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Richard J. Fehring, DNSc, RN, CNFPP

Professor of Nursing

College of Nursing

Marquette University

What does a Catholic parish have to do with health care? Doesn't a parish have enough to do besides becoming involved with a health ministry? Why would a Catholic parish spend resources on a health ministry when Catholic hospitals and other health care institutions already exist? These are some questions that a parishioner, pastoral council, and/or pastor might ask when introduced to the concept of Parish Nursing and/or Congregational Health Ministry.

From the perspective of holistic health (health of the mind, body, and spirit), the answer is: all Catholic parishes are already involved in health care, i.e., the spiritual health of their members. Many parishes also have specialized health-related ministries, such as, drug and alcohol outreach, grief support and counseling, AIDS/HIV support, nutrition for homeless individuals, Alzheimer Care Giver support, and spousal/child/elderly abuse support, to name just a few. One of the newer ministries that is experiencing phenomenal growth is Parish Nursing. Modern Parish Nursing grew out of the health promotion, wellness and holistic health movement. These movements are based not only on the belief that health involves the integration of the mind, body and spirit but also on the knowledge that 60-70% of today's major health problems are related to life style, how we handle stress, and how we interact with environmental factors. There is also a growing body of evidence demonstrating the link between spirituality and good health. Persons who are religious and view their faith as the primary motivation for life are healthier (mentally and physically), are more able to manage stress, have healthier life style patterns, and cope better with chronic and acute heath problems than those who are not religiously motivated. Recent research has also documented the influence of prayer and the "faith factor" on positive coping and health.

The biblical, spiritual, and Christian basis for Parish Nursing is rooted in the life and teachings of Jesus Christ. There are numerous references in the Bible to Christ's physical healing and to his involvement in psychological and spiritual healing as well. Jesus Christ was a holistic healer! Since the time of Christ, the care of the sick has been considered a Corporal Work of Mercy and a path towards salvation. Furthermore, early Christian communities provided outreach to the sick and often set aside special rooms to care for them. Deacons and Deaconesses of the Early Church practiced what is considered an early form of public health nursing.

The mother of modern nursing, Florence Nightingale, viewed her practice of nursing as following in the footsteps of Christ. She also viewed nursing as helping individuals to work with and not against nature. Modern nursing follows the philosophy of treating the whole person and the importance of health promotion, disease prevention, and not treating a normal function as a disease. Catholic religious orders (both men's and women's) had a tremendous influence on health care in this country in establishing hospitals, nursing homes and schools of nursing.

The start of the modern Parish Nursing movement is credited to a Lutheran Minister, Reverend Granger Westberg, who saw the potential of having a nurse on the ministerial staff of a parish in helping the pastor and parishioners carry out its role of being a community for healing and salvation. In the mid-1980s, under the encouragement of Reverend Westberg, Lutheran General Hospital in Park Ridge, Illinois, provided a nurse to six parishes in the Chicago area—two of which were Roman Catholic. Since that time the Parish Nurse concept has caught on, and there are now over 2,000 Parish or Congregational Nurses throughout this country in all types of religious denominations—including Jewish and Moslem. Parish nursing is not just having a nurse in a parish. According to the Health Ministries Association, Parish Nursing is "a specialized practice of professional nursing which focuses on the promotion of health within the context of the values, beliefs, and practices of a faith community such as a church, synagogue, or mosque." Parish nursing does not provide (invasive) traditional hospital-based "hands-on" nursing but rather functions in a more independent autonomous role.

The cited roles of the Parish Nurse are health educator, health counselor, referral source, facilitator, and a role model for integrating spiritual health. Parish Nurses assess and address the physical, mental and spiritual needs of individuals, families, and the community. A Parish nurse might be involved with support group development, coordinating volunteers, home visiting, grief work, prevention of abuse, health screening, health fairs, prayer, healing services, presence and numerous other activities in cooperation with the pastor and parish staff.

There are several Parish Nurse models. One model is having a Health Care Institution (most commonly a hospital or long-term care facility) sponsor a professional nurse for a percentage of time to a parish (the Institution Model). The Health Care Institution works closely with the parish staff to match the professional nurse with the needs and makeup of the parish. Some parishes are able to finance a full- or part-time salaried Parish Nurse on their staff (the Parish or Congregation Model). Many Parishes Nurses (whether from an institution or as a member of a parish) volunteer some or all of their time (the Volunteer Model). University nursing faculty and students augment some parishes and Parish Nurses. Educational and training programs exist for Parish Nursing in independent settings and at a few colleges and universities (some for credit and some as a continuing education program). Marquette University College of Nursing has a Parish Nurse Institute (under the direction of Rosemarie Matheus, RN, MSN) that conducts a continuing education parish nurse-training program at Marquette University and around the world. The National Parish Nurse Resource Center in Park Ridge Illinois is now involved with developing a standardized curriculum for Parish Nurses and Parish Nurse Coordinators/Directors. The Health Ministries Organization and the Parish Nurse Resource Center are also beginning to discuss the development of standards for Parish Nursing and credentialing through certification.

So what does Parish Nursing have to do with Natural Family Planning (NFP)? First of all, if parish nursing is practiced in the context of the values and beliefs of a religion, then Parish Nurses in a Catholic congregation have the opportunity to provide health care in the context of the Catholic faith. In the area of family planning and human sexuality, the Catholic Church has a wealth of knowledge and a wellspring of integrated and developed teachings. A Parish Nurse in a Catholic congregation would have the opportunity to provide education in NFP from a Catholic philosophy to engaged or married parishioners of reproductive age. NFP could be taught in order to help couples either achieve or avoid a pregnancy and to help couples view their fertility within the context of being open to life as co-creators with God.

Pope John Paul II recently mentioned parishes as ideal sites where NFP could be offered. NFP is a natural for Catholic parishes and for Parish Nursing. NFP fits in the holistic health promotion model. NFP can help couples to understand and integrate their fertility in relation to the mind, body, and spirit. NFP also fits the health education and counseling role of Parish Nursing and follows the biological laws of nature. That is, NFP treats fertility as a normal condition rather than a disease. Nurses who learn how to provide a method of NFP through an accredited education program should be able to integrate NFP into a Parish Nursing practice very easily—working with priests/pastors, and marriage preparation couples (Focus Couples) provide introductory sessions on NFP. The Parish Nurse could also have a role in promoting chastity in the teen and young adult population of the parish.

NFP and Parish Nursing are in a similar state of development. Both are continuing to refine their models of practice, standards, accreditation, and certification. Currently there are national standards for Diocesan NFP teachers (The National Standards of the National Conference of Catholic Bishops' Diocesan Development Program for Natural Family Planning) that were formulated by a national certification committee. These national standards for diocesan NFP programs should be integrated into Catholic Parish Nursing practice. If a Catholic Parish Nurse was involved with family planning, then not integrating NFP services would violate the context of Parish Nursing and Catholic health care standards. As the current health care system is undergoing changes in the United States, with the emphasis on primary care, health promotion, disease prevention, shorter hospital stays and more responsibility for personal health, both NFP and Parish Nursing will offer a growing benefit to Catholic and non-Catholic parishioners. Jesus Christ is the role model for healing and salvation; NFP and Parish Nursing are just a modern variation of that salvific role.

—Professor Richard Fehring

richard.fehring@marquette.edu