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In her 38-year career in hospital nursing, Cleo Bell, RN, of Durham, NC, realized that something was missing. "People might be getting good medical care, but a lot of the time there was no one to help them with the spiritual trials they were going through," she says. "Over and over again, there seemed to be a spiritual void."
Susie Surles, who started out as a hospital orderly and worked her way up to registered nurse in a 30 year-plus career in Durham, voices a similar frustration. "There seemed more and more paperwork, and I’m a bedside nurse who wants to be holding peoples’ hands," she says. Unlike many nurses, Surles says she was glad to be assigned in 1992 to the hospital AIDS unit, where she anticipated making more of a difference in patients’ lives. "A young lady with HIV wanted to be baptized, and her minister didn’t want to do it," she recalls. "I saw to it that she got baptized."
When they reached retirement age, Bell and Surles say they wanted to do something more, but did not know what. Then last summer, they were offered a chance they immediately jumped at — to train as parish nurses in a new program run jointly by the nursing and divinity schools of Duke University, also in Durham.
Now, as their training reaches its final weeks, each is entering upon this new career in her church in the largely African-American neighborhood of Walltown in Durham: Surles in St. James Baptist Church and Bell in St. John’s Baptist Church, where she serves as president of the health ministry.
One of their first projects will be hosting a six-session workshop in cervical cancer prevention offered by the American Social Health Association. It’s a vital service, since racial minorities have double the rate of cervical cancer that whites do. A key contribution of the parish nurses: finding the right citations from Biblical scripture to help bring the message of each session home to their Walltown parishioners.
Parish nurses are one puzzle piece in the complex solution to the challenge posed by the coming upsurge in the population of older Americans. As a result of the aging of baby boomers and an expected continuing increase in life expectancy, the number of Americans ages 65 and older is projected to increase from 35 million at present to 78 million in 2050. Moreover, the number of Americans ages 85 and older is projected to grow from 4 million to 18 million over those decades, with some demographers contending this number could go as high as 31 million.
The resulting growth in chronic illness and disability, medical planners predict, will require a much stronger partnership than exists today between the health care sector and religious institutions. And parish nurses, they say, will be key to building this partnership.
Parish nursing originated as a contemporary movement in the 1960s under the guidance of the late Granger Westberg, a Lutheran clergyman in Chicago. Its greatest growth has come in recent years, after parish nursing was officially recognized as a nursing subspecialty by the American Nurses Association in 1997. Today there are 4,000 to 5,000 graduates of parish-nursing certificate or degree programs in the United States and abroad, divided among those who are remunerated and those who work without pay, according to Mindy Beard, RN, associate director of outreach programs at Duke University Medical Center.
A short walk from Walltown, in a more affluent part of the city, Anne Drennan, RN, has served for the past two years as a parish nurse at the Watts Street Baptist Church. A former hospital nurse who now administers a volunteer center in Durham, Drennan also manages to find 12 to 15 hours a week to work unpaid as her church’s parish nurse. It is some measure of the unmet needs among parishioners that she supervises 30 members of the congregation (some of them health care professionals, but most are not). In January, she logged a total of 230 contacts as parish nurse with parishioners in need, fellow volunteers, and others.
Being a parish nurse may be as simple as getting volunteer help for an elderly couple to clean out a closet or as tricky as helping congregants negotiate an increasingly complex and impersonal health care system, Drennan says. For example, recently an 89-year-old woman with severe back pain asked Drennan for help in seeing an orthopedist after she was told she would have to wait two weeks to get an appointment. "On a scale of 1-10, what is the severity of your pain?" Drennan asked her. "Twenty," the woman replied.
In short order, Drennan arranged for an orthopedic appointment, but her work didn’t end with getting the woman back and forth to physician visits. She helped detail the woman’s list of medication, since several might interact in dangerous ways with drugs that might be prescribed. There was the need as well to keep the women’s two grown children abreast of her situation, one in Wisconsin and the other 150 miles away in Wilmington, NC. And when physicians made little headway in alleviating the woman’s pain and she moved in with her son, Drennan wrote a letter detailing the patient’s medical history.
All efforts notwithstanding, the woman died soon after she moved to Wilmington. Her children asked Drennan to be one of the ministers at her service in Durham, something she considers a great honor.
"In this very complicated system of health care, you are a person representing the story of the church," Keith Meador, MD, ThM, MPH of the Duke Divinity School recently told a class on parish nursing at Duke, where Drennan frequently sits in. "Yes, pray with your congregants," he told the class, "but make sure they get treatment."