“The Assignment”

The situation

Rachel isn't a real person. She's a composite, assembled out of letters that arrive sounding almost identical. Thirty-nine years old. Eleven years a surgical nurse at a regional hospital, two hundred beds, the one most everybody in the county was born in. Her husband drives a delivery route. Two kids, nine and six. The mortgage is fourteen hundred and sixty a month, and the health insurance comes through her badge, not his. At nine forty on a Tuesday night, the scheduling app pushes a change to her phone. She's been moved. Room three, seven thirty in the morning. She opens the chart to prepare, the way she always does. Elective termination. Nineteen weeks. The hospital has a conscience policy. Two pages. It asks that objections be filed in advance of scheduling. She was scheduled eleven hours before the case. So she texts the charge nurse. The reply comes at ten oh two. "You're the only one credentialed for room three tomorrow. If you decline the assignment I'll have to document it as refusal of patient care." Refusal of patient care is not a bad review. It's a phrase that can travel from a personnel file to the state board. Her license is the house.

The technique

Here's what's actually running on her. Nobody at that hospital is going to tell Rachel her religion is wrong. Nobody will debate her about God, or life, or the nineteenth week. They will tell her she has a performance problem. That's the move. In the book, William Green's Rules for Radical Christians, I call it a conviction redefined as conduct. A belief is something an institution has to consider, and there are recognized protections around it. Conduct is something an institution disciplines. So the belief is never attacked. It's refiled. Rachel didn't refuse to help kill a child; she "declined an assignment." Same woman, new folder. Then comes the clock. Nine forty at night to seven thirty in the morning. That is not enough time to read the policy twice, reach her manager, call an attorney, or pray it through with anyone who's awake. The deadline isn't testing her conscience. It's preventing deliberation. Whoever is still standing at sunrise makes the decision. And then the scarcity claim. "You're the only one credentialed." Maybe that's true. She cannot check it at ten at night. It arrives shaped like necessity, so her conscience shows up on the schedule as a staffing emergency. None of this is written in the policy. None of it has to be.

The temptation

Six twelve in the morning. Parking deck, level two. Engine off. Eighteen minutes. This is where the arguments come, and they come in her own voice, which is what makes them strong. It's one case. You're not performing it, you're handing instruments. God knows your heart. And the big one: if you lose that license, you help nobody, so stay, and you'll be at a thousand bedsides. Every one of those has truth in it. That is the danger. A lie you can spot. A truth pointed the wrong direction walks right past the guard. God does look on the heart. That's exactly why "God knows your heart" is no comfort at six twelve in a parking deck, because He knows it right now, while she decides. Turn to Exodus, chapter one. Pharaoh calls in the midwives and hands them an assignment. Kill the boys. These women had no rank and no severance. The king could have ended them before breakfast. And the text says, "But the midwives feared God, and did not as the king of Egypt commanded them." They didn't win an argument. They simply did not do it. And God made them houses. Shiphrah and Puah are named in Scripture. The king who gave the order is not.

Your move

Change the ground. Rachel cannot win a six a.m. hallway debate about abortion, and she shouldn't try. She also cannot win on their ground, which is whether she's a cooperative team player. So she moves it back. Conduct becomes conviction again, in writing, courteously, before the shift begins. She sends one short email, to the charge nurse, to the surgical services manager, and to herself, and it says this. "I have a sincerely held religious conviction against taking part in this procedure. Please reassign me, or state in writing the duty that requires me to assist." That's all. No sermon. No accusation. It names the conviction, it requests an accommodation, and it asks the institution to put its own demand on paper. Institutions will say to a nurse by text at ten at night what they will not write down at eight in the morning. I'm not your lawyer, and this is not legal advice. But there are recognized ideas here, and you should know their names: religious accommodation of a sincerely held religious belief, the federal conscience protections in health care often called the Church Amendments, and her employer's own written conscience policy. Ask a licensed attorney in your state. Ask before you need one. Second move. Tell a brother and tell an elder, before the room, not after. At six fifteen she calls a man from church and says out loud what she will do and what she will not do. That's pre-commitment. A decision made alone at the door gets made by fear. Third move. Be excellent. Best charting on the floor, first to take the hard patient, last to complain. The relabel only sticks to a mediocre nurse. Make it absurd.

Scripture & close

Proverbs twenty-four, verses eleven and twelve. "If thou forbear to deliver them that are drawn unto death, and those that are ready to be slain; If thou sayest, Behold, we knew it not; doth not he that pondereth the heart consider it? and he that keepeth thy soul, doth not he know it? and shall not he render to every man according to his works?" Rachel's personnel file may end up saying refusal of patient care. Heaven's record will read differently, and only one of those two documents is permanent. Say it early, say it in writing, and make them name the duty. This is the Family Mountain. Which of the seven mountains are you standing on? Take the free assessment at rules for radical christians dot com, slash start. Stand your ground. We'll see you on the wall.