September 14, 2009
Rev. Dr. Deborah Patterson is Executive Director of the International Parish Nurse Resource Center. She is an ordained minister in the United Church of Christ and the author of many books including her newest book, The Healing Word: Preaching and Teaching Health Ministry. She spoke with Church Health Reader about how parish nursing can effect change in congregations and communities.
John Shorb: What led you to parish nursing?
Deborah Patterson: When I was a pastor serving a local congregation I realized most of my work was health related. There were five women in our parish who were in a head-on collision on the highway and all ended up in Intensive Care at different hospitals in the area. I had all kinds of questions as I ran between the different ICUs. I wished that there had been someone in the church who could help me figure out what it meant if someone had a head injury. Or how to borrow durable medical equipment? Or help a family understand if the physical therapy services in their areas accepted their insurance? We needed more information to help us support the families as a congregation.
I had heard about parish nursing at that time and thought that would be a huge help to me in my ministry. There was also someone who was getting medicine from her doctor, what the patient called “nerve pills.” to keep her sedated. I suggested she get a second opinion and when she got a second opinion it turned out she had breast cancer. She was being sedated for symptoms of disease. Another person had a daughter who was living in the basement of her home with OCD. She kept washing her hands and could not leave the basement. So I helped that family get access to Mental Health resources where she got effective treatment. She was able to get out of the basement and get a job. I thought, “We are called to preach, teach and heal, but this healing stuff is taking all my time in a way that I am not equipped to do.”
Can you describe the role of a parish nurse?
They are Registered Nurses who have a minimum of 2-3 years experience – enough that they can operate on their own. Most parish nurses bring 10 to 30 years (or more) of experience – seasoned nurses attracted to this profession. They are guided by the Faith Community Nursing Scope and Standards for Practice which have been published by the American Nurses Association. There are seven roles:
- Health Educator
- Health Counselor
- Resource Liaison
- Developer of Support Groups
- Coordinator of Volunteers
- Integrator of Spirituality and Health
Spirituality has to be woven through all the other roles.
How do parish nurses integrate spirituality into their practice with a congregation?
Everything the parish nurse does must be a desired intervention from the client. Unless they have a huge parish, parish nurses serve both the people in their congregation and neighbors with related needs – a service of in-reach and outreach. It is not “we only serve our own” but “we serve.” We call our client forth to articulate their own spirituality. When someone says, “Why me? Why would God do this to me?” it is about listening and asking, “Why are you asking that question?” A parish nurse finds out what is happening in the body and the spirit.
Do you see a historical, biblical, or theological basis for the role of the parish nurse in a church?
Absolutely. As early as Acts 3 where you find ministries being divided up, some are called to go out and preach and some are called to go out and serve. This is clearly a ministry of service. Jill Westberg McNamara, following in the footsteps of her father, had this vision: every home has a medicine cabinet, so every faith community should have a health cabinet with resources for those with a health need. We found that a parish nursing ministry is not a ministry of one person; it is a ministry of the congregation. The health cabinet is responsible for making this visible to the congregation. The health cabinet helps do the initial health survey of the congregation to find out the health needs and interests. It also interprets parish nursing to the congregation – developing its form and function.
How do parish nursing and congregational health ministry work together?
They have to work together, otherwise, it is just one nice little person making visits on the homebound. That may be one role of parish nursing, but to integrate spirituality and health, it means all of us together; we are the body of Christ. If one suffers, we all suffer. This is all about inviting, empowering and equipping others to participate.
There is a Catholic parish in Cape Girardeau, Missouri where the parish nurse has the luxury of having 300 health professionals as members of that parish that she can call upon to help with health ministry. It is a large Catholic parish that is near a large medical center in Cape Girardeau. Basically all the doctors and nurses belong to that congregation. She is able to help pull folks together to make all kinds of things happen. In Texas, there is another parish nurse that serves a very large parish where there are social workers, teachers and other gifted people to work in their growing health ministry.
People who have received the services of a parish nurse ministry are the people that want to volunteer. They want to serve in the way they were served. They are the best volunteers and the best financial supporters because they have seen and felt the work of this ministry – a ministry that is often invisible to many.
Last year I fell down and fractured my back. We were very lucky to have a parish nurse in my home congregation. She came to look at the medications prescribed by different doctors to look for any possible interactions; she identified some warning signs of drug interactions. She showed me how to get in and out of bed correctly and surveyed my home environment for any safety hazards that I was more susceptible because of my injury. She brought over medical equipment from the church. This same care would be available to anybody in any congregation and any of their neighbors. Who is not a neighbor to a church somewhere? It is available for anyone and there is no charge.
How do you see the future of parish nursing and health ministry?
For the future, parish nursing must pursue evidence-based practice. A study of 4000 spouses and caregivers, done at New York University at Silverman Aging and Dementia Research Center, indicates that when the caregiver receives strong support the person who is ill can generally stay at home for 18 months longer rather than being placed in a nursing home. To provide this support, often the parish nurse and the clergy will make a home visit together. The nurse can care for the person who is very ill and the pastor may go for a walk with the caregiver to provide support. Having that kind of data allows us develop this profession and show what a difference we make.
Read Deborah Patterson's book recommendations>>
John Shorb is the Editor of Church Health Center.