Parish Nurse in Transition

[jeastridge, BSN, RN]

When Granger Westberg started Parish Nursing back in the mid-80's, medicine was very different than it is now: EMRs were unheard of, people had long hospital stays for what we now consider same day (same morning!) surgeries, costs had yet to get out of control, pharmaceutical companies were not profit centers and advanced interventional care, transplants, genetic-based therapies, and other cutting-edge medicine were just glimmers on the horizon.

As medicine and nursing have continued to change over the years, Parish Nursing has also evolved. We have gone from a fairly tight circle of influence that was largely defined by a particular congregation to a ministry that often reaches out in a variety of directions, helping to care for the community at large.

Now often known by the appellation "Faith Community Nurse," Parish Nurses are making inroads at being one of the most important pieces of the transitional care picture in modern medicine. The FCN is uniquely positioned in the community to help accomplish the goals of serving the community and promoting health and wellness for the larger area.

In churches, schools and community centers, FCNs work closely with individuals and groups. With front row seats to times of illness, wellness and everything in between, some of the ways FCNs serve include:

Promoting Emotional and Spiritual Wellness through Support Groups

By hosting Grief Support Groups and Caregiver Support Groups, the FCN contributes to improved community mental health and general well-being. By being able to identify problems early, the FCN can intervene before deeper problems develop. He/she can play a role in suicide prevention and mental health crisis identification by making appropriate referrals sooner. Additionally, the FCN helps keep mental health care as part of the whole picture of wellness, not just a crisis mentality with the emergency room as front line.

Diabetes Prevention and Improved Compliance with Treatment

Knowing their congregation's health and their goals, helps the FCN support the educational process that is ongoing in the health system and can identify reasons for non-compliance along with potential ways to overcome that chronic problem. Additionally, the FCN knows all the resources available in the area-from the health department, the doctor's offices, to seminars, to the YMCA. They are able to refer people in appropriate ways.

Long-term Management of Hypertension

The FCN helps monitor BPs, provide for home monitoring by securing devices and training people to use them. The FCN is also uniquely suited to re-enforce medication management, assist with compliance issues and assist with financial hardship associated with drug costs.

Weight Management for Adults and Adolescents

The FCNs consistently offer programs to help people improve their overall wellness: walking programs, Weight Watchers, the Daniel Plan, Hiking Clubs, sponsoring sports teams through City Parks and Recreation, promoting YMCA and other gyms, sponsoring exercise classes at the church, etc. Together, these activities add up to increased activity and better all-around health for our church families and the community beyond. The FCN generally plans activities starting in the home congregation but opening them to people in the general community. None of these activities is ever closed off to members only-they are always open and inviting to anyone that would like to participate. Additionally, the FCN is able to cooperate with city-wide or state-wide initiatives, joining more regional programs and encouraging the congregants to participate and bring others along into a healthier lifestyle.

Opioid Crisis

The FCN is in an important leadership role as they work together to address the current opioid crisis. All persons involved understand that this is a multi-layered problem with no simple solutions, but as liaisons to their communities, FCNs are uniquely positioned to make fast-track improvements and to implement programs that are effective. He/she can determine how to best address this national crisis in the confines of that particular congregation's needs and begin work in a multi-faceted way: prevention with children, education with pre-teens, crisis-intervention and treatment with addicts and support for associated family and community members.

Advance Directives/Living Wills

The established FCN has the trust of the community. He/she is able to offer opportunities for people to better understand the decisions they will face at the end of life. By working often with the older adult population, FCNs are uniquely positioned to make a difference in how we spend resources during the last few weeks of life.

Access to Health Care

The FCN serves as a triage nurse within her community. Often members ask for referrals, discuss insurance concerns or ask for financial help in addressing access to care. The FCN can help steer people in the right direction and distinguish fact from fiction for patients who are unsure.

Transitional Care

This role has been growing larger over the past few years as the patients are leaving inpatient stays sooner and with greater acuity to recover at home. FCNs have the ability to call or visit, to do medication reconciliation, to make sure patients have their prescriptions filled, to double check on equipment needs, nutritional needs and appropriateness of care. They are particularly well-equipped to answer triage questions and help patients know whether they need to return to the point of care for additional help.

The FCN is an important part of the new health care system. While knowledge has expanded and modalities of interventional care have grown by leaps and bounds, hands-on care and connection with compassion have not always kept pace. The nurse in the faith community is the perfect person to help address this disconnect and build bridges of care.