Parish nursing teaches prevention, wellness

Provides resource for follow-up, continuing ed

Parish nurses are becoming a valuable community resource across the nation, helping to deliver holistic care to members of churches, synagogues, and mosques who might otherwise fall through the cracks. Parish nurse programs, often sponsored by hospitals, train nurses to help manage or prevent chronic diseases, while lowering health care costs.

And while they do not diagnose or treat patients, parish nurses educate, counsel, and help people see the connection between spirituality and physical and mental well-being. "We teach people to be good stewards of the body God gave them," says Rosemarie Matheus, MSN, RN, director of the Parish Nurse Preparation Institute Wisconsin Model at Marquette University College of Nursing in Milwaukee.

The concept of parish nursing emerged in the 1970s, but each nurse decided how to minister to his or her congregation. In 1991, Matheus, who was concerned that nurses weren’t adequately prepared, established a formal training program that taught nurses how to develop a successful parish nurse ministry. Course curriculum covers grief counseling, theology and healing, legal issues, teaching and counseling roles, spiritual caregiving, wellness and prevention, assessment skills, ethics and values, and working with volunteers. More than 500 parish nurses have taken the course at Marquette.

Parish nurses are in a good position to educate the public. "A lot of times, people in a church may not want to go to the priest or their doctor to talk about something personal where they would feel comfortable going to a parish nurse," says Nancy Addison, RN, a parish nurse at the 250-member Episcopal church she attends in McComb, MS. Although working full time as a nurse at Southwest Mississippi Regional Medical Center, Addison volunteers several hours each week to help members of her church with their health care needs, including referring people to physicians and showing them how to get help for mental illnesses.

Acknowledging the value of parish nursing, many hospitals are facilitating parish nurse programs. St. Joseph’s Regional Health System in Stockton, CA, pays for several nurses to be trained each year and places them with congregations. The hospital pays the nurse for eight hours of parish nursing a week the first year. The second year, the church pays 50% of the salary, and the third year, it picks up 75%. By the fourth year, the program is totally supported by the church. The nurse’s salary is comparable to the hourly wage paid to other community nurses such as those who work for a hospice.

Many funding options

"The difficult part is the paid position. If you don’t have a huge congregation, there is always a fight for the budget money and who gets the funds for different projects," saysMillie Fickenscher, RN, the parish nurse at St. Andrews Lutheran Church in Stockton, which has about 750 members. St. Joseph’s paid for her training three years ago. Although her situation is unique, since she also is the minister’s wife, she has initiated many fund-raising activities to support the program. She supplements her salary by working part time for a home health agency.

There are many parish nurse models, in addition to the model used by St. Joseph’s. In some cases, a health care institution employs a parish nurse as part of its outreach efforts. The nurse works with a church, although he or she is an employee of the hospital. Sometimes the nurse is paid by the church and works either full time or part time. Most positions are either volunteer or part time. Some parish nurses work part time at two churches, allotting 20 hours per congregation each week. Other nurses work 20 hours a week for a hospital and 20 hours for a church.

Each parish nurse practice differs according to the makeup of its congregation. For example, Barbara Cirincione, RNC, MS, parish nurse at United Church of Christ in Manchester, NH, works with a large elderly population at her 700-member church. She holds weekly blood-pressure clinics and is planning to lead a regular exercise class for seniors. She visits many elderly parishioners regularly, especially if they have memory problems so she can note any decline. "Most of my referrals come from the clergy. However, there are people in the church who are concerned about other people and ask me to call," she says.

Cirincione volunteers about 20 hours each week. However, often she devotes many more hours to the practice since she attends staff and committee meetings in addition to organizing programs and visiting parishioners. Currently, she is setting up a health ministry within the church made up of members who are willing to plan programs. She hopes that church members who are physicians, nurses, and pharmacists will join the ministry and help conduct programs. The church allots some funds for educational materials.

The last two years, Fickenscher has arranged a health fair at her church. In 1996, there were 35 vendors. Booth services include body fat analysis, blood pressures, pulmonary function testing, flexibility and grip strength testing, and massage therapy. One booth called "Ask a doctor," was staffed by an obstetrician, a pediatrician, a family practitioner, and a chiropractor. "We invite other churches, but because we are located across from a mall, we don’t open it up to the community. We are afraid we wouldn’t be able to handle the crowd," says Fickenscher.

Reaching the community

To learn about the health care needs of church members, Addison keeps regular office hours before and after church and on Tuesday afternoons. Her practice includes visits to people in the hospital and while they recover at home. If the parishioner has been discharged with a complicated medication regimen, she’ll explain the drugs and their side effects and answer other questions.

In December 1996, Addison conducted a survey to find out what health care issues interest parishioners. Although she’s still tabulating results, she has found that many want to know more about high blood pressure, diabetes, living wills, arthritis, and aging. She plans to cover one topic a month at educational workshops held at the church.

Addison also is planning an AIDS workshop for teen-agers at her church and from neighboring congregations. She’s also going to do a safety check at seniors’ homes to help prevent falls.

[Editors note: For information on parish nurse training, contact: Rosemarie Matheus at Marquette University College of Nursing, P.O. Box 1881, Milwaukee, WI 53201-1881. Telephone: (414) 288-3802. Fax: (414) 288-1597.

The International Parish Nurse Resource Center produces a free orientation packet that contains articles on parish nursing, a catalogue of materials, and information about educational programs. Write: International Parish Nurse Resource Center, 205 West Touhy Avenue, Park Ridge IL 60068. Telephone: (800) 556-5368.]