Advance practice in Parish Nursing?

Moogie · Apr 25, 2009

I know this is an old thread, but I wanted to respond to this question anyway. In many respects, parish nursing is a form of advanced practice nursing. When I started up a parish nurse program, I used skills that hadn't been taught in my basic nursing education (BSN). I had to analyze the demographics of the faith community, mostly to see what the age ranges were of the members of the congregation to better predict what health needs might be presented. I also found that it was helpful to be well-versed in nursing theories, particularly those of Jean Watson. Additionally, I utilized research as a parish nurse because I often needed to relate research findings to my parishioners in a manner that non-health professionals could understand.

Ironically, I decided to go to graduate school because an instructor in my parish nurse preparation class had set up a parish nurse program in her church for her master's project. But because I set my program up before I started grad school, I was unable to use it as a master's project. I was able, however, to combine some of my parish nurse activities with my community health nursing coursework. Received a tremendous amount of support from most of the faculty though there were some who disparaged the role of parish nursing, particularly the volunteer aspect.

The biggest barrier to parish nursing as an advanced practice is the fact that many faith communities are financially struggling. Many churches cannot afford to pay the pastor a living wage, much less pay for parish nurses. I had one grad school professor argue with me that institutions pay for what they value; thus, if the church wasn't paying a parish nurse, it "obviously" didn't value the services of a parish nurse. I argued that the reality was that church budgets are tight and value had little to do with getting paid or not.

Would love, love, LOVE to do parish nursing full time but cannot afford to do so.

NurseKitten, MSN, RN · Jun 16, 2009

I'm new to the forum (didn't know it existed until recently) but I'd like to share a few thoughts here, too:

I'm currently working on an APN degree, and am a volunteer parish nurse. They can barely afford to pay the pastor - she's my mother, so I know exactly what she gets paid - and it was novelty enough for a woman minister to come in, much less the whole package of a parish nurse program to boot.

I would say that while I am very careful to not cross the legal boundaries of my state's nurse practice act so far as APN roles, I do function as an APN so far as assessments, understanding of pathophysiology, and ability to "gently suggest" courses of action to both church members but if they're willing to let me be involved, their physicians as well.

While my servant's heart is the most valuable tool in this role, my case manager's background runs a close second. It allows me to leverage the available community resources I know, while the APN aspect allows me to know exactly how to structure interventions, understanding what my specific target effect should be.

As to the legal implications, I'm currently still trying to work those out. I haven't graduated, and I have a while to go, so hopefully by the time I'm out, it'll be settled. Two options I have explored have been to partner with the county health department, and work under their medical director's license, or to work through a physician I know well, and have him cover me for any actual APN care I deliver.

Moogie · Jun 19, 2009

I did not finish my MSN---got about 2/3 of the way through and then life happened---but the courses I took were very helpful for me in getting my grounding as a parish nurse. I started my Master's twenty years after I finished my BSN (and after a lengthy hiatus as a SAHM), so I spent a good amount of time just getting up to speed with current practice.

I wish it would be feasible, in terms of time and money, to get some theological education from a seminary. (You know, I should just ask my pastor if I can borrow some of his books...)

Anyway, welcome to this forum, NurseKitten, and all the best to you in your journey through higher education!