Parish nursing: renewing a long tradition of caring.

Parish nurses are experienced registered nurses committed to helping people meet the health needs of their body, mind, and spirit. To fulfill this goal, parish nurses must be health educators and counselors, referral sources, facilitators, patient advocates, healthcare plan interpreters, and multitalented coordinators. The parish nurse uses the skill of nursing assessment of individual and congregational needs and matches the assessment findings to available resources. The parish nurse also advocates increased awareness of health-related issues that lead to earlier and more effective treatment and care. All ages benefit within a context of personal caring and attention offered by a parish nursing model that is often lacking from healthcare delivery systems. Congregations of all sizes, both urban and rural, have successfully started parish nurse programs. Parish nursing programs are a religious response to help bring wholeness and healing to the faith community. The purpose of this article is to explore parish nursing as it has evolved into a model of health care delivery contributing to the empowerment and health of both the individual and the community.     

Parish nurse practice with client aggregates

The purpose of this study was to describe 1 aspect of parish nurses' practice: working with client aggregates. Nineteen parish nurses practicing in 22 faith communities collected data using 2 standardized nursing classification systems--North American Nurses Diagnosis Association Taxonomy and Nursing Intervention Classification. Nurses recorded 77 group encounters for services provided over a 5-month period. The most frequent nursing diagnoses and nursing interventions are reported and emphasize health promotion and illness prevention. The parish nurse roles of educator, counselor, referral agent, and advocate-facilitator described in the literature were consistent with the findings of this study. In addition, the parish nurse as a member of the ministerial team is discussed. A focus group of the parish nurses provided validation of the results of aggregate practice.     

Partners in healing: home care, hospice, and parish nurses

A creative way to support patients in self-care strategies is to work with the parish nurse as a practice partner. This article shares approaches and innovative ideas on how home care and hospice nurses can work effectively with parish nurses.     

Reclaim the spirit

A system of parish nursing allows patients to receive spiritual care integrated with their other needs. There are now 29 churches in the U.K. with at least one parish nurse.     

Community assessment: a church community and the parish nurse

In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data. Four hundred and twenty-one questionnaires were completed, and six focus groups were held to validate the data. Results showed most parishioners felt they were in good health (93%), believed faith and spiritual beliefs were important in maintaining health and well-being (91%), and thought that the church should play a role in helping parishioners meet their health needs (70%). In addition, focus group discussions revealed a need for respite care for primary caretakers of the ill and elderly, and health education programs for their teen and elderly populations. In conclusion, parishioners were positive and articulated support of the parish nurse and activities designed to address the physical, emotional, and spiritual needs of their community.     

Parish nursing assessment--what should you know?

The prospective payment system will require agencies to become more creative and network with community resources. This article describes a health needs assessment survey that provided the foundation for a parish nurse ministry. The survey revealed that parish nurses could complement home health nurses by filling some of the gaps in healthcare not provided by third-party payers.     

Perceived health needs of urban African American church congregants

Theory-based assessment of congregant expectations and needs should be conducted prior to beginning a parish nurse program. However, no such assessments are found in the literature. Using Andersen's Health Access Model as a framework, investigators conducted interviews with 117 randomly selected congregants in five urban African American churches to describe their perceived needs and expectations. Causing most concern were the following: (a) symptoms of illness--high blood pressure (50.4%), dental problems (43.6%), and back pain (41%); and (b) health habits/risks--weight (75%), exercise (63%), and diet (63%). Younger adults were significantly more concerned about all aspects of their health than their older counterparts. Women were significantly more likely to express concern about health habits and health risks than males. No significant relationship was found between perceived need and access to care. Although terming health care services "adequate", congregants expressed many unmet health needs. This seemingly contradictory finding may illuminate a concrete role for the parish nurse, i.e., addressing personal health care concerns not alleviated by the current "adequate" health care delivery system. This study's significance lies not only in providing programming guidance, but also in theoretical insights into the role of the parish nurse.     

Use of a taxonomy to describe parish nurse practice with older adults

Parish nursing in a new model of health care delivery in which practitioners build partnerships to extend health care from institutions into the community. The study discussed in this article focused on the applicability of the North American Nurses Diagnosis Association taxonomy and the Nursing Intervention Classification to describe parish nurse practice with older adults. Findings from this study may help develop a framework for the practice.     

Parish nurses influencing determinants of health

How are the concepts health, health promotion, faith community, and health determinants connected? How can a nurse draw on the unique features of a faith community to promote health? In this article, we explore the relations among these concepts and consider the answers to these questions. Parish nurses provide a concrete example of the interactions among these concepts. They are often hired by faith communities to intentionally promote health within and beyond the faith community. Increasingly, faith communities are being used as settings for health promotion interventions. We describe examples of how a parish nurse can influence 2 determinants of health: social support and healthy child development.     

Spiritual care in Christian parish nursing

AIM: This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. BACKGROUND: Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. METHOD: Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. FINDINGS: From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. CONCLUSION: The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.     

Hospital and parish (county) utilization of master's-prepared nurses in Louisiana

Recent regulation in Louisiana involving advanced practice nursing, combined with new educational standards at the Master's level established by the Louisiana State Board of Nursing, prompted a statewide survey of hospitals and parish health units. The purpose of the survey was to determine whether and to what extent Master's-prepared nurses were being used in Louisiana and to identify the importance placed on role functions and activities generally associated with the advanced practice nurse (APN). The survey included open-ended questions concerning expectations about future hirings and perceptions of future roles and duties of the Master's-prepared nurse as well as suggestions to educators on what is needed to better prepare nursing students at the Master's level. Results from this exploratory survey provide information on APN utilization with implications for nursing educators and administrators as well as APNs.     

Faith community nurses: implementing Healthy People standards to promote the health of elderly clients

The face of aging in our society has changed dramatically over the past generation. Many seniors struggle to access needed services, which include health promotion and disease prevention activities. A “Parish Nurse Questionnaire” was developed by the authors using the Healthy People 2010 Critical Health Indicators, the International Parish Nurse Resource Center functions of the parish (faith community) nurse, and the ANA Scope and Standards for Faith Community Nurses to ascertain if, and how frequently, faith community nurses practice interventions that address strategies mandated by theses organizations. Data collected on 102 participants supported that the faith community nurse model of community-based practice guides the development of strategies addressing those established standards. Those who provide health promotion and disease prevention activities in faith communities serve as viable partners with community initiatives, which may help to provide more seamless and efficient services to the elder in the community.     

Parish nursing: holistic nursing care in faith communities

Modern-day parish nursing is a specialized practice in professional nursing that addresses the spiritual, physical, and emotional health needs of clients within a faith community. Parish nursing care has been described as holistic care; however, few studies have focused on the holistic nature of parish nursing care. A qualitative study was conducted with the clients of parish nurses. Seventeen clients utilizing the services of 3 parish nurses in Christian faith communities participated in the study. Following the institutional review board approval, the clients were recruited with the assistance of the parish nurses. The clients completed a 7-item demographic questionnaire, followed by a face-to-face interview with the author who used a semistructured interview tool. The interview questions encompassed 6 aspects of parish nursing: education, personal counseling, health screenings, spiritual support, referrals, and health advocacy. The interviews were transcribed and analyzed by the author. The results of the study indicated that the clients in all 3 churches received holistic care from their parish nurses. The care they received addressed their spiritual, physical, and emotional health needs. Recommendations for future research and implications for the clinical practice of parish nursing, using a holistic approach, are included. The findings of future research and the holistic interventions of parish nurses could influence the funding and positions for parish nurses in the future.     

Mapping parish nurse documentation into the nursing interventions classification: a research method

Mapping, or linking like terms that represent the same concept, is a research method increasingly used for testing the reliability and validity of standardized taxonomies. For mapping to be useful, it is critical that the procedure is reliable. One way to maximize reliability is to develop standardized mapping procedures, or rules to follow when linking the terms. This article will present a standardized mapping procedure method in a study that mapped narrative parish nurse documentation (170 health records, 1607 interactions) into the Nursing Interventions Classification (NIC), yielding an intercoder reliability kappa of 0.92. The mapping process identified conceptual issues in the NIC, which also are presented. Because the NIC is included in the Systematic Nomenclature of Medicine of Clinical Terms (SNOMED CT), these conceptual issues raised data aggregation issues in SNOMED CT. Those issues are also presented.     

A path to greater inclusivity through understanding implicit attitudes toward disability

Individuals with visible disabilities are underrepresented in nursing and have been denied admission to nursing education and discriminated against based on their disability, although nurse educators have been found to hold positive explicit attitudes toward disabled individuals. This study examines nurse educators' implicitly held attitudes toward individuals with disabilities through the use of the Disability Attitude Implicit Association Test. Findings demonstrated that nurse educators are strongly biased toward individuals without disabilities (N = 132, D = 0.76, SD = 0.46) and demonstrated a stronger preference than the general population (N = 38,544, D = 0.45, SD = 0.43). Study results suggest the need for a timely critique of the continuing focus on physical abilities as a prerequisite for admission to nursing programs. In addition, faculty in schools of nursing and practicing nurses must engage in discussions of attitudes toward individuals with visible disabilities for the discipline to be more inclusive.