Program joins health care, faith

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BANGOR – Noah Clark stops by the nursery at St. John’s Episcopal Church after lunch. The 7-year-old is not looking for toys to play with while his parents finish eating.

He has come to get his blood pressure taken and to check in with registered nurse Bridget Larson. He rests his tiny arm on the table while Larson unpacks her pediatric kit.

The nurse chats with Noah and hands him the gauge to hold while she place her stethoscope in the crook of his arm and pumps up the bulb. The boy stares at her, his eyes full of adoration and wonder.

Larson writes down Noah’s blood pressure level, normal for a child his age, on a wallet-sized card. She hands it to the boy and reminds him to give it to his mother.

The nurse notes his blood pressure on her own records as the boy heads back to his mother who is still eating. In the doorway, Noah pauses briefly to look back at Larson. He flashes her a loving grin.

Noah is one of the more than two dozen people Larson and Marteile Benson, a retired R.N., see on the second Saturday of each month. The two volunteer during one of the two free noontime meals the parish offers every month.

St. John’s is one of the first churches in the Bangor area to venture slowly into the field of parish nursing. The idea of churches providing health care education and services to their members took root in the Midwest about 30 years ago.

In the early 1990s nursing school began offering coursework in the field. The American Nurses Association identified it as a specialty in 1997 and released scopes and standards a year later. During the past three years, more than 2,000 U.S. nurses have completed curriculum work in the specialty. There are an estimated 6,000 parish nurses worldwide.

The major difference between parish nurses and other nurses is in the approach taken to their practice, according to the International Parish Nurse Resource Center. Parish nurses hold the spiritual dimension to be central to their work. They also encompass the physical, psychological and social dimensions of nursing practice.

Locally, the Interfaith Program of St. Joseph Hospital is helping the faith community understand how it fits into the larger health care system. Sandy Smith, a registered nurse and part-time coordinator of the program, is helping more than a dozen congregations assess the health care needs of their faith communities are as well as what their resources may be.

Smith’s current goal is to build an “interfaith system which joins the strengths of St. Joseph Healthcare and area faith communities into an interactive network. Its focus is on health education and health-related counseling which addresses the needs of the whole person: body, mind and spirit. Programs are tailored to grow with the unique talents and resources of each faith community by working with volunteers.”

The seeds of health ministry already exist in many congregations, according to Smith. Churches simply don’t identify food cupboards and visits to shut-ins as health ministry.

“Health ministry,” she said, “allows for an integrated approach … The point is not to fragment a person, but to approach them and their health needs holistically.”

The historic roots of parish nursing are intertwined with those of monks and nuns, deacons and deaconesses, according to the IPNRC. Parish nursing services are designed to build on and strengthen capacities of individuals, families and congregations to understand and care for one another in light of their relationship to God, faith traditions, themselves, and the broader society.

“Parish nursing is not about starting IVs and changing bedpans,” said Jo Beta Wescott, manager of Parish Nursing Services for Via Christi Health Systems, a Catholic health organization that serves Kansas and northern Oklahoma. “It’s about referrals, educating and teaching – a health ministry based on health prevention and promotion, centered on spirituality.”

It is also about “being a listening presence to give people an opportunity to express their cares and concerns with someone who’s safe,” said Smith. “A parish nurse also can be an advocate for those unable to articulate their needs or negotiate the complex American health care system.

“Fifty years ago, medical care was very straightforward and simple,” she added. “The huge growth of medical specialties has made a huge difference in the way care is delivered. People move into the system and they feel fractured.

“The system breaks them into pieces – the physical body, the psyche and the spirit. We’re trying to say that nobody is just one part. Also, people need a way to have some continuity in negotiating the system.”

To illustrate the goals of the Interfaith Program, Smith chose a drawing of two hands joining a piece of broken pottery. The words “nurturing wholeness” surround the graphic. Nestled beneath “wholeness” are the words “body, spirit, mind.”

“The illustration … captures the essence of health ministry on more than one level,” said Smith. “On an individual level, it recognizes the fragmentation of the whole and the potential for returning the vessel to a state of wholeness – not perfection, but wholeness.

“On a more societal level, the drawing represents the fragmentation of the current health care system and the potential for active assistance in negotiating the system in promoting and maintaining optimal health and wholeness.”

That approach is what appealed to Larson 18 months ago when she volunteered to do the blood pressure screenings at her church on French Street. A former school nurse, she now works as a psychiatric nurse and is the liaison from Acadia Hospital to the pediatric unit at Eastern Maine Medical Center.

“I feel that our church has a number of different things I can do,” she said. “But, when this idea came up, I thought it was something I could do and have a passion for. I approach people from a biological, sociological, psychological and spiritual perspective. It’s a holistic approach.

“I may be taking someone’s blood pressure, but I’m dealing with the whole person,” she added. “I may talk about emotional feeling or talk about church. I really connect with these people. And, for me, it really is something I can give to my community and church. God’s given me the skills to do this.”

Many of the people Larson interacts with the second Saturday of each month are unable to negotiate the health care system by themselves. Most qualify for Medicaid or Medicare, but others are unsure of how to apply for those programs. Many have multiple physical and mental health problems.

One of the regulars, who comes with her son, declined to give her name but appreciates the extra service offered by the church.

“I have high blood pressure and diabetes,” she said as Larson wrapped a cuff around her upper arm. “I’m on a low-fat, low-salt diet, so it’s nice to have an extra check that I don’t have to pay for. It’s an extra filtering system.”

On one occasion, Larson’s presence at the church may have saved a life. A man who had been released from the hospital earlier in the day came to lunch. After eating he came into the nursery to see Larson. After speaking with him and checking his blood pressure, the nurses called an ambulance and he returned to the hospital.

“I really try to meet them where they’re at that particular day,” said Larson. “This is primary intervention. Oftentimes, their lives are in shambles. Because of my background [in psychiatric nursing], I work really well with these people. Their lives are always in crisis.”

Larson added that she particularly likes working with the children who come in. She believes that she can have a positive effect on how the children feel about the health care system.

While St. John’s has taken the biggest step toward developing a health care ministry for the community, it is still in the process of discerning how parish ministry can best serve its members, according to Smith.

Five of the churches she works with are assessing the needs of their congregations with an eye toward education. Others, such as St. Mary’s Catholic Church, have taken small steps. The Ohio Street church is setting up a health bulletin board, as well as a blood pressure screening program.

No matter how congregations decide to define their own health ministries, according to Smith, the common element will be their holistic approach to care.

“Each of us as individuals represents the integration of body, mind and spirit,” said Smith, “however, the Interfaith Program sees the spirit as the glue that holds body and mind together.”

For more information on the Interfaith Program of St. Joseph Healthcare, call 262-1772.