Faith Community Nursing

Caring for the congregation

A nurse is taking the blood pressure of an older patient while they both sit at a table

Mary Lynne Knighten, RN, DNP, PN, NEA-BC, serves as director of the health ministry of L.A.’s St. Dominic Catholic Church. Volunteering in this role is her way “to give back to our faith community.” As the “chief nurse,” Knighten oversees health screenings, makes referrals and organizes events like Blood Pressure Sundays, working with a group of other volunteers to improve the physical, emotional and spiritual well-being of church parishioners.

It was the late Granger Westberg, a Lutheran pastor, chaplain and theology professor, who first coined the term “wholistic” for healthcare that encompasses a patient’s body, mind and spirit. This integration of faith and health underlies the practice of Westberg’s other legacy: parish nursing, now more broadly known as congregational or faith community nursing.

Today, there are about 16,000 faith community nurses across the U.S. The ANA recognizes congregational nursing as a distinct nursing specialty, with its own standards of practice and an American Nurses Credentialing Center (ANCC) board certification program. Many congregational nurses are volunteers, but some are paid, credentialed employees of their church or ministry.

Caring for the Community

Faith community nursing has some similarities to public health and home health nursing, but the goal is to complement rather than replace those specialties. The congregational nurse’s central objective is to address the needs of their faith community, whether that means teaching parishioners about nutrition, addressing problems like diabetes or hypertension or helping seniors deal with declining health and mortality. Faith community nursing is very much a team effort.

Nurses work in close collaboration with faith leaders, other healthcare providers and lay volunteers. Many activities are organized around regular services. For example, after a weekly sermon, a church pastor might invite parishioners to stay for a free health screening, which the congregational nurse would then conduct.

Although faith community nurses work with and sometimes organize non-clinician health promoters, being an RN enables the nurse to provide a broader range of care and advocacy, such as holding weekly “office hours” to answer health-related questions or providing referrals to local health resources.

Sometimes, the nurse’s work is more hands-on. Deborah Ringen, RN-BC, MSN, FC, a faith community nurse for Visiting Nurses of the Lower Valley in Connecticut and an adjunct professor at Azusa Pacific University School of Nursing, recalls playing a health advocacy role for an older patient, accompanying her to appointments to explain what the doctors were saying and helping the patient ask the right questions. When treatment proved unsuccessful, Ringen was the one to propose hospice care.

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Throughout, Ringen was able to apply her intimate personal and spiritual perspective on the patient’s needs. One staff member who treated the patient remarked, “I wish every patient who comes from a nursing home would come with someone like you.” Work like this can lead to deep connections between nurse and patient. Ringen says that her first patient was a woman in her 90s who lived alone.

They prayed together — Ringen for her patient, then the patient for her nurse — and exchanged cards for years afterwards. Ringen says she treasured those cards because they symbolized the real bond the two had developed.

Why Faith Community Nursing?

Advocates of this type of nursing practice, like Scott Morris, M.D., M.Div., founder and CEO of the Church Health Center in Memphis, Tenn., believe that the health ministry should be a basic part of all faith communities, just like choir or Sunday school. Morris describes health ministry as a Christian imperative, but the practice is also slowly catching on with other faiths. A few synagogues and Jewish centers have recently begun employing congregational nurses and similar programs can be found in a number of other religious communities throughout the U.S. This type of nursing practice offers several potential advantages:

  • Religious services are a regular meeting place for members of a community, including those who are otherwise isolated by age, low income or linguistic barriers. Bringing vulnerable individuals together is an opportunity for targeted health outreach.
  • Parishioners often seek out faith leaders — whether priests, pastors, rabbis or imams — to share personal problems, which sometimes include health challenges. Of course, a rabbi can’t diagnose heart disease, but being able to refer a congregant to a nurse who’s also a familiar member of the community can make the difference between getting needed care and leaving undiagnosed, untreated problems to fester.
  • Faith community nurses and their patients share a common spiritual perspective and often a similar cultural framework, allowing nurses to build trust in ways that may be difficult in a normal clinical setting. This can be especially beneficial in communities with many immigrants, for whom healthcare providers may seem alien or even hostile. Knighten says her connections with members of her church community allow her to recognize when they have problems that require emotional support and when it’s time to help someone make a doctor’s appointment or an ER visit.
  • Last, but hardly least, this specialty gives nurses an opportunity to provide the kind of hands-on personal care that many RNs feel has been lost in an increasingly numbers-driven medical industry. “Most nurses who come to our courses and learn about faith community nursing love it because it’s like, ‘This is what I went into nursing for,’” explained Maureen Daniels, RN, MN, the Church Health Center’s former international faith community nursing specialist, in a 2013 video.

Limited Resources

One drawback is that health ministry can strain the resources of smaller or poorer faith organizations, even if the nurses are volunteers. Elly Walters-Bible, RN, BSN, PHN, a parish nurse in the Santa Barbara area, recalls the lengthy struggle she faced in trying to persuade her pastor to purchase a portable defibrillator for their church.

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It was not until after the pastor himself had suffered an emergency requiring fast intervention by paramedics that he agreed to spend the money. However, Knighten, Ringen and Walters-Bible argue that faith community nursing quickly “sells itself” as faith leaders and parishioners see how vital the services can be. Congregational nursing can also play an important role in maintaining community cohesion, giving congregants another reason to remain part of the faith community.

To Learn More

If you’re interested in learning more, a good place to start is by taking a look at the ANCC certification requirements at nursecredentialing.org. Those requirements will give you a quick overview of the skills and obligations this specialty demands.

Beyond the professional standards, Walters-Bible notes that this calling requires “patience, humility, generosity and the ability to deal with reality.” Not every patient situation will be fixable, so this is not a specialty for nurses who thrive on quick, clear-cut results.

For a more in-depth description, you’ll want to pick up a copy of Faith Community Nursing: Scope and Standards of Practice, 3rd Edition. Jointly authored by the ANA and the Health Ministries Association, these standards reflect input from 21 practicing congregational nurses, spelling out “the who, what, where, when, why and how of faith community nursing.”

You can find additional resources at the websites of Faith Community Nurses International (www.fcninternational.org) in St. Paul, Minn., and the Westberg Institute for Faith Community Nursing (westberginstitute.org).

Closer to home, Azusa Pacific University School of Nursing offers a continuing education course in faith community nursing, taught by Mary Lynne Knighten and Deborah Ringen. The eight-week course is primarily online, but culminates in a two-day onsite retreat, providing a total of 40 contact hours. For more information, please visit https://www.apu.edu/nursing/continuing/.

Faith Community Nursing Roles

Here are some roles of the faith community nurse, as identified by the Westberg Institute (westberginstitute.org):

• Personal health counselor
• Health educator
• Volunteer trainer/coordinator
• Support group organizer
• Referral agent
• Health advocate
• Integrator of faith and health

Editor’s note: As of Feb. 2021, the ANCC is only offering renewals, not new certifications.

ELIZABETH HANINK, RN, BSN, PHN is a Working Nurse staff writer with extensive hospital and community-based nursing experience.

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