There is an intimate relationship between grief and spirituality before, during and after experiencing pain, agony, and sorrow. Spirituality, faith and belief in God play significant in overcoming sadness, rejection, and grief. The existence of grief is very natural and common It is extremely hard and overwhelming to interact with the people who are grieving in their life for various reasons. In the healthcare system, grief primarily affects the nurses due to nature of their job and their direct involvement with the patient during patient care process. Grief can also influence the hospital staff, including Doctors and patient’s families, relatives, and friends. Therefore it is very critical to understand grieving stages, and effective measures in overcoming the damaging effects of grief towards establishing spirituality, acceptance and Joy to everyone in the health care system. According to Kubler-Ross grief is followed by a natural phenomenon and series of cycles of denial, anger, bargaining, depression and acceptances (Kübler-Ross, 1969).
In this literature, we will compare the grieving processes defined by Kübler-Ross against Job, the prophet (Bible) against another religion which is Islam (Quran). We also discuss an Interaction between Joy and grieving models followed by my own preferred methods of handling and overcoming grief. Grieving Processes (Kübler-Ross), Job (Bible), and Islam (Quran) Dr. Elizabeth Kübler-Ross developed and introduced five stages to support and to counsel during personal trauma and grief associated with dying and death and improved the practices associated to bereavement and hospice care. She also specified that the grief cycle actually represents a change model to help and to understand how to deal with and to counsel personal reaction to trauma in the health care environment. These methodologies are not just for death and dying but for everyone who suffers grief (Kübler-Ross, 1969). According to the Old Testament (Bible), Job was abundantly blessed by God, having large family of ten children, loving wife because of his strong faith and belief in God. Job’s wealth and richness was unimaginable comprising significant amount of sheep, camels, Oxen, donkeys, and servants.
His greatness and riches flourished amongst all the people in the east being the richest man on earth (Job 1:2-3). He was challenged by Satan with the consent of God with series of tragedies to test his level faith and belief in God during unbearable sufferings in his life (Job 1:2-3). We compare the cycles and stages of grief experienced by Job in relation to the stages of grief defined by Kübler-Ross and with another religion called “Islam”. These stages (cycles) of Grief outlined by Kübler-Ross are Denial, Anger, Bargaining, Depression, and Acceptance (Kübler-Ross, 1969). Denial: Denial is the very first stage when someone hears about the loss of their loved ones. In other words denial includes shock of not believing or not agreeing to something happening to their loved ones ((Kübler-Ross, 1969). The tragic death of seven sons and three daughters of Job might have definitely given Job and his wife enough shock to put them straight to the process of denial stage despite Job’s strong faith in Jesus (God). But, Job was not on denial and did not react to his wife’s comments and Satan’s temptations.
Instead Job continued praising God for everything and knelt down and said “I was born northing and will die nothing; the Lord gave me everything and now he has it taken away” (Job 1:21). In contrast the Quran (Holy book of Muslims) did not mention that Satan wiped out Job’s family and richness with series of evil events because Satan obtained permission from God. They believe that Allah (God) would not do any harm to his faithful servants. (Quran 38:41). Anger: Anger results from shock and denial. According to Kübler-Ross, people get angry against the person who caused it. They simply blame the patient, nurse, doctor and God out of frustration and pain when they suffer and grief (Kübler-Ross, 1969). Job was further challenged by Satan and God permitted Satan to perform destructive tests including body sores. Job scraped his itchy sores with a piece of pottery. His wife again commented with Anger “Why don’t you curse God and die?” (Job 2:9). Job corrected his wife and did not say anything against God and showed no signs of anger but asked God why his testing him and continued praising him.
In contract, Quran mentions that Allah desires nothing but destruction with rage and anger when he is insulted and challenged. For example, eye for an eye and retaliation, vengeance against the person who caused grief which is contradictory statement against New Testament (Bible). Bargaining: According to Kübler-Ross bargaining takes place in exchange of the bad experiences, difficulties, and sufferings in the past towards something good, change in their habits, beliefs and life styles after understanding the fact that things are not within their control. They welcome good against bad in an attempt to forget the past and to move on in life (Kübler-Ross, 1969). Job did not bargain with God rather mourned and lamented the loss he suffered. He attempted to remain silent and tried to digest the situation, meaning behind his sufferings. Job did not sin by blaming God (Job1:22). God asked him “Job, will you be annoyed if I speak?” (Job 4:1). Job mentioned to God that If his troubles and grief’s weighed on scales, they would weigh more than the sands of the sea” (Job 6:1). In Quran, Allah said, “The case of a believer is amazing!
Every affair of his is good for him, and this is not for anyone except a believer who experiences healing” (Quran, Surah Fussilat 41:44) Depression: According the Kübler-Ross, depression brings decreased interest in people’s lives. At times the depression seems to be so bad that people encounter hopelessness, sadness, pain, and sorrow (Kübler-Ross, 1969). Bible clearly illustrates the series of depression experienced by Job after suffering physically, emotionally when he lost everything he had. As a result his spirit also suffered when he felt that God left him to suffer (Job 3:1-13). According to Quran, “Allah does not change men’s condition unless they are willing to change their inner selves” (Quran 13:11). According to Quran depression is often experienced by Moses, Job and Mohammed when they went thru very deep form of sadness. Depression steals freedom, controls and captivates people with selfishness (Quran 13:11). Acceptance: According to Kübler-Ross acceptance is the end result after sufferance depression which takes people to the right path towards comfort and stability.
In this stage people experience less pain compared to the prior stages and accept God’s series of tests and challenges. They develop confidence and accept that life is very important rather than worries (Kübler-Ross, 1969). Job accepts the realities of life and asks God to teach him and to tell his faults and promises to stay away from sins (Job 6:24) Job approaches God for his counsel and asks to grant him wisdom. As Job repents and doesn’t give up hopes and trust, God replaces everything that Job had lost in the past and blesses him more than ever before (Job 42:2-12). Quran also depicts about countless blessings from God for the true worshippers who trust in him, grateful and those who give thanks. “Therefore, remember me and I will remember you; be grateful to me and never be ungrateful to me” (Quran 2:152). Interaction between Joy and Grieving stages
There is a strong interaction between Joy and grieving cycles despite few of the grieving stages (Anger and depression) seem to be enemies of joy and happiness. Grief signifies heartrending appreciation of things that matter us most whereas Joy is shows us life’s wonders. Denial and Joy are never the same where the former brings realm of darkness and the latter one brings hope in life. Anger represents emotional reaction to the painful loss or death and steals our joy away when unexpected series of events take place (Kübler-Ross, 1969). Anger can turn into most intense and frightening. Therefore it is important to process through the anger to uncover the pain in search of peace, and joy. Bargaining includes promise against giving up something that is bad for health and volunteering to do something better for life in search of Joy at this stage (Kübler-Ross, 1969).
Depression brings frustration and lack of sleep resulting in deep pain and physical and psychological imbalances in life. As the time passes depressed people tend overcome this stage and show positive signs of getting out of this stage in search of happiness and joy (Kübler-Ross, 1969). Acceptance leads to see a bigger picture and they tend to move on with the existing situation in search for joy and happiness in life. They tend to learn new ways of living with an agreement that worries do not do any good other than harm (Kübler-Ross, 1969). I personally experienced all these stages when my family member was hospitalized and went through all the grief stages. I strongly believe that Kubler-Ross methodologies are perfectly aligned with the realities in life. Personal grieving methodologies
It is extremely essential for the nurse to be healthy, physically and mentally strong and able to cope with stress while taking care of the critical patients. Therefore, Physical, Emotional, Behavioral, and Spiritual strength and understanding of Kubler-Ross stages of grief and the ability to handle the situations in each stage are important. As a nurse I have come across several patients and their families battling multiple heath issues at the hospital where their grief is unbearable due to their financial situations that affects me as a nurse significantly. I often discuss these issues with my husband who is pretty much undergone serious difficulties in life and is in a position to guide me and battle my grief with his philosophical and religious thoughts, beliefs and action plans.
I also discuss my issues with my manager and colleagues who provide the support with valued suggestions and guidance. As a family, we attend church every Sunday and try to digest the teachings and believe that perseverance and acceptance to the realities is the key factor in seeking Joy especially when we give ourselves to God the almighty who controls everything that is good and bad. Having these thoughts and beliefs I get satisfaction as well as answers to my question with the divine intersection of Jesus and the Holy Spirit. Therefore, as a health care professional I would recommend that the hospital should educate all the nurses and the medical staff in grieving processes and methodologies to provide adequate support that is needed to all the patients regardless their health issues, financial abilities and any other personal problems.
Elisabeth Kübler-Ross & David Kessler “The Five Stages of Grief”
Retrieved from http://grief.com/the-five-stages-of-grief/
Bill Hood “Brothers of the Book” January 7, 2011, the Love of God, Job 10-12 Retrieved from http://brothersofthebook.com/tag/elisageth-kubler-ross/ Jack William, December 31, 2011 “Job Bible Story Summary with Lesson” Retrieved from http://www.whatchristianswanttoknow.com/job-bible-story Mission Islam, “Health and Well-being”
Retrieved from http://www.missionislam.com/index.htm
J. Hashmi, 2008 The Religion of Islam, “dealing with grief in Islam”. Retrieved from http://www.islamreligion.com/articles/1823/