Parish Nursing in the New Millennium

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They say, “We think in general, but we live in details.” In today's pragmatic world people tend to forget about on a first glance simple things and do not pay much attention to events that are beyond their everyday concerns. We do not think about the elderly people, but this is what awaits almost for every person. At one point in the history, the elderly contributed to the future of our generation, and now it is time to give them their due. This paper provides an insight into who does good when person's life is flickering and when the fire of life is gone – parish nurses.

Parish nursing is developing like no other healthcare profession. Despite the fact that this branch is regarded to be new, an estimated number of 3000 parish nurses were employed throughout the USA in 1996. Five years later, this number reached more than 6000 nurses. Nowadays parish nursing appears to be key to American ailing healthcare system, especially with regard to the elderly care. What is more, this tendency does not show any signs of changes in the nearest future.

In 2001, there were approximately 35 million people in the US over the age of 65. Hence, according to middle series estimates, over 77 million Americans will overcome the milestone of 65 in the year 2040. Having only 35 million people at age 65 and more, the US healthcare system is facing difficulties. Therefore, this raises a question about the state of affairs in 20-30 years, when the aging population doubles. According to Ed Schneider, in the year 2040 a large number of elderly in the USA has high chances of spending their later years without healthcare, consequently being deprived of normal living conditions (Koenig & Smith 17). The author speculates that hospitals will accept the sickest patients and then discharge them to nursing homes. Recent initiatives suggest that parish nursing might be the answer to this issue. This literature review considers whether parish nursing is an effective solution to the provision of care in the future by giving answers to the following questions:

1. What are the responsibilities of parish nurses?

2. Why will parish nursing be of great importance in the future?

3. What is the role of parish nursing in the end-of-life care?

An urgent need in parish nursing is presupposed by such matters as limitations of the healthcare system, growth of the elderly population, and an acute shortage of professional nursing. On this account, one should dwell upon the responsibilities of parish nurses. Parish nursing is defined as a unique specialized practice of professional nursing that promotes health and healing within faith communities. The Scope and Standards of Parish Nursing Practice (1998), based on the Standards of Clinical Nursing Practice (ANA, 1991), addresses "the independent practice of professional nursing, as defined by the jurisdiction's nursing practice act, in health promotion within the context of the client's values, beliefs, and faith practices" (Koenig & Smith 212). These standards describe the nature of parish nursing, reflect values and priorities of the profession, and provide a framework for evaluating the practice. In the introduction, the American Nurses Association says the following:

Health is viewed as not only the absence of disease, but also as a sense of physical, social, psychological, and spiritual well-being and a sense of being in harmony with self, others, the environment, and God. Healing is the process of integrating the body, mind, and spirit to create wholeness, health, and a sense of well-being, even when curing may not occur.

Professional nursing is rooted in these concepts of health and healing. Parish nursing promotes health and healing within faith communities. With the recognition that most illnesses and premature death are a result of life-style choices and diet, exercise, substance abuse, violence, and risk-taking behaviors, parish nursing integrates current medical and behavioral knowledge with the beliefs and practices of a faith community to promote health as wholeness and to prevent or minimize illness (Stavrevsky 2001).

Granger Westberg describes seven functions of a parish nurse. These functions include health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups, integrator of faith and health, and health advocate. Solari-Twadell and McDermott claim in their book Parish Nursing-Promoting Whole Person Health Within Faith Communities, that the main aspect behind this profession is that “parish nursing holds the spiritual dimensions to be central to the practice.” (Solari-Twadell & McDermott 15). This work also encompasses physical, psychological, and social dimensions of nursing practice. It focuses on the spirituality of nurses and their experience. The uniqueness of this profession is the individual approach of a nurse, and, thus, serving patient's special needs. Parish nursing is a way to cover both the science of healthcare and the spirituality of religion. Granger Westberg believes that parish nursing bridges the gap between religion and health. Since parish nursing continues to grow as a profession, educational standards and models of framework will be improved and the success of parish nurse programs will flourish. Parish nursing is a profession dedicated to serving a person and caring for his mind, body, and spirit. Thus, it would be a benefit to any faith community and healthcare setting in the future.

Having analyzed the Scope and Standards of Parish Nursing Practice, one may find an answer to a question why parish nursing will have big importance in the healthcare system. In one of his research studies Harold G. Koenig claimed: “Americans are going to face an immense health care crisis within the next 20 years, the population aged 65 and older is simply growing exponentially. Hospitals and nursing homes are already at capacity in this country and we have a shortage of caregivers" (Koenig & Smith 2012). This statement cannot be rejected. According to Forbes, National Health Expenditures indicated in 2009 spending $ 2.5 trillion, last year hit $3 trillion, and by 2019 will reach $ 4.6 trillion (Munro 2013). These figures may serve as an evidence for abovementioned claims about necessity of parish nurses. According to Koenig & Smith:

We don't have a debt problem in this country, but we have a healthcare problem. Expenditures on health care include the cost of physicians' service, medications, nursing home care, oth. Although managed care plans may reduce or help control NHE, the personal and financial impact of the cumulative effect of chronic illness and disability is a major concern among the growing population of the elderly and their caregivers, diminishing resources and increasing need have historically characterized the elderly population (2012).

Resource allocation and end-of-life issues will provide new roles for parish nurses. Bioethical issues facing older people and their families will require a commitment on the part of the healthcare system and faith community to hire nurses that are trained in both theological and social contexts. Parish nursing can be of two types, namely paid model and volunteer model. By donating some of their time to communities, nurses ensure an ideal solution to provision of care and leadership needed to assure that healthcare requirements of this vulnerable and culturally diverse population are met (Koenig & Smith 209).

Because of aging population, parish nurses of the future, being an integral part of faith communities, will be confronted with end-of-life issues as congregations become more involved in ministries to aging (Koenig & Smith 195). As a result, a question appears: what is the role of parish nursing in the end-of-life care, especially to the elderly? It is known that parish nursing provides care based on the belief that health is growth towards well-being, and that it emphasizes the interrelationship of body, mind, and spirit. Health is related to everything a person does, thinks, and feels, and is not merely the absence of diseases.

The material analyzed supports a general disappointment that people have experienced at the end of life. Nurses are present when patients and families are confronted with health crisis, and decisions concerning end-of-life issues are focal. In advocating for the patient and family, nurses must communicate and coordinate holistic care, care of mind, body, and spirit. Creation of a transitional bridge between life and death presupposes spiritual and religious aspect of nursing care. A survey by George H. Gallup International Institute has investigated the role of spiritual beliefs in preparing for and dealing with death. Results show that human contact enables a person to find comfort in dying. That includes sharing fears, having someone to hold hands with etc. At this stage of life, people realize that they must leave, but they still do not lose their faith. With regard to this fact, it is important to have a parish nurse, who will take care of a person. Today’s American nursing model has its roots in England. In 1860, Florence Nightingale, the founder of modern nursing, was the first to define the profession as the “act of using the environment of the patient to assist him in his recovery” (Lippincott 15). This definition may be interpreted in the following way: conditions of healing and wellness are not individualistic by nature, but rather dependent on fullness of individual’s environment. What may serve as a more appropriate environment than our churches with nurses assisting and taking care of friends and loved ones in sickness and wellness? Also, in her manuscript Suggestions for Thought Nightingale discussed her philosophy and introduced her spiritual beliefs as a sense of a "presence higher than human, the divine intelligence that organizes, sustains the universe, and awareness of our inner connection with this higher reality” (Perkins 2003). In a national survey by George H. Gallup International Institute, ''the overarching message that emerges is that American people want to reclaim and reassert the spiritual dimension in dying'' (Bregman 2010). End-of-life education and support for families and patients on the verge of death is an area where parish nursing facilitates valuable care because of the unique role in creating a transitional bridge of holistic care for the dying and contributing to a peaceful death.

To draw a conclusion, this research paper exposes a concept of parish nursing on the large picture of the US healthcare system. Demands for healthcare in the new millennium will rise disproportionately to the availability of resources, and health workforce issues may require parish nurses to get involved. Having taken into account recent tendencies within American healthcare system, one may outline the main aspects, in particular lack of professional assistance in sufficient proportion for people, who are about to lay their lives down. Parish nursing should be viewed from two different perspectives. The first one consists of theoretical knowledge and practical experience in terms of medical field. This fact contributes to expanding the healthcare scope. Another side of the coin is the moral part of parish nursing, i. e. the connection of the occupation with spiritual state, faith-focused issues, and ability to treat an elderly person with respect to her acute need to feel support and emotional bond with people. Therefore, the contribution of parish nursing should not be underestimated and viewed as an influential source of help and care.

Works Cited

Bregman, Lucy. Religion, Death, and Dying. Santa Barbara: ABC-CLIO, 2010. Print.

Drenning, Cindy. Promoting Quality End of Life Care: The Role of the Faith Community Nurse. Loretto: Saint Francis University, n.d. Web. 15 Apr. 2017.

Koenig, Harold G., and Smith, Sybil D. Parish Nursing. A Handbook for the New Millenium. London: Routledge, 2012. Print.

Lippincott, Williams & Willkins. Best Practices: Evidence-based Nursing Procedures. Ed. H. Nancy Holmes. Ambler: Lippincott Williams & Wilkins, 2007. Print.

Munro, Dan. “2012 – The Year In Healthcare Charts”. Pharma & Healthcare. Forbes, 30 Dec. 2012. Web. 15 Apr. 2013.

Parish Nursing is a Fast Growing Trend. Nursing Studies Research Paper. Free Online Research papers, n.d. Web. 15 Apr. 2013.

Perkins, Joyce B. Healing through spirit: the experience of the eternal in the everyday. Visions: The Journal of Rogerian Nursing Science. 11 (2003). Web. 18 Apr. 2013.

Solari-Twadell, Phyllis Ann, and McDermott, Mary Ann. Parish Nursing: Promoting Whole Person Health Within Faith Communities. Thousand Oaks: Sage Publications, 1999. Print.

Stavresky, Natalie M. “Development Of An Orthodox Parish Nursing Ministry”. Orthodox Church in America, 2001. Web. 16 Apr. 2013.

Van Dover, Lee, and Pfeiffer, John Bernard. “Spiritual Care in Christian Parish Nursing”. Journal of Advanced Nursing. 57.2 (2007): 213-221. Web. 17 Apr. 2013.