HRO: (11) Faithful Perseverence Despite Failure

The 2013 discussion by Mark Chassin and Jerod Loeb entitled “High-Reliability Health Care: Getting There from Here” starts with a comprehensive review of what makes an organization highly reliable.  They continue by asking rhetorically how far hospitals are from being HROs—with their assessment being “quite far.”  They state that “[A]s opposed to preoccupation with avoiding failure, hospitals and other health care organizations behave as if they accept failure as an inevitable feature of their daily work.”  The article then goes on to discuss several characteristics which make health care “non-HRO”, characteristics such as “misplaced confidence” in inadequate safety systems; complacency; poor communication coupled with a “culture of low expectations” leading to failure to be sensitive to operations.  All of this complicated by a work environment littered with complex and poorly coordinated medical equipment, frequently burdened with a climate of intimidation and abuse.

A pretty dismal assessment, yet a depressingly accurate one.  Most of us working in healthcare would agree with their statements and conclusions with a wry and exhausted “yup, that pretty much sums it up.”  And we turn back to the braying of alarms, the constantly malfunctioning equipment, the frequent ungrateful critique—extending even to abuse—by patients and families, the poor communication and lack of respect among coworkers, the staffing shortages, the emotional, physical and spiritual fatigue.  “This is just healthcare” we are tempted to say, putting noses back to grindstones and eyes back to the ground as we shuffle forward on aching feet, doing our futile best.

“But we are not of those who shrink back and are destroyed, but of those who believe and are saved.”  So says Hebrews 10: 39.  

This verse comes in a much larger context, a discussion by the writer of the book of Hebrews about perseverance, faithfulness and discipline.  Specifically, the readers are encouraged to persevere in faith, faith which allows us to enter confidently into God’s presence because of the bloody sacrifice of Christ on the cross; to “…draw near to God….hold unswervingly to the hope we profess, for He who promised is faithful.” (Heb 10: 22-23).  They (and we) are to reject sin (10: 26 ff) and stand their ground in the face of great suffering and persecution, to include loss of property, public insult, and imprisonment (10: 32ff).  All of this precedes the great “Faith chapter”, Hebrews 11, which provides an abstract of Old Testament heroes of faith flowing into a narration of New Testament martyrs; all of this is preliminary to the “Therefore” which begins Hebrews 12:   “Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us.  Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before Him, endured the cross….” (Heb 12: 1-2a).  

Let me not be mistaken:  the passages above specifically discuss perseverance on earth to live out our faith in Christ, to hold onto the gospel message of forgiveness, reconciliation, and life eternal with God.  We have Christ as the author of our salvation, the One who “…endured the cross, despising its shame…” in order to bring us to a right relationship with God here on earth and in eternity.  If I fail in all other areas of my life—as a spouse, parent, employee, supervisor—but die in faith, I will not lose my reward. Nothing that we do in life can add to our salvation.  If I fail to create a safe and reliable medical environment in my immediate scope, I will not earn eternal damnation; only sinful rejection of Christ’s redeeming work can do that.  

That said, we live on earth; we each have a calling and a sphere in which our Christian faith should be lived out; we have not barricaded ourselves into a monastery or stranded ourselves on a desert island.  What does real, raw life on earth, out in the world, look like?  It is confusing, painful, difficult and draining.  Healthcare looks no different than any other earthly environ clouded and corrupted by sin. Persevering in faith, in life, includes persevering at work.  Resisting evil will often look like resisting the temptations to idolatry, profanity, adultery and hate.  But resisting evil will also include resisting the temptation to laziness and complacency, the temptation to passively let harm happen; resisting evil will mean resisting the temptation to snap and snarl, to berate a teammate or trainee, to give in to fatigue and frustration; resisting evil will mean resisting hubris and pride, rejecting personal confidence in infallibility and instead choosing humility and repentance.  Those of us working in healthcare happen to have a particularly exhausting environment to live out our faith; we come in direct contact with immediate impacts of sin, with suffering, disease and death.  The stakes are high, as human life is in our hands—lives created in God’s image, people whom He loves enough to die for.  We cannot sinfully chose to leave our faith in the parking lot, to enter this place of care and service without the Spirit of love, compassion and perseverance in which, as Christians, we are called—and empowered—to live.  We must “not be of those who shrink back and are destroyed” (and allow our patients to suffer and die), but instead live out our faith to God’s glory and in service to others.

1)      Read Hebrews 10: 19 through Hebrews 12.  Meditate on what it means to you as a Christian, striving against sin to live out your faith despite challenges.  This passage clearly speaks to persecution by the world, of danger and hardship.  How have you experienced challenges to your faith that have caused you to persevere, to trust God more despite circumstances, to grow in faith and discipleship?

2)      Read Hebrews 10: 19 through Hebrews 12 again.  This time, read it in light of your role as a healthcare worker:  what areas is your faith challenged, where are you tempted to sin?  Do you see some of the failures outlined by Chassin and Loeb lived out in your professional life (complacency, disrespect, blaming)?

3)      Meditate specifically on Hebrews 10:  22, 23.  We have forgiveness in Christ Jesus.  His sacrificial death split the temple curtain—we have direct access to God’s holy presence, as we are declared righteous and holy for Jesus sake.  What does this mean for you when you are faced daily with failures at work—when you have been impatient, un-compassionate, complacent, angry, disrespectful?  How does the forgiveness you have in Christ impact your daily interactions with other people? 

4)      Spend time specifically praying that God will strengthen your faith; that He will bless you to serve others in His name and to His glory; that He will give you clear insight into how you can live out your faith each day.