Parish nursing fulfills community mission

Service recently recognized as practice specialty

Looking for a new business opportunity with a strong community focus? Then consider collaborating with area churches to establish a parish nurse program.

While such an initiative won't line your pockets with money, it offers both a huge community goodwill reward and spiritual pay back, sources advise.

Though its roots spring from most religions' credos about the body serving as a vessel for the spirit and the strong spiritual-physical health connection, parish nursing is a late twentieth century invention. Formalized about 15 years ago by Chicago-based Lutheran minister and physician Granger Westberg, the field is now growing by leaps and bounds. Sources estimate that over 3,000 congregations nationwide now have formal parish nurse programs. The service was recently recognized as a practice specialty by the American Nurses Association, which also recently published practice standards.

Parish nurses do not provide hands-on care but perform multiple services that support congregants' access to and understanding of the health care system, and promote their physical and spiritual Welfare. Parish nurses advocate for patients' health needs and liaison between parishioners and both the health care system and the church congregation. They provide health education and basic health screening and are a valuable link in the church's ministry, sources say. "They are just as important as the education or youth minister," says Jeanne Nist, BSN, director of the Parish Nurse Program at Silver Spring, MD-based Holy Cross Health.

"Parish nurses are not substitute pastors, but they can take the pressure off a pastor who recognizes additional needs but doesn't know where to go," says D. Mark Cooper, DMin, executive director of Lutheran Social Services of the National Capitol Area in Washington, DC. "A minister who has education in theology and social science may say 'Mrs. Smith, you don't look well,' but that is as far as they can go with it. A parish nurse can help people get into the system," explains Martha Erbach, RN, MEd, MSN, assistant professor of nursing and director at the Center for Parish Nursing at Shenandoah University in Winchester, VA.

"It is a real supportive service for people who need it," says Judy Morris, RN, director of professional services for Harrisonburg, VA-based Continuing Care. "For example, with nursing home patients, the nurse can sit and talk [longer] - the minister has such limited time - and she can intervene in issues on a nurse level to try to get them fixed."

"And for people coming home from the hospital who haven't been funneled into home care, [parish nurses] can see in a minute whether they need [resources], and the minister can't touch that with a 10-foot pole," Morris continues.

"[Parish nurses] can lend support and knowledge to the family that there are resources; they can intervene and call physicians or go back [with the family] on a physician visit. They can explain on a medical level 'the family's struggling, the patient is home bound and needs PT and OT.' [At the same time], the family may be unsure about the care or have concerns, and they are not secure enough to ask the doctor, so the nurse can ask questions [on their behalf] in front of the physician."

"And with the family's approval, the nurse can also go back to the church and say, 'The family's struggling' and help organize meals and transportation," she adds.

The ideal parish nurse is someone with an active faith who is comfortable practicing independently and is very knowledgeable about community health resources, health education, and communication and care compliance issues, according to sources. "It's a ministry that appeals to those ready to retire. Why waste all that nursing judgment and experience?" asks Erbach.

Programs should be flexible

Flexibility and openness are important in developing a program, according to sources. Private duty providers may approach more than one congregation or even congregations of different faiths as joint sponsors and collaborators. "There are all sorts of models depending on the local needs and circumstances," says Erbach.

"It's a place where congregations can work together," says Cooper. Lutheran Social Services plans to establish an area-wide program that would support over 100 congregations with 24 nurses. It is now submitting proposals to three foundations for initial program support. Over time, Cooper expects that the local congregations will assume both operational and financial responsibility for the service.

While she agrees that there are many successful models, and parish nurse programs "are wonderful public relations for whoever initiates [them, that organization] should try not to impose other agendas," Nist cautions. "Philosophically, the agenda, the ownership, and the values have to be with the faith community," she adds.

The future of parish nursing is bright, according to sources. The service will continue to grow as more concerned faith communities try to fill in the gaps of an increasingly fragmented and dysfunctional health care system.

Churches, too, see it as a way to boost membership. "A lot of people today are not committed to a particular faith and they shop around for [congregations] with a healthier spirit and additional services. [Parish nursing] attracts people as an indicator that the congregation is a leader and looks at the whole person," says Cooper.

Editor's note: Private duty providers interested in establishing a parish nurse program may first contact the International Parish Nurse Resource Center at (800) 556-5368. Or for information about the service and start-up support, contact their Web site: www.advocatehealth.com/sites/pnursctr.html/.