Picture: Kreg via flickr.com

The ideas of service and duty have been mentioned a lot recently, particularly in relation to the fatal shooting of a Shrewsbury policeman, and the royal deployment in the Iraq war. The connotations seem to include noble but slightly unwelcome tasks which we'd prefer to let someone else deal with, albeit a 20-something anxious to march in the family footsteps.

I use the words service and duty a lot too, although as a student nurse I'm usually referring to working within the National Health Service. I tend to cringe at the thought of seemingly endless lectures on the subject of my 'professional duty of care', a context which seems far distant from our lads doing the dirty work in a foreign desert.

However, nursing and military jargon have many similarities and overlaps, for which I'm quite happy to blame Florence Nightingale and her lamp. We speak of off-duty rosters, inspection rounds, duties and states of alert. The media insist on referring to us 'in the firing line of Department of Health reforms', in the face of an enemy which is codenamed Mrs A. Service and duty seem to be ideas which haven't developed much since the selfless stiff-upper-lip, grin-and-bear it attitude of the Edwardians. Just old-fashioned words to describe a bygone world of empire, class etiquette, country houses, servants and the horror of the Flanders trenches.

But where is God in all this? The idea of being morally bound to perform a task or provide something needed by others seems permanently intertwined with Christian theology, particularly relating to Christ's Passion. But unlike the Edwardian example, my experience of service and duty is that they have moved away from the idea of blindly obeying orders. Today, I'd argue that there is an increasing degree of free thought and will involved; the idea that you can only do a task well if you are fully aware of your actions and their consequences. In the current culture of litigation, nurses are increasingly being held publicly accountable for their own actions, a process slowly being mirrored in the military. It is no longer acceptable to simply follow orders, as the Abu Ghraib prison abuses and American friendly fire incidents have shown. The duty to take the blame for incidents on the ward or battlefield no longer rests with the overall authority, but often with the individual. Does this come full circle to our relationship with God, if we are required to begin to take greater responsibility for our actions in His service?

Like the Iraqi battlefields, my experience of duty in a busy hospital ward can sometimes feel a long way from the peace-and-love kingdom-on-earth we're promised. I'll rush to abandon wet eyed Edwardian sentimentality about caring for the sick, (or, indeed, fighting for one's Queen and Country). But a few thoughts persist through my sceptical student's eyes, which tenuously adhere to the ideas of service and duty. However, they do not stand as saintly pillars of example - I'm well aware that everyone has their own ideas on how their Guide / Scout promise to 'do my duty to God, to serve other people etc etc' could be fulfilled.

The idea of Christianity in nursing makes perfect sense, as throughout the ages many people have seen it as their faithful duty to serve their neighbours who are sick or injured. Fortunately, this blind faith in religious duty has abated slightly - nurses are no longer required to kneel and pray before the start of every shift. In order to best help your neighbour; patient or otherwise, there needs to be a degree of independent thought based on your experience and knowledge in a unique situation. The idea of thinking for yourself therefore seems to require an even greater degree of faith in what you do and believe, as your service is tested every time, and you can't pass the blame at the end of it.

Given the dour Yorkshire attitude to religion which some of my patients express; notably that Christianity should be seen at births, marriages and funerals, and not heard in between, I find it quite hard to link this sort of experience to 'a meaningful higher being' (as my nursing textbook piously informs me that I should, please pass the vomit bowl...) But the practical side of my course, working in hospitals with real, live people has shown me that most people have faith. It may be as simple as faith that Friday teatime brings fish and chips. But to care for someone and help them through injury and illness includes a duty to unearth and cultivate faith, which is hard especially when people are alone, scared, or in pain.

Being responsible and accountable in this service of care (Christian or otherwise) means that I'm required to have a wider duty; to accept people as they are. It may be something which Istruggle with, such as the need for lucky crystals or a particularherbal remedy brewed from Tibetan yak milk, but there is still thisannoying word, duty, lurking in the background which requires me to get on with caring for their needs to the best of my ability. Interestingly, military lingo in the Iraq war has replaced the idea of duty with the phrase "got a job to do" - which seems devoid of any moral obligations. Duty nags me even more when there is a particular bit of my job which I don't like very much, but which I'm still accountable for, such as talking to the bed manager or mopping up a flood in the sluice... but hang on, doesn't every job have its Monday morning moments?

Picture: Kreg via flickr.com