifestyles
by smoking less, drinking less, and making more conservative, less risky
decisions in marriage, the workplace, and recreational activities, there
is good reason to expect that they will have better physical health as
well. All of these factors influence health in ways that are increasingly
being understood through the field of psychosomatic medicine.6 It should
not be surprising, then, that in 2006 more than 70 published research
studies examined the relationships between religion, spirituality and
health, many finding positive relationships.7
The articles in this supplement review research on religion, spirituality
and health relevant to Australian patients and practitioners and discuss
the application of that research to clinical practice. Although not all of
the research comes from Australia, the articles provide an important
summary and background that will assist Australian researchers in
designing and implementing future research. While most of the articles do
not contain original research, they begin to address some of the research
gaps identified by Peach in 2003.8 Williams and Sternthal9 assess the
importance of religion and spirituality to Australians and discuss the
evidence for both positive and negative effects of religion on health
(→ Spirituality, religion and health: evidence and research
directions). Eckersley10 looks at the relationship between spirituality,
religion and health in a broad cultural context (→ Culture,
spirituality, religion and health: looking at the big picture), while
Wilding11 presents a case study to illustrate the meaning of spirituality
at a personal level (→ Spirituality as a sustenance for mental
health and meaningful doing: a case illustration). The different
approaches to spiritual assessment in health care practice are summarised
by Rumbold12 (→ A review of spiritual assessment in health care
practice), and Winslow and Wehtje-Winslow13 raise a number of ethical
issues relating to the provision of spiritual care (→ Ethical
boundaries of spiritual care). Jantos and Kiat14 present evidence on the
health benefits of prayer (→ Prayer as medicine: how much have we
learned?), and D’Souza15 suggests ways in which clinicians can approach
the subject of spirituality with their patients (→ The importance of
spirituality in medicine and its application to clinical practice).
Hopkins and colleagues16 focus on evidence-based strategies that could be
implemented by church-associated organisations to reduce high-risk
behaviours in young people (→ Developing healthy kids in healthy
communities: eight evidence-based strategies for preventing high-risk
behaviour), and, at the other end of the age spectrum, MacKinlay and
Trevitt17 provide a model of spiritual tasks in later life (→
Spiritual care and ageing in a secular society).
The contributions presented here suggest that spirituality and religion
are important to many Australian patients, and that the spiritual needs
arising from religious beliefs should be identified and addressed as part
of whole person health care. They also suggest that much more research in
this area is needed in Australia. While some of the findings of US
research may be applicable to Australian patients, there are important
cultural differences between the two countries that may influence the
relationship of religion to health and the needs of patients in this
regard.
Competing interests
None identified.
Author details
Harold G Koenig, MD, Professor,1 Associate Professor2
1 Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, USA.
2 Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Correspondence: koenigATgeri.duke.edu
References
Koenig HG. An 83-year-old woman with chronic illness and strong religious
beliefs. JAMA 2002; 288: 487-493. <PubMed>
Koenig HG. Religion, spirituality and health: an American physician’s
response. Med J Aust 2003; 178: 51-52. <eMJA full text> <PubMed>
Sloan RP, Bagiella E, Powell T. Religion, spirituality, and medicine.
Lancet 1999; 353: 664-667. <PubMed>
Sloan RP, Bagiella E, VandeCreek L, et al. Should physicians prescribe
religious activities? N Engl J Med 2000; 342: 1913-1916. <PubMed>
Koenig HG, George LK, Titus P. Religion, spirituality and health in
medically ill hospitalized older patients. J Am Geriatr Soc 2004; 52:
554-562. <PubMed>
Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction:
implications for health. Nat Rev Immunol 2005; 5: 243-251. <PubMed>
Center for Spirituality, Theology and Health, Duke University Medical
Center. Research on spirituality, theology and health. Latest research.
http://www.dukespiritualityandhealth.org (accessed Apr 2007).
Peach HG. Religion, spirituality and health: how should Australia’s
medical professionals respond? Med J Aust 2003; 178: 86-88. <eMJA full
text> <PubMed>
Williams DR, Sternthal MJ. Spirituality, religion and health: evidence and
research directions. Med J Aust 2007; 186 (10 Suppl): S47-S50.<eMJA full
text>
Eckersley RM. Culture, spirituality, religion and health: looking at the
big picture. Med J Aust 2007; 186 (10 Suppl): S54-S56.<eMJA full text>
Wilding C. Spirituality as sustenance for mental health and meaningful
doing: a case illustration. Med J Aust 2007; 186 (10 Suppl): S67-S69.<eMJA
full text>
Rumbold BD. A review of spiritual assessment in health care practice. Med
J Aust 2007; 186 (10 Suppl): S60-S62.<eMJA full text>
Winslow GR, Wehtje-Winslow BJ. Ethical boundaries of spiritual care. Med J
Aust 2007; 186 (10 Suppl): S63-S66.<eMJA full text>
Jantos M, Kiat H. Prayer as medicine: how much have we learned? Med J Aust
2007; 186 (10 Suppl): S51-S53.<eMJA full text>
D’Souza R. The importance of spirituality in medicine and its application
to clinical practice. Med J Aust 2007; 186 (10 Suppl): S57-S59.<eMJA full
text>
Hopkins GL, McBride D, Marshak HH, et al. Developing healthy kids in
healthy communities: eight evidence-based strategies for preventing
high-risk behaviour. Med J Aust 2007; 186 (10 Suppl): S70-S73.<eMJA full
text>
MacKinlay EB, Trevitt C. Spiritual care and ageing in a secular society.
Med J Aust 2007; 186 (10 Suppl): S74-S76.<eMJA full text>
(Received 20 Mar 2007, accepted 23 Apr 2007)

    AND -  -   -   -

> BMJ 2002;325:1434-1435 ( 21 December )
>
> Spirituality and clinical care
> Spiritual values and skills are increasingly recognised as necessary
> aspects of clinical care
>
> Medicine, once fully bound up with religion, retains a sacred dimension
> for many. Differing religious beliefs and practices can be divisive.
> Spirituality, however, links the deeply personal with the universal and is
> essentially unifying. Without boundaries, it is difficult to define, but
> its impact can be measured.1 This is important because, although
> attendance in churches is low and falling,w1 people increasingly (76% in
> 2000) admit to spiritual and religious experiences.2
>
> The World Health Organization reports: "Until recently the health
> professions have largely followed a medical model, which seeks to treat
> patients by focusing on medicines and surgery, and gives less importance
> to beliefs and to faithin healing, in the physician and in the
> doctor-patient relationship. This reductionist or mechanistic view of
> patients is no longer satisfactory. Patients and physicians have begun to
> realise the value of elements such as faith, hope, and compassion in the
> healing process."w2 In one study, 93% of patients with cancer said that
> religion helped sustain their hopes.3 Such high figures deserve our
> attention.
>
> A signal publication offers a critical, systematic, and comprehensive
> analysis of empirical research, examining relations between religion or
> spirituality and many physical and mental health conditions, covering more
> than 1200 studies and 400 reviews.4 A 60-80% relation between better
> health and religion or spirituality is found in both correlational and
> longitudinal studies covering heart disease, hypertension, cerebrovascular
> disease, immunological dysfunction, cancer, mortality, pain and
> disability, and health behaviours and correlates such as taking exercise,
> smoking, substance misuse, burnout, and family and marital breakdown.
> Psychiatric topics covered include psychoses, depression, anxiety,
> suicide, and personality problems. The benefits are threefold: aiding
> prevention, speeding recovery, and fostering equanimity in the face of ill
> health.
>
> Especially interesting are the excellent results obtained in intractable
> conditions through teaching people coping methods based on meditation.5 w3
> Qualitative research complements empirical studies, and "new paradigm"
> methods provide helpful detail about spirituality in clinical practice. 6
> 7 Examples include questionnaires,8 w4 interviews, focus group studies,9
> and narrative based enquiries.w5
>
> It is instructive to distinguish cure of symptoms from healing of people.
> 6 7 The words "heal" and "whole" have common roots. Healing entails
> restoration of psychobiological integrity, with the implication of
> personal growth and a sense of renewal.
>
> Spiritual values and skills are increasingly recognised as necessary
> aspects of clinical care, to be more openly discussedw6 and taught.w7 A
> textbook of nursing, for example, states: "In every human being there
> seems to be a spiritual dimension, a quality that goes beyond religious
> affiliation, that strives for inspiration, reverence, awe, meaning, and
> purpose even in those who do not believe in God. The spiritual dimension
> tries to be in harmony with the universe, strives for answers about the
> infinite, and comes essentially into focus in times of emotional stress,
> physical illness, loss, bereavement, and death."10 Mental illness should
> be added to this list.
>
> Guidance is available for doctors to assess spiritual needs and provide
> for healing even when they are unable to cure.7 w8 It may be especially
> cost effective if the hypothesis that to provide spiritual care affords
> reciprocal benefit proves true. If patients and their professional carers
> both gain, lower levels of conditions such as substance misuse and burnout
> can be forecast, with improvements in staff morale and hence recruitment
> and retention. Greasley et al's cohort, however, observed that spiritual
> needs are not a priority for medical staff, relative to more tangible
> issues.9 This is important because, for Nathan's patients, spiritual care
> is an area perceived as necessarily involving all care providers.11
>
> With much new research showing that prognosis is radically improved by
> spiritual care,4 what are the hindrances to implementing it? Haines and
> Donald describe some general problems about getting evidence into
> practice.12 w9 McSherry gives more details where spirituality is
> concerned.8 The problem areas are interrelated: education (lack of
> training, resulting in lack of knowledge or insight or confidence) and
> economics (lack of staff or time or resources), environment (lack of space
> or privacy), and personal obstacles (sensitivity or own belief systems).8
> These need addressing under the two headings of clinical governance and
> continuing personal and professional development and can be remedied if
> given priority.
>
> Compare spirituality with nutrition; neither is a subject that healthcare
> providers can take for granted. Inadequate nutrition is costly. If people
> are not fed properly, resistance weakens and wounds do not heal. Evidence
> is growing in volume and quality that this holds for spiritual sustenance
> too.4
>
> The way forward is to give rein to natural inquiry, to rediscover and
> communicate openly about this vital area, and to foster the rhetoric of
> spirituality.w6 Our managers, multidisciplinary colleagues,
> andespeciallyour relatively few chaplainsw10 are natural coalition
> partners with whom to engage in this endeavour, together with our patients
> and their families.
>
> According to Nathan, spiritual care promotes the healthy grieving of loss
> and the maximising of personal potential.11 It provides a sense of
> meaning, resulting in renewed hope and peace of mind, enabling people to
> accept and live with otherwise insoluble problems. Physical and mental
> illnesses therefore provide all concerned with particular opportunities
> for healing, personal development, and spiritual growth. Improved outcomes
> naturally follow.
>
> Many see religion and medicine as peripheral to each other, yet
> spirituality and clinical care belong together. The time is thus ripening
> for doctors to recall, reinterpret, and reclaim our profession's sacred
> dimension.
>
> Larry Culliford, consultant psychiatrist.
> South Downs Health NHS Trust, Brighton Community Mental Health Centre,
> Brighton BN1 3RJ (larry.culliford at southdowns.nhs.uk)
>
>
> Footnotes
>
> Competing interests: LC is a Christian with wide ranging ecumenical and
> interfaith interests. He is on the steering group of the "Spirituality and
> Psychiatry" special interest group of the Royal College of Psychiatrists
> (www.rcpsych.ac.uk/college/sig/spirit). As Patrick Whiteside he writes
> spirituality oriented self help books (www.happinesssite.com).
>
>
>  Extra references appear on bmj.com
> -------------------------------------------
>
> 1.  King M, Speck P, Thomas A. The Royal Free interview for religious and
> spiritual beliefs: development and standardization. Psychol Med 1995; 25:
> 1125-1134[ISI][Medline].
> 2.  Hay D, Hunt K. Understanding the spirituality of people who don't go
> to church: a report on the findings of the adults' spirituality project.
> Nottingham: University of Nottingham, 2000.
> 3.  Roberts JA, Brown D, Elkins T, Larson DB. Factors influencing views of
> patients with gynecologic cancer about end-of-life decisions. Am J Obstetr
> Gynecol 1997; 176: 166-172[CrossRef][Medline].
> 4.  Koenig HK, McCullough ME, Larson DB. Handbook of religion and health.
> Oxford: Oxford University Press, 2001.
> 5.  Kabat-Zinn J. Full catastrophe living: using the wisdom of your body
> and mind to face stress, pain and illnessthe program of the stress
> reduction clinic at the University of Massachusetts Medical Center. New
> York: Delta Books, 1990.
> 6.  Swinton J. Spirituality and mental health care: rediscovering a
> forgotten dimension. London: Jessica Kingsley, 2001.
> 7.  Culliford LD. Spiritual care and psychiatric treatmentan introduction.
> Adv Psychiatr Treatment 2002; 8: 249-260.
> 8.  McSherry W. Nurses' perceptions of spirituality and spiritual care.
> Nursing Stand 1998; 13: 36-40.
> 9.  Greasley P, Chiu LF, Gartlands M. The concept of spiritual care in
> mental health nursing. J Adv Nursing 2001; 33:
> 629-637[CrossRef][ISI][Medline].
> 10.  Murray RB, Zentner JP. Nursing concepts for health promotion. London:
> Prentice Hall, 1989.
> 11.  Nathan MM. A study of spiritual care in mental health practice:
> patients' and nurses' perceptions [dissertation]. In: Enfield: Middlesex
> University, 1997.
> 12.  Haines A, Donald A. Getting research findings into practice. BMJ
> 1998; 317: 72-75[Free Full Text].
>
> --------------------------------
> © BMJ 2002
> Related Article
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> BMJ 2003 326: 881. [Extract] [Full Text]
>
> This article has been cited by other articles:
> (Search Google Scholar for Other Citing Articles)
>
> Culliford, L. (2007). Taking a spiritual history. Adv. Psychiatr. Treat.
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> Ai, A. L., Cascio, T., Santangelo, L. K., Evans-Campbell, T. (2005). Hope,
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> Nethercott, D. R, Hawker, M. J, Day, E., Wilkes, S., Copello, A. (2003).
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> bmj.com, 31 Dec 2002 [Full text]
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> bmj.com, 1 Jan 2003 [Full text]
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> Re: Spiritual care - a confusing term
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> Spiritual Care; An Unmet Training Need
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> Spirituality:A necessary complement to holistic care.
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> bmj.com, 27 Jun 2005 [Full text]
>
>
>> This is not clinical content!  Send to NP-Info
>> Ted Scott, NP-C
>>   _____
>>
>> From: np-clinical-bounces at nurse.net
>> [mailto:np-clinical-bounces at nurse.net]
>> On Behalf Of stephanie2u at optonline.net
>> Sent: Thursday, August 16, 2007 12:31 PM
>> To: NP Clinical
>> Subject: Re: OT Re: [NP-Clinical] Clinical Spirituality
>>
>> I hope this is the lawyer speaking anonymously, because I wouldn't want
>> to
>> go to a health professional that had that sort of attitude & quoted Jean
>> Shepherd when I was most in need of their emotional support. (Nor would
>> I
>> want an attorney with an attitude like that.)
>>
>>
>>
>> The ability and skills to provide emotional support are not the
>> exclusive
>> province of Christians, as we all know.
>>
>>
>>
>> Stephanie Walker, FNP
>>
>> ----- Original Message -----
>> From: Calif NP
>> Date: Thursday, August 16, 2007 11:16 am
>> Subject: OT Re: [NP-Clinical] Clinical Spirituality
>> To: NP Clinical
>>
>>> That sort of sounds like a patient/client trying to rationalize
>>> why they
>>> cannot pay their bill.
>>> A good climate to create might be the posting of a small sign,
>>> showing an
>>> artistic rendering of a pair of placed in a classical position
>>> of prayer
>>> above which the saying would appear:
>>> "In God We Trust, All Others Pay Cash. . . . . .
>>> Our prayers are with you for your continued
>>> prosperity and
>>> health".
>>> This may be the extent of what a culturally and spiritually
>>> sensitive yet
>>> secularized medical practice serving a diverse population can handle.
>>>
>>>
>>> ----- Original Message -----
>>> From: "Dena"
>>> To: "'NP Clinical'"
>>> Sent: Wednesday, August 15, 2007 8:51 PM
>>> Subject: RE: [NP-Clinical] Clinical Spirituality
>>>
>>>
>>> > That sometimes, for whatever reason, some things are simply
>>> out of our
>>> > control and we are not responsible for what happens nor is it
>>> our fault.
>>> Try
>>> > to shake off the burden of guilt by saying we don't understand
>>> how these
>>> > things work or why some innocent child has to die young, etc.
>>> If they
>>> > believe in a higher power of ANY sort (whatever it may be),
>>> you can pin
>>> > everything on it. Fate, divine intervention, karma, kismet,
>>> the will of
>>> God,
>>> > Allah, or Buddha, etc.
>>> > Dena Galler
>>> >
>>> > -----Original Message-----
>>> > From: np-clinical-bounces at nurse.net [mailto:np-clinical-
>>> bounces at nurse.net]> On Behalf Of Phil Noe
>>> > Sent: Wednesday, August 15, 2007 7:58 PM
>>> > To: NP Clinical
>>> > Subject: [NP-Clinical] Clinical Spirituality
>>> > Ok-Here's an interesting spiritual / religious clinical
>>> > question -> How would you handle this scenario? I
>>> > recently say a child with a chronic incurrable and life
>>> > shortening illness. The mom who is very involved in her
>>> > local congregation carried a good bit of guilt and told
>>> > me that as she studied her Religious book she believed
>>> > that if she could lead a good enough life that her child
>>> > would be cured but she had not achieved that yet was
>>> > still trying. She obviously felt that the illness was
>>> > somewhat her fault. After telling me this , she then
>>> > paused for me to reply - what would you say?
>>> > Phil Noe
>>> > Pediatric Pulmonology and Sleep Medicine
>>> > Children's Hospital
>>> > Knoxville, TN
>>> >
>>> >
>>> > --- Calif NP wrote:
>>> >
>>> > > There are numerous health care providers who
>>> > > deliberately or unwittingly
>>> > > unrelentlessly proselytize to their patients, often in
>>> > > subtle ways such as
>>> > > verbalizing religion based quotes or offering prayer
>>> > > for someone's
>>> > > difficulties (a kind gesture which I appreciate). But,
>>> > > it is compelling that
>>> > > we support the ethic that in a society based on secular
>>> > > respect for others
>>> > > beliefs this may not be appropriate, especially in
>>> > > areas/populations which
>>> > > are medically underserved.
>>> > >
>>> > > ----- Original Message -----
>>> > > From: "Dena"
>>> > > To: "'NP Clinical'"
>>> > > Sent: Monday, August 13, 2007 6:20 AM
>>> > > Subject: RE: OT Re: [NP-Clinical] Prayer subject not
>>> > > closed -
>>> > > Prayforworldsobriety
>>> > >
>>> > >
>>> > > > I'm sorry-- perhaps I've misunderstood the purpose of
>>> > > this professional NP
>>> > > > listserve after 13+ yrs of being an active member....
>>> > > I had no idea I had
>>> > > > signed up for a "religious NP" listserve. Or perhaps
>>> > > the mission statement
>>> > > > of the list changed somewhere along the line when I
>>> > > was out of town. Or
>>> > > > perhaps the official Email announcing the changes
>>> > > ended up in my junk mail
>>> > > > box and I just never saw it. Or perhaps newer members
>>> > > are just ignorant of
>>> > > > common proper netiquette because it isn't spelled out
>>> > > in big bold letters
>>> > > > somewhere. If this list had a moderator/administrator
>>> > > (I nominate Andy!!),
>>> > > > I'm sure these discussions would not be allowed.
>>> > > >
>>> > > > This is NOT the platform to discuss PERSONAL
>>> > > religious beliefs-- of ANY
>>> > > > kind... I'm sure there are other, more appropriate,
>>> > > venues for that.
>>> > > Perhaps
>>> > > > those that are interested in exchanging prayers and
>>> > > religious ideology can
>>> > > > form their own listserve on NPCentral and leave this
>>> > > one to its intended
>>> > > > purpose???
>>> > > >
>>> > > > The ONLY time I think religion and politics have any
>>> > > place on the list is
>>> > > AS
>>> > > > THEY APPLY TO PATIENT CARE AND RESTRICTION OF OUR OWN
>>> > > PRACTICE and then it
>>> > > > should be as IMPERSONAL as possible. The two subjects
>>> > > are very sensitive
>>> > > and
>>> > > > volatile and people's feelings can too easily get
>>> > > hurt. It's just NOT
>>> > > > necessary. I could care less about the personal
>>> > > religious beliefs of
>>> > > ANYONE
>>> > > > on this listserve-- it is immaterial to NPInfo and
>>> > > NP-Clinical. I find it
>>> > > > real hard to believe that some on this list actually
>>> > > believe their own
>>> > > > personal religious views have any bearing on
>>> > > discussions of NP issues-- or
>>> > > > that others care to hear about it.
>>> > > > Dena Galler
>>> > > >
>>> > > >
>>> > > > -----Original Message-----
>>> > > > From: np-clinical-bounces at nurse.net
>>> > > [mailto:np-clinical-bounces at nurse.net]
>>> > > > On Behalf Of Joanne DaCunha
>>> > > > Sent: Monday, August 13, 2007 3:20 AM
>>> > > > To: NP Clinical
>>> > > > Subject: RE: OT Re: [NP-Clinical] Prayer subject not
>>> > > closed - Pray
>>> > > > forworldsobriety
>>> > > >
>>> > > > Interesting that it is NOT ok to post a prayer but
>>> > > perfectly OK to
>>> > > > ridicule that same religion. Perhaps I should not
>>> > > express my view, but
>>> > > > religion, or lack thereof, is part of one's culture,
>>> > > just as any other
>>> > > > part of their beliefs. It's not something that anyone
>>> > > should ignore to
>>> > > > be a whole person. I happen to not agree that
>>> > > religion and politics
>>> > > > should NOT be out of the social discussion context. I
>>> > > think it teaches
>>> > > > all of us how to have civilized discourse with those
>>> > > with whom we
>>> > > > disagree and allows disallows those who intend to
>>> > > disrupt the beliefs of
>>> > > > others to continue their efforts "underground"
>>> > > without ever being
>>> > > > challenged. Putting those issues on the discussion
>>> > > table allows each of
>>> > > > us to learn the beauty of others' culture and beliefs
>>> > > and learn what we
>>> > > > need to understand and live respectfully with others,
>>> > > and that is a good
>>> > > > thing.
>>> > > > Joanne
>>> > > >
>>> > > >
>>> > > >
>>> > > > -----Original Message-----
>>> > > > From: np-clinical-bounces at nurse.net
>>> > > > [mailto:np-clinical-bounces at nurse.net] On Behalf Of
>>> > > Linda Marie De Zago
>>> > > > Sent: Sunday, August 12, 2007 11:20 PM
>>> > > > To: 'NP Clinical'
>>> > > > Subject: RE: OT Re: [NP-Clinical] Prayer subject not
>>> > > closed - Pray for
>>> > > > worldsobriety
>>> > > >
>>> > > > Love it!!!
>>> > > > This is going in my favorite folder.
>>> > > > What a great way to end the weekend.
>>> > > > Thanks for the laugh.
>>> > > >
>>> > > > Linda
>>> > > >
>>> > > > -----Original Message-----
>>> > > > From: np-clinical-bounces at nurse.net
>>> > > > [mailto:np-clinical-bounces at nurse.net]
>>> > > > On Behalf Of np at c-zone.net
>>> > > > Sent: Sunday, August 12, 2007 10:40 PM
>>> > > > To: NP Clinical
>>> > > > Subject: OT Re: [NP-Clinical] Prayer subject not
>>> > > closed - Pray for world
>>> > > > sobriety
>>> > > >
>>> > > > Politically Incorrect Humor Warning!!!
>>> > > >
>>> > > >
>>> > > >
>>> > > > Read on at your own eternal peril, read on at the
>>> > > risk of.........
>>> > > >                 "SIPPING VODKA"
>>> > > >
>>> > > > A new priest at his first mass was so nervous he
>>> > > could hardly speak.
>>> > > > After mass he asked the monsignor how he had done.
>>> > > The monsignor
>>> > > > replied, "When I am worried about getting nervous On
>>> > > the pulpit, I put a
>>> > > > glass of vodka next to the water glass. If I start to
>>> > > get nervous, I
>>> > > > take a sip."
>>> > > > So next Sunday he took the monsignor's advice. At
>>> > > the beginning of the
>>> > > > sermon, he got nervous and took a drink.
>>> > > > He proceeded to talk up a storm. Upon his return to
>>> > > his office after
>>> > > > the mass, he found the following note on the door:
>>> > > >
>>> > > > 1) Sip the vodka, don't gulp.
>>> > > >
>>> > > > 2) There are 10 commandments, not 12.
>>> > > >
>>> > > > 3) There are 12 disciples, not 10
>>> > > >
>>> > > > 4) Jesus was consecrated, not constipated.
>>> > > >
>>> > > > 5) Jacob wagered his donkey, he did not bet his ass.
>>> > > >
>>> > > > 6) We do not refer to Jesus Christ as the late J.C.
>>> > > >
>>> > > > 7) The Father, Son, and Holy Ghost are not referred
>>> > > to as Daddy, Junior
>>> > > > and the spooky.
>>> > > > 8) David slew Goliath, he did not kick the sh*t out
>>> > > of him.
>>> > > >
>>> > > > 9) When David was hit by a rock and was knocked off
>>> > > his donkey, don't
>>> > > > say he was stoned off his ass.
>>> > > >
>>> > > > 10)We do! not refer to the cross as the "Big T."
>>> > > >
>>> > > > 11) When Jesus broke the bread at the last supper he
>>> > > said, "take this
>>> > > > and eat it for it is my body." He did not say " Eat
>>> > > me"
>>> > > >
>>> > > > 12 The recommended grace before a meal is not:
>>> > > Rub-A-Dub-Dub
>>> > === message truncated ===