Faith Community/Parish Nurse Literature: Exciting Interventions, Unclear Outcomes Arkreligion.Com / Art Directors & TRIP / Alamy

2.5 contact hours Faith Community/Parish Nurse Literature: Exciting Interventions, Unclear Outcomes ArkReligion.com / Art Directors & TRIP / Alamy

by Robyn Dandridge

Robyn Dandridge, MSN, RN, CAPA, is a staff nurse in the recovery room of an outpatient surgery center. She completed her parish nurse training in 2010. The author declares no conflict of interest. Accepted by peer review 5/2/2013. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article at journalofchristiannursing.com DOI:10.1097/CNJ.0000000000000063 Sean Pavone / Alamy

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Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. he concept of health ministry— the necessity to continue to promote used by parish nurses in the United supporting and caring for the faith community/parish nurse practice States. A secondary purpose was to Tsick through the faith commu- (Thompson, 2010). determine the value of the parish nity, has existed for millennia. Today, Furthermore, as hospitals strive to nurse in health promotion and ongoing changes in healthcare have contain healthcare costs, partnerships disease prevention based on measured led to an increasing need for health with parish nurse programs are seen as outcomes.

CONTEXT FOR PARISH NURSING The modern day concept of parish nursing has its origins in Germany as far back as 1836 (Kreutzer, 2010). Parish ABSTRACT: Faith community/parish nurses provide a variety of nursing has its contemporary origins in services thought to yield positive health outcomes. An integrative literature the United States beginning in the review was conducted to identify interventions most commonly used by 1970s with the Reverend Granger parish nurses in the United States and determine the value of the parish Westberg (Solari-Twadell & Hackbarth, 2010). The American Nurses Association nurse in health promotion and disease prevention. A review of 22 articles (ANA) and Health Ministries published 2008 to 2013 revealed that parish nurses are providing a Association (HMA) currently use the wealth of interventions to diverse populations but are not successfully title faith community nursing because evaluating outcomes. this term encompasses all faith traditions KEY WORDS: faith community, health promotion, logic model, (Thompson, 2010). Patterson and Slutz Nursing Interventions Classification (NIC), parish nursing, program noted that in Christian settings, the term “Parish Nurse” can be more evaluation appropriate because it implies this ministry is more than just nursing to a faith community. They also point out the ANA and HMA Scope and Standards of Practice (2012) allows for ministry through the faith community. a mutually beneficial way to collaborate the faith community nurse to be As healthcare becomes progressively with the community, reach out with referred to as a parish nurse, congrega- difficult to navigate as well as cost pro- services, and support parish nurse tional nurse, health ministry nurse, hibitive, many will be unable to access programs (Messerly, King, & Hughes, crescent nurse, or health and wellness preventive and supportive care. The 2012; Sheehan et al., 2013). Patterson nurse to fit the community’s culture and elderly are particularly vulnerable given and Slutz (2011) point out that while faith tradition (Patterson & Slutz, 2011). alterations in the traditional family healthcare agencies may see the church Parish nurses actively serve faith structure, advancements in healthcare, going segment of the population as an communities that are Christian, Jewish, and increase in life expectancy. Faith “untapped market for clients...parish Muslim, Buddhist, and other faith community/parish nurse programs are nursing is not a way for community traditions in the United States, Canada, stepping in to fill the gaps (McCabe healthcare organizations to ‘get into Australia, Korea, the United Kingdom, & Somers, 2009). In fact, not only are churches.’ Parish nursing is a way for New Zealand, countries in Asia and such programs assisting with access churches to ‘get into the community’” Africa, and possibly all over the world issues in healthcare, parish nurses may (p. 33). In other words, health ministry (Solari-Twadell & Hackbarth, 2010, represent a new way to help under- allows the church to reach beyond its p. 69). served populations take responsibility own congregation and serve the larger Faith community/parish nurses are for their health (Monay, Mangione, community. knowledgeable in professional nursing Storrell-Thompson, & Baig, 2010). Identification of common and and spiritual care. By definition, Faith community/parish nurses provide successful interventions will assist in a variety of services, many related to defining the role of the faith community/ Faith community nursing is a educational interventions and refer- parish nurse (Solari-Twadell & Hackbarth, specialized practice of professional rals, and it is thought faith-based health 2010) and influence future practice. nursing that focuses on the inten- services yield positive health outcomes. This article reports on an integrative tional care of the spirit as well as on These identified positive outcomes literature review conducted to identify the promotion of wholistic health and and other community needs indicate nursing interventions most commonly prevention or minimization of illness journalofchristiannursing.com JCN/April-June 2014 101

Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. within the context of a faith community...The goals of an FCN Table 1: Nursing Journals Publishing Faith are the protection, promotion, and Community Nurse Intervention Articles 2008 to 2013 optimization of health and abilities; Number of Intervention the prevention of illness and injury; Journal Name: Articles Reviewed: and the alleviation of suffering in the Geriatric Nursing 1 context of the values, beliefs, and practices of a faith community...or Issues in Mental Health Nursing 1 faith-based community agency. Journal of Advanced Nursing 1 (ANA & HMA, 2012, p. 5) Journal of Christian Nursing 11

In terms of basic training, the Journal of Community Health 1 International Parish Nurse Resource Journal of Gerontological Nursing 1 Center offers a basic preparation Journal of Obstetric, Gynecologic, & Neonatal Nursing 4 curriculum. This course, “Foundations Journal of Trauma Nursing 1 of Faith Community Nursing,” was “developed from a Judeo-Christian Public Health Nursing 1 theological framework and is applicable to and respectful of other faith nurses. Although these services are adherence and lifestyle modifications traditions” (Thompson, 2010, p. 76). accessed mostly by older adults, parish (Mayermik, Resick, Skomo, & For ongoing development, parish nurses offer care to diverse populations, Mandock, 2010). Services specifically nurses read faith community nursing who, among other things, are, “the for women included providing coping literature and attend workshops and young and old, newly married and assistance by implementing behavioral symposia such as the annual HMA recently widowed, new parents, and interventions (Solari-Twadell, 2010), a conference and Westberg Symposium. families whose young adults have community-based program for recently left home” (Anaebere & Mexican-American women with EXPLORING PARISH NURSE DeLilly, 2012, p. 339). Although usually gestational diabetes (Mendelson, LITERATURE provided in the client’s home or place McNeese-Smith, Koniak-Griffin, A literature search of articles of worship, parish nurses serve in Nyamathi, & Lu, 2008), and a program published in peer-reviewed journals community health fairs, on mobile for osteoporosis prevention and was used to explore interventions health units, in outpatient clinics, via management (Foster-Burke, Ritter, & employed by parish nurses. The search telecommunication, and more. Zimmer, 2010). was limited to articles available in Patient populations represented Parish nurses provide wholistic care English and published U.S. journals. were the elderly, low-income individu- believing the nurse must care for the Using EBSCO Host and OVID search als, those with mental health issues, body, mind, and spirit. In a grounded engines, a search initially was conduct- chronic disease sufferers, women, theory study, Van Dover and Pfeiffer ed for the period of 2008 to 2012 children, and populations at high-risk (2012) relayed how patients of parish using the key words parish nurse, for certain illnesses. For example, parish nurses experienced renewed spiritual parish nurse interventions, faith nurses provided blood pressure identity. Anaebere and DeLilly (2012) community nurse, programs by a faith measurements, hypertension-specific examined how parish nurses seek to community nurse, programs by a education, and counseling to commu- understand the impact of religious parish nurse, and effective programs by nity-dwelling, low income patients beliefs on life transitions and spiritual a faith community nurse. The initial with elevated blood pressure (Monay et and mental healthcare. search, using “parish nurse” yielded al., 2010). In another study, a physical 299 results while the search phrase, activity intervention was implemented CLASSIFYING INTERVENTIONS “effective programs by a faith commu- for members of an African Methodist When the parish nurse role was nity nurse” yielded only two results. Episcopal (AME) Church (Baruth, envisioned by Granger Westberg, the Additional articles published in 2013 Wilcox, Laken, Bopp, & Saunders, model was based on seven proposed were later added to this review giving 2008). In collaboration with a school functions: Integrator of Faith and a total of 22 articles from 9 different of pharmacy, parish nurses offered a Health, Personal Health Counselor, publications, which met the criteria of variety of free health screenings to Health Educator, Trainer of Volun- discussing interventions employed by a vulnerable adults in low-income teers, Developer of Support Groups, parish nurse (Table 1). neighborhoods (502 women received Referral Agent, and Health Advocate This literature provides an impres- 1,915 screenings) and pharmacists and (St. Vincent’s Parish Nurse Ministry of sive amalgamation of interventions, parish nurses counseled and educated North East Florida, 2009, p. 3). The actions, and services delivered by parish on the importance of medication current literature review revealed that

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Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. the majority of the parish nurses A randomized controlled trial collaborative project between univer- continue to use this model to describe comparing care as usual with a sity faculty members and parish nurses their interventions. However, Solari- supplementary 1-hour education to provide a variety of free health Twadell and Hackbarth assert that, session by a parish nurse was imple- screenings and consultation services. To “describing nursing based on a limited mented to examine the effects of an help patients control their blood set of hypothesized functions dimin- intervention on maternal health pressure, pharmacists and parish nurses ishes the complexity of the role and behaviors, glycemic control, and counseled and educated on the fails to capture its essence in spiritual neonatal outcomes among Mexican- importance of medication adherence care and promotion of health” (2010, American women with gestational and lifestyle modifications. In an effort p. 70). They recommend these seven diabetes. The parish nurse intervention to improve medication self-care in functions no longer be used as the group showed improved Health older adults, Shillam, Orton, Waring, primary description of parish nurse Promoting Lifestyle Profile II scores and Madsen (2013) organized a series practice and present the Nursing but no difference with the control of collaborative hospital, pharmacists, Interventions Classification (NIC) group on glycemic control and neona- and parish nurse brown bag medication system as a way of bringing parish tal outcomes (Mendelson et al., 2008). review events. A key role of the parish nurses into the mainstream and using a In an attempt to examine how nurses was personal health counseling. standardized language (Solari-Twadell parish nurses can support mental health Measurements taken at the events and & Hackbarth, 2010). The NIC core for faith communities during transi- 3 months later revealed a statistically interventions for faith community tions in life, Anaebere and DeLilly significant decrease in the number of nursing (Bulechek, Dochterman, (2012) found health education to be medications taken by the elders. King Butcher, & Wagner, 2013) are shown the number one parish nurse interven- and Tessaro (2009) found that parish in Table 2. tion. Cockroft (2012) reported on a sex nurses promote communication and For this review and because authors education intervention used by parish resource links and also frequently have used the seven function model, nurses for parents and their fourth- and provide education and counseling. The the seven functions were used to fifth-grade children. Nursing continues results of their study reflect a nursing organize the findings of parish nurse to be rated the most trusted profession practice focused on health promotion. interventions. When appropriate, NIC and parish nurses usually are personally Integrator of Faith and Health. The interventions also are noted. Of the known by parents and children, making presence of a faith community/parish seven basic functions, health education, them ideal to assist in this needed nurse program at a church serves to counseling, and integrator of faith and educational intervention. show integration of faith and health. health were the most used and almost Personal Health Counselor. Furthermore, parish nurse interventions all articles described multiple overlap- Mayermik et al. (2010), reported on a frequently incorporate a spiritual basis ping functions (i.e., integrator of faith and health, health educator, personal health counselor) within a single Table 2: Nursing Interventions Classification: intervention. Core Interventions for Faith Community Nursing Health Educator. In a study to learn more about the health promotion • Abuse Protection Support • Humor • Active Listening • Listening Visits activities of parish nurses, King and • Anticipatory Guidance • Medication Management Tessaro (2009) found education and • Caregiver Support • Presence counseling concerning physical health • Coping Enhancement • Referral (nutrition, exercise, weight control, • Crisis Intervention • Religious Addiction Prevention stress reduction) to be the most • Culture Brokerage • Religious Ritual Enhancement • Decision-Making Support • Relocation Stress Reduction frequently used parish nurse interven- • Emotional Support • Self-Care Assistance: IADL tions. In a large scale physical activity • Environmental Management: Community • Socialization Enhancement initiative (Baruth et al., 2008), bulletin • Family Integrity Promotion • Spiritual Growth Facilitation boards related to healthy eating and • Family Support • Spiritual Support physical activity was the most com- • Forgiveness Facilitation • Surveillance • Grief Work Facilitation • Sustenance Support monly reported intervention followed • Guilt Work Facilitation • Teaching: Group by bulletin inserts. Monay et al. (2010), • Health Care Information Exchange • Teaching: Individual described the services parish nurses • Health Education • Telephone Consultation provided to patients with elevated • Health Literacy Enhancement • Touch blood pressure where the most • Health System Guidance • Values Clarification • Hope Inspiration frequent services were blood pressure Source: Bulechek, G., Dochterman, J., Butcher, H., & Wagner, C. (2013). Core interventions for nursing specialty measurement, hypertension-specific areas: Faith community nursing. In Nursing Interventions Classification (NIC) (6th ed., p. 429). St. Louis, MO: education, and counseling. Mosby Inc. journalofchristiannursing.com JCN/April-June 2014 103

Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. for health (i.e., Bopp et al., 2007; might be avoided through parish nurse (Austin et al., 2013). Hayman (2012) Cockroft, 2012; Whisenant, Cortes, & actions. Several interventions were organized telephone support groups Hill, 2013). Baruth et al.’s (2008) study reported in this study, including for homebound church elderly, and of activities designed to encourage anticipatory guidance, values clarifica- although not measured, the elderly positive changes in congregations tion, grief-work/guilt-work, prayer/ showed improvements in speech and incorporated physical activity messages reframing, empowerment, and procur- movement. Parents and children in into the pastor’s sermons, and an ing assistive devices. Cockroft’s (2012) sexuality workshops exercise CD to use during meetings Referral Agent and Health Advocate. found it helpful to be in regular small and events. Praise aerobics, chair Health education, support, advocacy, groups to discuss sensitive issues. exercises, and walking programs also and assisting elders to get vaccinated Trainer of Volunteers. Parish nurses were used. In a study to ascertain are interventions noted by Pappas- frequently employ volunteers to assist whether the parish nurse model of Rogich (2012) in her article describing with health ministry. Ellis and Morzin- community-based practice supports how parish nurses can protect the ski (2013) brought together two

Identification of common and successful faith community/parish nurse interventions will assist in defining the role of the parish nurse. implementation of strategies to address elderly through immunizations, a organizations and community health standards set forth by Healthy People needed and cost effective intervention and parish nurses to train lay volunteers 2010, King and Pappas-Rogich (2011) as only 66% of elders are vaccinated. to teach on health promotion and provided a glimpse into the nature of Parish nurses must understand the illness topics (i.e., diabetes, heart parish nurses interventions and their barriers and facilitators to helping disease, cancer, healthy eating, etc.). impact on the quality of life of older older adults be immunized to reach the Although no outcomes were assessed, adults. The top three parish nurse Healthy People 2020 goal of vaccinat- the lay volunteers reported active interventions used were integration of ing 90% or more of older adults. participation in their churches and faith and health, counseling, and health A group of public health personnel positive learning outcomes for parish- education. and parish nurses collaborated to ioners. Other authors also reported McCabe and Somers (2009) develop a 224 page Infection Control and using lay volunteers for health teaching conducted a survey to understand the Emergency Preparedness Toolkit for the (Reilly et al., 2011) and leading needs of seniors and the barriers that Faith Community. The introduction of exercise (Whisenant et al., 2013). exist in meeting those needs. The study the toolkit led to an increase in the Risk Assessment and Healthcare provided useful insight into the types number of resources faith communities Provider Collaboration. An important of services provided by parish nurses, planned to use to prevent the spread of role related to the seven functions of perceived gaps in services, barriers infection, as well as an increase in the the faith community/parish nurse is seniors face as they attempt to have number of practices planned to deal health risk assessment; another role is health and personal care needs met, with emergencies (Reilly et al., 2011). to work in collaboration with other and how parish nurses can advocate Developer of Support Groups. healthcare providers. Both of these for seniors. Although not discussed directly as a nursing interventions are documented Van Dover and Pfeiffer (2012) used a specific intervention, parish nurses throughout NIC for nurses in various grounded theory method to explore the reported forming support groups to practice areas. experiences of patients receiving spiritual help parishioners. Whisenant et al. In this literature review, many care from a parish nurse. The results (2013) organized participants in healthy interventions involved risk assessment showed that renewed spiritual identity is living classes into small groups of five to and collaboration with other providers. a process experienced by patients who exercise together, share concerns, and To plan an osteoporosis prevention and receive spiritual care from parish nurses. pray for each other. Monthly support management program in a faith A study by Rydholm et al. (2008) group meetings were held for partici- community, a parish nurse, a family used quantitative and qualitative pants in the Defy Diabetes! intervention nurse practitioner, and a registered strategies to capture access concerns held in six churches in lower-income dietitian worked together (Foster-Burke, faced by community dwelling older settings. At the end of the program Ritter, & Zimmer, 2010). “Defy adults, actions parish nurses take to group participants wanted to continue Diabetes!” partnered a hospital system, address those concerns, and costs that the monthly support group meetings Certified Diabetes Educators, and parish

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Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. nurses in multiple faith communities Framework for future RECOMMENDATIONS FOR (Austin et al., 2013). Willis and Krichten evaluation PRACTICE (2012) reported on a collaboration The logic model is proposed as a The findings of this review between a community teaching theoretical framework for future indicate that parish nurses are provid- hospital’s trauma services and faith com- parish nurse program planning and ing a wealth of interventions to diverse munity nurses to increase awareness and evaluation. Used since the 1970s when populations but are not documenting provide resources for injury prevention it was introduced by Joseph Wholey, in a way that allows for critical in the faith community. Although not the logic model has undergone several appraisal. Parish nurses must adopt a an intervention with individuals, a state revisions (Stinson & Wilkinson, 2004). unified language and document clear university partnered with a large “The Logic Model process is a tool goals and measurable outcomes. The hospital-based parish nurse program to that has been used for more than 20 delivery of healthcare in the United assess an under-served community for years by program managers and States is undergoing drastic change. health risks and develop programming evaluators to describe the effective- Many, especially seniors, “struggle to (Maitlen, Bockstahler, & Belcher, 2012). ness of their programs. The model access needed services because of describes logical linkages among prohibitive costs, fragmentation and INTERVENTION LIMITATIONS program resources, activities, outputs, discontinuation of services, and The greatest limitation found in the audiences; and short, intermediate, complicated and changing insurance articles was the lack of clear goals and and long-term outcomes related to a reimbursement structures” (King & documented outcomes. For example, in specific problem or situation” (Mc- Pappas-Rogich, 2011, p. 459). Parish a physical activity health intervention, Cawley, n.d., p. 1). The logic model is nurses “frequently care for vulnerable Baruth et al. (2008) stated their data a tool that can be used throughout the populations living with harsh socio- collection methods did not capture the life of a program. Using the logic economic realities; inner-city neigh- quality of the study intervention model offers greater learning oppor- borhoods and declining small towns because they did not know what health tunities, better documentation of are home to many of society’s margin- information was placed on bulletin outcomes, and shared knowledge alized individuals” (Mayermik et al., boards or into Sunday bulletins. Many about what works and why (W. K. 2010, p. 227). Faith communities are authors described interventions in Kellogg Foundation, 2006). an increasingly popular place to detail but offered only anecdotal Here is an example of how the logic conduct health promotion programs. evaluations. Indeed, most interventions model was used by the author to plan a Parish nurse interventions hold involved behavioral change, which is health literacy program for refugees: promise in helping to reduce health- difficult to achieve and measure, and • The model begins by clearly stating care disparities (Baruth et al., 2008; takes time to lead to outcomes (i.e., the situation: refugees are unable to Timmons, 2010). changes in B/P, body mass, etc.). communicate their healthcare needs. Although interest grows in develop- Other limitations included small • Goal: refugees will be able to ing health programs in faith communi- sample size and attrition of subjects communicate their healthcare needs. ties, studies on the efficacy of faith (i.e., Shillam et al., 2013; Whisenant et • A solution is proposed: health community/parish nursing in promot- al., 2013). In a randomized controlled literacy program. ing and maintaining positive health trial providing an educational interven- • Program events and actions are behaviors are lacking. Furthermore, a tion, Mendelson et al. (2008) identified planned to achieve objectives: large volume of literature that describes a limitation as the scarcity of research classroom instruction, funding, use of the functions of parish nurse practice is on the potential impact of the parish hospital facilities, field trips, guest available but there is a paucity of nurse. Additionally, their study results speakers, hands-on activities. literature that discusses the impact of did not support the intervention as • Measurable objectives are listed. parish nurse interventions on individu- being effective. Authors frequently Short-term objectives related to al and community health outcomes discussed being unable to evaluate knowledge, awareness, and skills can (Dyess, Chase, & Newlin, 2010). interventions because of lack of be assessed during the program to To understand what parish nurses measurable process or outcome allow for adjusting interventions to do and what interventions work, there endpoints, lack of measurement achieve the program goals. Long-term must be a standardized nursing resources, and other evaluation issues. goals and objectives usually involve a language and programs designed with One of the purposes of this litera- change in behavior and are more measurable outcomes. Timmons ture review was to determine the value difficult to achieve and measure. (2010) found evaluation of church- of the parish nurse in health promotion A more complete illustration of the based health programs to be limited, and disease prevention. Because of the logic model with application to the causing some to withhold confidence lack of documented outcomes in the refugees is provided online as supple- in programs conducted by faith-based articles, the measurable value of the mental digital content at http://links. organizations. Parish nurses must parish nurse cannot be determined. lww.com/NCF-JCN/A29 understand how health programs journalofchristiannursing.com JCN/April-June 2014 105

Copyright © 2014 InterVarsity Christian Fellowship. Unauthorized reproduction of this article is prohibited. work so they can replicate successful study. Health Education Research, 22(6), 815–826. doi: Public Health Nursing, 27(6), 537–543. doi:10.1111/ interventions. Experimental research 10.1093/her/cyl149 j.1525-1446.2010.00881.x designs are ideal but not practical for Bulechek, G., Dochterman, J., Butcher, H., & Wagner, C. Pappas-Rogich, M. (2012). Faith community nurses: (2013). Core interventions for nursing specialty areas: Protecting our elders through immunizations. Journal parish nurses. Process evaluation is a Faith community nursing. In Nursing Interventions of Christian Nursing, 29(4), 232–237. doi:10.1097/ more realistic choice in determining Classification (NIC) (6th ed., p. 429). St. Louis, MO: CNJ.0b013e318266efe5 whether a parish nurse intervention is Mosby. Patterson, D. L., & Slutz, M. (2011). Faith community/ effective. The logic model is ideal for Cockroft, M. C. (2012). When the topic is sex: parish nursing: What’s in a name? Journal of Christian Facilitating parent child communication in the faith Nursing, 28(1), 31–33. doi:10.1097/ churches because it offers an easily community. Journal of Christian Nursing, 29(3), 152–155. CNJ.0b013e318200317c understood, consistent, and visual doi:10.1097/CNJ.0b013e318257f21a Reilly, J. R., Hovarter, R., Mrochek, T., Mittelstadt- guide for program planning, imple- Dyess, S., Chase, S. K., & Newlin, K. (2010). State of Lock, K., Schmitz, S., Nett, S.,...Behm, L. (2011). Spread mentation, and evaluation (Timmons, research for Faith Community Nursing 2009. Journal of the word, not the germs: A toolkit for faith communities. Religion and Health, 49(2), 188–199. doi:10.1007/ Journal of Christian Nursing, 28(4), 205–211. doi:10.1097/ 2010). s10943-009-9262-x CNJ.0b013e31822afe7f Solari-Twadell and Hackbarth Ellis, J. L., & Morzinski, J. A. (2013).Training lay Rydholm, L., Moone, R., Thornquist, L., Alexander, W., (2010) present evidence for a new volunteers to promote health in central-city African Gustafson, V., & Speece, B. (2008). Care of community- paradigm of parish nursing practice American churches. Journal of Christian Nursing, 30(2), dwelling older adults by faith community nurses. Journal 112–116. doi:10.1097/CNJ.0b013e318283ba3a of Gerontological Nursing, 34(4), 18–29. Retrieved from using the Nursing Interventions EBSCOhost Foster-Burke, D., Ritter, L., & Zimmer, S. (2010). Classification system. When parish Collaboration of a model osteoporosis prevention and Sheehan, A., Austin, S. A., Brennan-Jordan, N., Frenn, D., nurses use a standardized language they management program in a faith community. Journal of Kelman, G., & Scotti, D. (2013). Defy diabetes! Impact on can succinctly describe to funders, Obstetric, Gynecologic, & Neonatal Nursing, 39(2), 212–219. faith community/parish nurses teaching healthy living doi:10.1111/j.1552-6909.2010.01111.x classes. Journal of Christian Nursing, 30(4), 244-247 policy makers, and others invested in Hayman, K. (2012). Teleclasses: Improve belonging, Shillam, C. R., Orton, V. J., Waring, D., & Madsen, S. healthcare reform the unique contri- vitality, and health in church homebound. Journal of (2013). Faith community nurses & brown bag events help bution made by parish nurses to the Christian Nursing, 29(4), 243–245. doi:10.1097/ older adults manage meds. Journal of Christian Nursing, 30(2), 90–96. doi:10.1097/CNJ.0b013e3182831eff health of their communities. CNJ.0b013e31826708bd Solari-Twadell, P. A. (2010). Providing coping assistance King, M. A., & Pappas-Rogich, M. (2011). Faith Identification of the most commonly for women with behavior interventions. Journal of community nurses: Implementing Healthy People Obstetric, Gynecologic, & Neonatal Nursing, 39(2), 205–211. used interventions will assist in defining standards to promote the health of elderly clients. doi:10.1111/j.1552-6909.2010.01109.x the role of the parish nurse. Clear goals Geriatric Nursing, 32(6), 459–464. doi:10.1016/j. and interventions and well documented gerinurse.2011.09.007 Solari-Twadell, P. A., & Hackbarth, D. P. (2010). Evidence for a new paradigm of the ministry of parish King, M. A., & Tessaro, I. (2009). Parish nursing: Promoting outcomes are necessary to influence nursing practice using the nursing intervention healthy lifestyles in the church. Journal of Christian Nursing, classification system. Nursing Outlook, 58(2), 69–75. policy and funding decisions. Successful 26(1), 22–24. doi:10.1097/01.CNJ.0000343922.78680.fb doi:10.1016/j.outlook.2009.09.003 parish nurses must appreciate the value Kreutzer, S. (2010). Nursing body and soul in the parish: St. Vincent’s Parish Nurse Ministry of North East Lutheran deaconess motherhouses in Germany and the of collaboration and strengthen partner- Florida. (2009). History and philosophy of parish nursing/ United States. Nursing History Review, 18, 134–150. ships with other disciplines. Accurate faith community nursing. Jacksonville, FL: St Vincent’s doi:10.1891/1062-8061.18.134 documentation with clear goals, Health Care. Maitlen, L. A., Bockstahler, A. M., & Belcher, A. E. interventions, and outcomes will Stinson, S., & Wilkinson, C. (2004). Creating a successful (2012). Using community-based participatory research clinical extern program using a program planning logic facilitate effective faith community/ in parish nursing: A win-win situation! Journal of model. Journal for Nurses in Staff Development, 20(3), parish nurse interventions and future Christian Nursing, 29(4), 222–227. 140–144. Retrieved from http://www.ncbi.nlm.nih. research. 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