Good Works: Parish Nurses Reach Out, Pray with Patients
Monday July 28, 2003
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Parish nurses will tell you that their field is more a vocation than a job. As one St. Petersburg RN who switched from cardiac care to parish nursing says, "I was called by God to do this. It was not hard making the transition - it was joyful!" Photo courtesy of Florida Hospital.
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mother about baby care, guiding a new patient through the healthcare maze, or holding a dying patient's hand at the end of life. For dozens of Florida parish nurses, ministering to the ill - and praying with them as well as promoting healthy habits - has become a daily activity.
Healing the Body Through the Spirit
"I like being able to blend my Christian beliefs and spirituality with my medical training," says Roberta Jerz, RN, CRNH, a parish nurse at Lee Memorial Health System, Fort Myers. "We're so much more than a mere body that grows sick, old, and weary. There's a spiritual dimension, where prayer and the Holy Eucharist can be not only comforting but miraculous."
Jerz works at St. Columbkille, a Catholic church with 4,000 parishioners. She visits some 150 mostly elderly congregants each month. And she's very good at what she does: Jerz recently received Nursing Clinical Excellence honors from her Florida Nurses Association district after writing an exemplar outlining the difference her care made for an 85-year-old retired priest.
"You're using everything you've ever done with nursing, and it all comes together," she says. "I can offer the communion and be a good friend."
Parish nurses consult with congregants at their assigned church and make home, hospital, and nursing home visits. They may accompany a patient to a doctor's appointment, then talk about the diagnosis or answer questions about a prescribed medication. In the home, the nurse may check the patient's blood pressure, monitor meds, and offer emotional support.
While parish nurses provide no hands-on care, they may advocate for parishioners or help them connect with community resources, and they often ask physicians for community referrals. And while changing a dressing is outside their scope of practice, as defined by the American Nurses Association and the Health Ministries Association, they might teach how it's done to a family member or neighbor.
Parish nurses also organize health fairs, screenings, exercise classes, and other group activities. Dorothy Guida, RN, PhD, a parish nurse at Holy Cross Hospital in Fort Lauderdale, began loss support groups at two of the three churches she covers. The group discussion may include death of loved ones or personal losses, such as moving to a nursing home. "It's totally different from hospital nursing," says Guida. "This is more one-on-one contact. I love it - I receive far more than I give."
"The role of the parish nurse is to be present - not necessarily to do or fix anything, but to be along on the journey and to shepherd individuals and guide them to use their faith in the hope of healing," says Carol Jones, RN, manager of the parish nurse program for St. Anthony's Health Care, St. Petersburg, part of BayCare Health System.
More a Calling Than a Job
Some nurses have a hard time making the switch from providing direct patient care, but not Lisa Crumbley, RN, BSN, a St. Anthony's parish nurse. After more than a decade in cardiac care, she made the switch to parish nursing nine years ago and has never looked back. "I was called by God to do this," Crumbley says. She often prays with her patients, and because she knows her congregants so well, she'll often notice subtle changes in their condition. With their permission, she'll notify the doctor.
St. Anthony's placed Crumbley at First Presbyterian Church in Tampa, which has 250 active members. The hospital's mission includes reaching out to and connecting with people in the community. St. Anthony's program began in 1990, with a grant from the Princeton, NJ-based Robert Wood Johnson Foundation, and was the first parish nursing program in Florida. With 160 paid and volunteer nurses working in four counties, it remains one of the largest programs in the southeastern US.
Some facilities, including St. Anthony's and Lee Memorial, have received grants to expand programs. The Blue Foundation for a Healthy Florida, funded by Blue Cross and Blue Shield of Florida, gave Lee Memorial a two-year, $40,000 grant in 2002 to hire and place two RNs in impoverished churches.
Most parish nurses arrive at the position after years of clinical experience. Strong assessment and people skills are essential, as is an ability to work autonomously.
Nurses can learn parish nursing skills at Lee Memorial, Florida Hospital in Orlando, or a number of universities across the country. Lee Memorial offers its program annually, while Florida Hospital's is twice a year. Both are weeklong, retreat-style conferences.
Florida Hospital's program works cooperatively with Marquette University, Milwaukee. The course uses a standard curriculum developed by the International Parish Nurse Resource Center. Candace Huber, RN, BSN, MPH, community outreach director for the hospital, works with congregations to develop health ministries. She often helps match graduates of her program with churches that are seeking a parish nurse.
"It's exciting to see health ministry teams develop within congregations to address the concerns of not only their own membership, but also of others in need in the surrounding community," says Huber. "Parish nursing can stimulate and empower individuals to make healthy choices and truly live a full life."
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