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  1. jeastridge

    Faith Community Nurse 101

    This article is written in response to a query which was posted in the thread Examining the role of a Parish Nurse. As a long time Faith Community Nurse, I hope to be able to answer this nurse's questions fully in this article and possibly inform others that may wonder about what a congregational nurse is and what the role entails. "Hello everyone! I am in progress of obtaining my BSN and right now I am taking a class called Community Health Nursing. One of our assignments is to conduct a short interview with a parish nurse. If there is anyone willing to help me with my assignment, I would very much appreciate it!" Describe the nurse's role in the community and give examples of what he/she does on a daily basis. Real-life examples should be included whenever appropriate. First of all, what's with the name? The official designation by the American Nurses Association is Faith Community Nursing (FCN); other titles used include parish nurse and community health nurse. All are correct and can simply be a matter of preference for the nurse and his/her faith community. The ANA defines the FCN role as, "...the specialized practice of professional nursing that focuses on the intentional care of the spirit as part of the process of promoting holistic health and preventing or minimizing illness in a faith community." (American Nurses Association, 2012, Faith Community Nursing: Scope and Standards of Practice, Silver Springs, MD: Author, p1). The nurse working in a faith community serves as an advocate, a resource person, a bridge between those who have needs and those who wish to serve them. Some examples from the particular congregation that I serve include: home visitation, card ministry, casserole delivery, prayer shawls, free mobile unit health care once a month, grief recovery, support group for caregivers, blood drives, dental clinic, haircutting salon and many others. In day-to-day practice, the outreach of a congregational nurse spans everything from welcoming new babies to making hospice-type visits in the home. The FCN provides information, support, encouragement and links the members with any services they might need. FCNs work in a variety of partnerships. Some are totally volunteer; others receive a stipend and still others are paid a regular nursing salary. Some are part time and others full time. Hospital systems can be sponsors for FCN programs or they can originate in the church. Identify how and who the nurse(s) would work with for coordination of services to provide a comprehensive health program in the community. At my church, I work with a large group of volunteers. They actually implement the outreach efforts-I encourage and coordinate. I also work as a liaison with the medical community, helping people understand their diagnoses, assisting them in finding ways to get to tests and doctors' appointments. Sometimes when parishioners are in the hospital, I work with the case managers and families to make sure that everyone understands what the plan is, thus avoiding unnecessary repeat hospitalizations. How would the nurse utilize a population-based approach in his or her role? A FCN must continually assess the needs of the particular congregation that she/he serves, deciding where to expend energy and time. In my particular situation, I meet with a Congregational Care Team and they help me plan what we will be focusing on each six months. Does this role include assessment and screening of individuals, families, or groups? If yes, please include examples. We do routine blood pressure screenings as well as occasional special event screenings, measuring parameters such as BMI, height, weight, waist circumference, body fat composition. When visiting our "at home" members, or our members long term care facilities, I do brief assessments-always noting changes and progression. What health education responsibilities does the nurse have in the community? The FCN often serves as an information source as well as a referral person, helping people to connect with the medical community as needed. She can answer questions about services surrounding rehab, home health, hospice, nursing home care, assisted living and a variety of other living arrangements for people with physical needs. At times, the nurse coordinates with others to help promote programs that might be of interest, for example: grief support, advance directive preparation sessions, caregiver helps, etc. Does this nurse work with a vulnerable population? If so describe. Many congregations have a sizable population of elderly. At our church, I work hard to keep an updated list of our at risk elderly. I try to connect those that have needs with people that want to be of service. In this way, I can serve as a bridge. Describe an ethical dilemma that this nurse has faced and describe how you would have handled that situation. The most common ethical dilemma many FCNs face has to do with confidentiality. When working on a church staff there is a need to share information that is helpful but not private. It is important to constantly draw that line at the point of confidentiality. How important would record keeping and documentation, including computerization, be for a nurse in this role? Different nurses have different strategies for keeping records. Because we are professional nurses, we do keep careful records of encounters and interventions. SOAP notes are helpful and brief. Sometimes simple narrative notes on the computer can be valuable for when another encounter is needed. What about you? Have you had any contact with a FCN? Are you familiar with a congregation that has one? Choosing a Specialty but not sure which one is best for you? Download Nursing Specialties Guide!
  2. tnbutterfly - Mary

    Faith Community Nursing (FCN) / Parish Nurse

    Overview Far more than just "a nurse in the church", the Faith Community Nurse (FCN), or Parish Nurse, is an experienced Registered Nurse (RN) with additional training who serves as part of the ministerial team to promote wellness and spiritual care within the congregation and community. The Faith Community Nurse is not a primary caregiver, but serves more as a bridge between the church and healthcare system. The nurse does not replace the doctor or the pastor, but assists both. Unlike the doctor, the FCN recognizes the importance of spiritual health Unlike the pastor, the FCN can provide medical support and assistance Parish Nursing Recognized as Faith Community Nursing (FCN) In 1997, the American Nurses Association (ANA) recognized Parish Nursing as a specialty practice. The Standards and Scope of Parish Nursing was published in 1998 and revised in 2005. According to the ANA, "Parish Nursing was officially recognized as Faith Community Nursing in 2005 to reflect the full range of faiths in the United States". In 2017, the ANA published the 3rd edition Faith Community Nursing: Scope and Standards of Practice and Faith Community Nursing reflected the new specialty name. Roles of the Faith Community Nurse Faith Community nursing is a professional model of health ministry because the individual is a registered professional nurse working according to the Nurse Practice Act of the state in which he/she is practicing, while also complying with the identified standards of the practice. Since most nurses are not familiar with working in a congregation or the theological perspectives on health and healing, additional training is often required. Although the FCN shares the common goal of integrating faith and health, no two congregational ministries function the same way. Each ministry is dependent upon the demographics and needs of the congregation. Typically, the roles will include the following areas: Health Educator Raises the health awareness level and promotes healthy lifestyles within the congregation through a variety of formats, seminars, conferences, and classes. Personal Health Counselor Discusses personal health problems, recommends medical intervention, answers questions regarding medications and medical tests, offers blood pressure screenings, etc. Visitation Minister/Integrator of Faith and Health Visits in the home, hospital, nursing home providing spiritual care. Referral Agent Helps members obtain needed services from church or community agencies or support groups. Volunteer Coordinator Recruits, trains, and supervises volunteers to respond to physical, mental, and spiritual needs in the church. Client Advocate/Navigator Intervenes for the patient as necessary in the hospital or office setting by talking to the nursing/medical staff. Education Graduate of an accredited RN nursing program. Note that most employers hire the BSN-prepared RN. Degree: Diploma ADN BSN, or higher Successfully passed NCLEX-RN Current, unencumbered RN license in U.S. state of practice Successfully complete a faith-based nursing program (optional) Certificates and Certifications (not all-inclusive) Shenandoah University Shenandoah University’s Eleanor Wade Custer School of Nursing offers the Foundations of Faith Community Nurse Course. Currently (2020), the course is offered via virtual, online via Zoom, and tentatively, in-person. West Virginia University (WVU) WVU's Faith Community Nursing (FCN) course is an online program (with face-to-face optional sessions). It is open to not only RNs, but to chaplains, pastors, social workers and others. However, only RNs who complete the course can use the title Faith Community Nurse (FCN). Westberg Institute In addition to the aforementioned universities, the Westberg Institute offers Faith Community Nursing courses in several locations of the U.S. Concordia University Wisconsin The university offers an undergraduate Parish Nursing Certificate. American Nurses Credentialing Center (ANCC) The ANCC offers the Faith Community Nursing Re-Certification (RN-BC)*. Re-Certification Eligibility (not all-inclusive) Mandatory 75 continuing education hours (CH) and 1 or more of the 8 renewal categories for your certification credential within 5 years preceding renewal application submission All APRNs (CNS and NP) required to complete 25 CH of pharmacotherapeutics as a portion of the mandatory 75CH in the CNS or NP certification held Current ANCC certification that is expiring within 12 months Current, unencumbered RN license in a state or territory of the U.S. *NOTE: This ANCC certification/credential is available for renewal only. Salary (2020) Many Faith Community/Parish Nurses work under a volunteer model or are paid a stipend. They may be paid through a grant, by a single congregation, or by multiple congregations through which they serve. While the percentage of paid FNC's is growing, salary is not what validates or is the reason why many nurses choose this path. Their rewards are manifested in other ways. Choosing a Specialty but not sure which one is best for you? Download Nursing Specialties Guide!
  3. The doors to the ICU swung open as I swiped my badge and I took a deep breath before stepping forward to face Jane and her family. An elderly woman, 90+, Jane faced day 7 on a vent in the ICU after a serious bout with pneumonia. I greeted her son who sat quietly at her bedside, by now impervious to the low key but constant whirr and beep of the machinery that worked to keep his mom alive. After greeting him, I stepped over to take Jane’s flaccid and swollen hand in mine and greeted her, too. Talking with the son, he related the events of the past 24 hours. He emphasized that the doctors assured him she was “stable” and “not suffering.” Despite her advance directive that stated her preferred wishes not to be intubated, when the time came, she was lucid and changed her mind, giving hurried permission for interventional care. After talking a while, I brought up the idea of talking with the doctor about having a Palliative Care Consult. Emphasizing that this was something the doctor would have to order if she thought it was appropriate, I described the possible perspective they might bring to the overall picture. During our conversation, his internist came in and said, “I have put in for a Palliative Care Consult” clearly seeing the same picture that we were and thinking it might be time to pause and consider how to move forward. After prayer and a moment with scripture, I went on to see others in the hospital before heading over to the church where I have an office. Seeing patients in the ICU is not an everyday occurrence but does happen with a fair degree of regularity. In that environment, the Parish Nurse can serve as a spiritual support person, an interpreter for medical terminology and procedures and a liaison between the family and the staff, especially if difficulties arise. At the church, I briefly checked email and made a note to call Mr. S back about his grief. Having lost his wife of 57 years just a few short months ago, Mr. S told me he felt adrift; one of the things a Parish Nurse can do is help cast out lines of communication and connection, helping him find new ways to anchor himself —social activities, service opportunities, and spiritual comfort. I prepared a devotional thought before going to a Caregiver’s Support Group and sharing an hour with them. Meeting once a month, the group of a dozen or so people helps one another through the thick and thin of caregiving, discussing different topics each month and sometimes even having special speakers from nearby facilities. After a quick lunch at my desk, I joined a weekly meeting with the pastors on congregational care, discussing how we could best address the needs of our members who were going through a variety of crisis. We usually assigned one designated person to be in charge of responding to a particular need, then bring the others in as was necessary. After the meeting, I spent the afternoon returning phone calls, checking on people who were post-op, making notes after each phone call or contact, and working on coordinating some of our outreach ministries: prayer shawls, frozen casseroles, cards, and birthday visits to our “At Home” members. One of the beautiful things about Parish Nursing is that there is not a “typical” day. Every day is different and some more challenging than others. What I have described above could stand as a representative sample of what happens many days. As members of the church staff, Parish Nurses work closely with pastors, collaborating in the wholistic care of their parishioners: body, mind and spirit. Parish Nursing, begun in the 1980s by Grainger Westburg, is a place where nurses can find new ways to use their skills. While my position is a regular part-time position and I receive a small stipend for my work, many Faith Community Nurses are volunteers who work just a few hours a week, checking blood pressures on Sundays and answering questions or making phone calls. There are a number of definitions of Parish Nursing, but they all include most of the following, “A Parish Nurse is a registered nurse with specialized knowledge who is called to ministry and affirmed by a faith community to promote health, healing and wholeness. The role of the parish nurse is to promote the integration of faith and health in a variety of ways that reflect the context of the faith community. Specific examples include: health advocacy, health counseling, health education and resource referral (http://www.capnm.ca/fact_sheet.htm )” If you are interested in being a Parish Nurse, how do you get started? First and foremost you will need to have the support of your church’s leadership to work in this capacity. Talk with your congregation’s governing body and gauge their support. If you feel led to continue after that, you can take an online course in becoming a Parish Nurse to better prepare yourself. You can also seek out other Parish Nurses in your area. Nationally, the Westburg Institute serves as the unifying organization for FCNs, holding an annual symposium, publishing articles and books and providing visionary leadership. After a busy afternoon, I snapped my computer closed, double checked my calendar for the next day and got ready to meet a girlfriend for a walk in the spring sunshine, feeling blessed to be able to be a nurse in a church.
  4. jeastridge

    Parish Nurse in Transition

    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 GroupsBy 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 TreatmentKnowing 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 HypertensionThe 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 AdolescentsThe 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 CrisisThe 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 WillsThe 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 CareThe 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 CareThis 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.