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The parish nurse

April 11, 2007 -- Today The Gainesville Times (GA) published Debbie Gilbert's "'More of a calling than a job': Church hires 'parish nurse.'" The article is a profile of registered nurse Lori Floyd, who recently joined the staff of the local First United Methodist Church as a "parish nurse." The article does a good job explaining some of the important community health benefits such a nurse can provide to church members. These include health teaching, counseling, and coordinating care initiatives like health screenings and vaccination clinics. The piece explains how the religious setting may aid Floyd's work. It does not directly address conflicts that licensed health professionals may face in religious employment, though it does note in passing that Floyd's work may include discussing "issues that some churches shy away from, such as sexuality." We thank Ms. Gilbert and the Gainesville Times for this generally helpful piece.

The article suggests that in the era of "megachurches," which "offer everything from fitness clubs to food courts," having a nurse on staff at a church seems less novel than it once did. It reports that Gainesville's First United is not a megachurch, but its pastors did see a need for a paid nurse. Pastor of congregational care Rev. Hugh Cauthen says that Floyd "serves on the pastoral staff as our health minister." Cauthen notes that churches throughout the nation have added staff nurses. Floyd, a nurse with varied experience who works part-time for the church, actually works on a contract through a "parish nurse program" at Gwinnett Medical Center. The piece does a good job of explaining what Floyd will do as a parish nurse. It suggests that she will not diagnose or treat specific illnesses, but that she will coordinate broader health initiatives, and act as a teacher and counselor. Floyd explains:

Even though we have the expertise to administer injections, if there's a flu-shot clinic we don't give the shots ourselves. We just coordinate it. ... My primary role is to promote wellness, and to help people understand what they need to know at various stages of their lives, whether it's teenagers, newlyweds or the elderly.

The piece notes that this may include "discussing, without being judgmental, issues that some churches shy away from, such as sexuality." It also explains that Floyd will promote health through "individual health counseling" (which could actually be considered diagnosing and treating), and also by organizing support groups, teaching CPR classes, and promoting better nutrition and measures like smoking cessation. Floyd will visit ailing church members at home or in health facilities, but she distinguishes her work from that of a chaplain:

The difference is that a nurse has medical knowledge that a clergy person does not have. There are some things people will tell a health-care professional that they won't even tell their pastor.

This comparison points to the relationship between a parish's nurse's health care and spiritual roles. At one point, Cauthen notes: "As a congregational care pastor, I bring spirituality to the healing process, and that is what our nurse will do as well." Floyd explains:

It's more of a calling than a job for me. What I like about it is that in a hospital setting, you're somewhat restricted in terms of being able to pray with patients and families. But within the church, that's not a problem. ...   From a Christian standpoint, we consider our body the temple of God, but we don't always take care of it as we should. ...   We can tap into the eternal power of God to help us change our habits.

These comments underline how helpful the religious setting may be to Floyd's work. By drawing on the religious faith that she shares with Church members, she may be able to enhance the effectiveness of her work to promote health. Spirituality can of course be a key element of health and overall wellbeing. And although we are sometimes critical of media items that associate nursing with spirituality because of the common angel stereotype--which has long reinforced the idea that nurses themselves are relatively unskilled spiritual beings, noble handholders--this piece manages to resist that stereotype.

The piece is less good at drawing out potential problems. There is presumably little risk that a parish nurse will be viewed as forcing her personal religious views on the unwilling, which is of course the reason her ability to "pray" with people in hospitals is "restricted." Vulnerable hospital patients who may not share their health workers' religious beliefs should not feel pressured, even in subtle ways, to conform to those beliefs in order to feel confident that they will receive good care.

However, the piece only hints at the additional potential for conflict, or at least tension, for someone like Floyd who is licensed by civil authorities as a health professional but who also owes allegiance to a sectarian religious organization. This occurs in the reference to Floyd's potential discussions of issues like sexuality.

We assume that on most relevant issues there would be harmony between the church position and a nurse's duties. But it's not hard to imagine some areas where a parish nurse might have particular difficulty resolving conflicts. Possible examples include problems related to abortion, sexual orientation, and end-of-life care. How would a parish nurse react if a church member came to her with a problem, and her profession required that she counsel and explain lawful health options, but her religious employer required that she not discuss, or even actively discourage, one of those options? Floyd notes that nurses have health knowledge the clergy lacks, but they also have different legal and ethical responsibilities. And although Floyd is probably right that people will tell health professionals things they will not tell their pastors, how will they react to a "health minister" who seems to combine the two roles?

On the whole, we commend Ms. Gilbert and the Gainesville Times for this article.

See the article: "More of a calling than a job': Church hires 'parish nurse" by Debbie Gilbert in the April 11, 2007 Gainesville Times.

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