Faith Community Nursing Chapter 32 Faith Community Nursing Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

“What if churches, mosques, and temples worked together to improve the health of their communities? If faith groups adopted one small area and made sure that every single child was immunized … that every person had a basic medical exam … that every woman who became pregnant would get prenatal care? Are these possible? We believe the answer is yes.” – President Jimmy Carter, The Interfaith Health Program (2005) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Faith Community Nursing: Role in Health and Wellness Throughout history, churches provided care for the indigent and disenfranchised, meeting basic needs and basic health care. Many religions have traditions and rituals related to health and healing. Some religions give specific guidelines for ministering to ill, homebound, or dying members. All major religions describe the relationship among health, healing, and wholeness. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Faith Community Nursing: Role in Health and Wellness (Cont.) Old Testament discusses Shalom, or God’s desire for health and wholeness New Testament documents healing activities of Jesus, restoring health to people The Talmud describes the importance of maintaining physical health and vigor so that Jewish people will understand God’s will in their lives. Followers of Buddhism believe that health and healing are connected and illness occurs when there is an imbalance between life and the environment Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

– Myers (2004) and Koenig & George (2004) Faith communities contribute to the well-being of their members through support, prayer, and providing a sense of hope. – Myers (2004) and Koenig & George (2004) Individuals who reported intrinsic religion (internalized or regularly practiced) and regular attendance at a religious service reported decreased stress. – Williams & Sternthal (2007) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

…“religion provides things that are good for health and well-being, including social support, existential meaning, a sense of purpose, a coherent belief system and a clear moral code.” – Eckersley (2007) People who reported the highest level of religious involvement also reported practicing healthier lifestyles, including exercising more and smoking less. – Tsuang, Williams, & Lyons (2002); Myers (2004, 2008) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

A positive correlation between religion and health has recently been termed the faith factor. – Handbook of Religion and Faith, Koenig, King, & Carson (2012) Community health nursing has evolved from early church efforts to provide care for the sick and disenfranchised. Modern parish nursing focuses on the global health and wellness issues of all people and has its roots in more recent efforts to encourage the re-emergence and blending of health care roles into the healing ministry of faith communities. – Hickman (2006); Patternson (2004); Solari-Twadell & McDermott (1999) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Foundations of Faith Community Nursing Rev. Granger Westberg, a Lutheran minister, is considered the founder of the modern FCN movement. Envisioned a partnership between the hospital and all church congregations in the hospital’s community. 1984: Proposed first parish nurse program at Lutheran General Hospital in Chicago. Six nurses hired in Chicago area in 1985, funded primarily by churches. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Foundations of Faith Community Nursing (Cont.) International Parish Nurse Resource Center (IPNRC) provides leadership for FCN; in 2011 moved to community outreach division of the Church Health Center in Memphis, TN ANA and Health Ministry Association (HMA) established Scope and Standards of Parish Nurse Practice in 1998; revised in 2005 to Faith Community Nursing FCN now practiced in more than 23 countries; nurses identify themselves in a manner most accepted by faith communities. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Key Elements of Faith Nursing Spiritual dimension is central to the practice. Balances nursing science and technology with service and spiritual care. Clients are members of the faith community defined by the church and its public service philosophy. Services built on principles of self-care and capacity building with a focus on understanding the connection between health and the individual’s relationship with God, faith traditions, nursing, and the broader society. Holistic health is a dynamic process that requires a connection among the person’s spiritual, psychological, physical, and social dimensions. – Solari-Twadell & McDermott (1999); Westberg (1999) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Nursing in Faith Communities “Parish nursing (aka faith community nursing) is the intentional integration of the practice of faith with the practice of nursing so that people can achieve wholeness in, with, and through communities of faith in which the parish nurse serves. Parish nurses educate, advocate, and activate people to take positive action regarding wellness, prevention, appropriate treatment of illness, and social and spiritual connections with God, members of their congregations, and their wider community.” – Patterson (2004) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Roles/Functions of the Faith Community Nurse Health educator Personal health counselor Referral agent Health advocate Coordinator of volunteers Developer of support groups Integrator of health and healing – Hickman (2007); IPNRC (2013) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Suggested Core Curriculum for Faith Community Nurse Spirituality History and philosophy of FCN Self-care Healing and wholeness Professionalism Ethical issues Documenting practice Legal issues Beginning an FCN ministry Communication and collaboration Holistic Care Health promotion Transforming life issues (e.g., family violence, suffering, loss, grief) Community Assessment Resources Advocacy Care coordination – IPNRS (2009) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

The FC Nurse and Spirituality Spirituality: “the human desire for a sense of meaning, purpose, connection, and fulfillment through intimate relationships and life experiences.” – Wright (2005) Spiritual distress: “a disruption in the life principle that pervades a person’s entire being and that integrates and transcends one’s theological and psychosocial nature.” – NANDA (1992) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

CIRCLE Model of Spiritual Care C aring I ntuition R espect for religious beliefs and practices C aution L istening E motional support – Schnorr (1988, 2003) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

… through prayer, spiritual assessment, and hope and faith, the FCN facilitates important client outcomes for spiritual health and well-being, including self-esteem, self-actualization, hope, trust, and peace. – Hickman (2006) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Issues in Faith Community Nurse Practice Providing care to vulnerable populations End-of-life issues: grief and loss Family violence prevention Confidentiality Accountability Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Providing Care to Vulnerable Populations FNC works as a member of a caring church community to meet the health and related needs of vulnerable populations Sponsor and support refugees Develop programs for homeless individuals and their families Provide assistance and resources to low-income families Provide resources to entire communities during disasters Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

End-of-Life Issues: Grief and Loss Partner with hospice and home care nurses to provide palliative care to members Educational sessions on living wills Establish health care surrogates Understanding hospice and palliative care Home visits to dying congregational members Emotional support to family and survivors Development of grief support groups Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Family Violence Prevention Understand risk factors for family, child, and elder abuse Knowledge of the cycle of abuse Assessment skills related to identification of individuals and families at risk for violence Intimate partner violence (IPV) Child abuse or neglect Elder abuse Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Confidentiality Code for Nurses (ANA) and Scope and Standards of Faith Community Nursing Practice (ANA) provide ethical guidance to FNC Protect client’s right to confidentiality of health and health-related conditions Share confidential information with other church ministry leaders (or prayer groups) with the client’s permission FCN not required to follow HIPAA guidelines because congregations are not identified as health providers Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

Accountability Same degree of accountability as paid employees Not exempt from discrimination laws May be required to disclose confidential information in court Accountable to nursing standards and civil laws designed to protect individuals from abuse, neglect, and discrimination Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.