When Betsy suspected her husband had Alzheimer’s disease, she turned to a nurse to help her find a medical practice that accepted their health insurance. When multiple sclerosis kept Sylvia alone and homebound, a nurse who’d been making regular visits found an appropriate long-term care facility and assisted her with moving. When Margaret starting losing weight rapidly and had difficulty getting a diagnosis, a nurse accompanied her for a second opinion, where laboratory work found an aggressive cancer.
In each case, the helpful nurse was a parish nurse based in her faith community.
A specialty practice recognized by the American Nurses Association (ANA), parish nursing (also called faith-community nursing) combines professional nursing with health ministry, emphasizing health and healing in a faith community. What started with six congregations in 1984 now includes more than 10,000 parish nurses, both in the United States and internationally.
Integrating spirituality with care
Parish nursing was conceived by the Rev. Dr. Granger E. Westberg, a Chicago Hospital chaplain, who saw it as an integrative link between physicians and clergy working in the Wholistic Health Centers he’d helped found. Westberg envisioned the parish nurse working in congregations, whose ultimate goal?the community’s health and well-being?is the same as the hospital’s. That base, as he saw it, would give the nurse a broader opportunity to interact with people of all ages and in various stages of health and sickness. The parish nurse would integrate spirituality with all aspects of care while emphasizing prevention and early intervention.
Today, the parish nurse plays many roles?integrator of faith and health, health educator and counselor, referral advisor, health advocate, support-group developer, and volunteer coordinator. Besides congregations, settings for parish nurses include long-term care, hospice, day care, soup kitchens, schools, seminaries, and other faith-based community settings.
How the specialty practice developed
In 1997, the ANA designated parish nursing a specialty practice. At the same time, the Health Ministries Association, a membership organization for parish nurses and others in health ministry, developed the “Scope and Standards of Parish Nursing Practice.”; Revised in 2004, these standards are now called “Faith Community Nursing: Scope and Standards of Practice.”; Today, the International Parish Nurse Resource Center (IPNRC) in St. Louis, Missouri provides educational materials and resources.
Four integral concepts
IPNRC’s basic parish-nurse preparation curriculum identifies four concepts: spiritual formation; professionalism; Shalom (which means peace in Hebrew) as health and wholeness; and community, which incorporates culture and diversity.
Parish nursing is based on spirituality, regarding all persons as sacred and worthy of being treated with respect and dignity. Parish nurses serve the faith community (and in many cases, the surrounding neighborhood), create safe and sacred places for healing, and advocate with compassion, mercy, and dignity. Practicing in collaboration with the pastoral staff and congregants, they participate in the ongoing transformation of the faith community into avenues of health and healing.
IPNRC’s preparation curriculum describes the philosophy of parish nursing as follows:
The spiritual dimension is central to parish nursing practice. Personal spiritual formation is an intentional process of intimacy with God to foster spiritual growth. It is an ongoing, essential component of practice for the parish nurse and includes both self-care and hospitality, through opening the heart to self and others. The parish nurse role reclaims the historic roots of professional nursing…Each parish nurse practices under the scope and standards of practice and the ethical code of nursing as set forth in their country…Shalom, God’s intent for harmony and wholeness, serves as a foundation for understanding health.
Congregational and clerical perspectives
Many clergy are eager to learn more about parish nursing, because much of their work is health-related?visiting ill congregants, helping people find counseling or care resources, and promoting the well-being of the congregation and community. Most clergy who learn about parish nursing see the benefits of having a nurse to help them coordinate and implement the health ministry of the congregation and serve on the leadership team.
Some congregations are reluctant to consider parish nursing, fearing that providing health care can expose them to legal liability. Yet in the 20 years of parish-nursing practice, no documented instances of lawsuits have been lodged against parish nurses for healthcare-related matters.
Faith-based nursing is attracting seasoned nurses in growing numbers. The work provides autonomy, which allows for creativity and flexibility, as well as the chance to network with community health organizations and providers to create and implement plans for healthier communities. Perhaps most importantly, faith-based nurses work in a setting that encourages people to make body, mind, spirit, interpersonal, and environmental connections for holistic health.
What are the disadvantages? Salaries generally start near beginning salaries for nursing graduates, and some positions provide no benefits. In fact, some parish nurses hold unpaid positions because their congregations can’t afford another paid staff position. Those who seek full-time paid employment may need to work for multiple congregations.
Supporting best practices in parish nursing
Growing evidence suggests that parish nursing is most effective when supported by a strong, vital health committee that participates in planning, implementation, and evaluation of programming. Despite the professional standards and curriculum of parish nursing, however, research in parish nursing is scarce.
IPNRC recently formed a research committee to examine the role of the parish nurse, best practices of the profession, spirituality as integral to the practice, and the educational preparation of parish nurses. Through education and research, the professional practice of parish nursing continues to maintain its specialty status.
Faith-based nursing challenges the nursing profession to reclaim the spiritual dimensions of care, challenges the healthcare system to provide whole-person care, and challenges the faith community to revitalize its healing mission.
Deborah Patterson is Executive Director of the Deaconess Parish Nurse Ministries and the International Parish Nurse Resource Center (IPNRC) in St. Louis, Mo. Barbara Wehling is on the nursing faculty at Webster University in Webster Groves, Mo. and is IPNRC’s Acting Director. Gayle Mason is IPNRC’s Manager of Coordinator’s Care.
Health Ministries Association. Faith Community Nursing: Scope and Standards. Silver Spring, Md.: American Nurses Association; 2005.
International Parish Nurse Resource Center. About parish nursing. www.parishnurses.org/AboutParishNursing_5.aspx. Accessed August 25, 2008.
McDonald L, ed. Florence Nightingale, “Parish Deaconesses.”; In: The Institution of Kaiserswerth on the Rhine, for the Practical Training of Deaconesses. 2nd ed. London: London Ragged Colonial Training School;1851. Reprinted in: Florence Nightingale’s European Travels (Collected Works of Florence Nightingale). Vol. 7. Waterloo, Ont.: Wilfrid Laurier University; 2004:508-510.
Patterson D. The Essential Parish Nurse: ABCs for Congregational Health Ministry. Cleveland, Ohio: Pilgrim; 2003.