Parish Nursing: where spiritual care and community collide
Meet a nurse network adapting how it delivers holistic care to vulnerable and isolated people amid the pandemic
The long-term effects of the coronavirus pandemic will require new thinking and a wide-ranging healthcare response long into the future.
Parish Nurses have demonstrated how, by adapting their practice, they are perfectly placed to respond holistically to individuals and communities struggling to make sense of the new ways of living we may all face.
Who are Parish Nurses and what are they doing?
In short, they are registered nurses who practise through churches across the UK. They are independent practitioners serving parish populations, including people of all faiths and none.
While they are spread across the UK, supported by the national framework of Parish Nursing Ministries UK (PNMUK), they are rooted in local communities, complementing statutory services.
Parish Nursing: the role in a nutshell
Parish Nurses are registered nurses certified by Parish Nursing Ministries UK (PNMUK) on completion of a detailed preparation for practice course.
The course explores a holistic definition of health and the theoretical and professional underpinnings of Parish Nursing practice. This helps individuals adapt their nursing knowledge and competencies to the different dimensions of this unique and demanding role.
Parish Nursing has a robust professional infrastructure with continuing professional development and regular support for individual nurses and assurance through accreditation for their Parish Nursing ministry through PNMUK.
An additional layer of nursing support in the community
Parish Nursing is community healthcare that aims to enable people to maintain health and independence and make the best use of statutory services.
It provides an additional layer of nursing support to people with existing health problems, those nearing the end of life or who are at risk in some way.
Adapting practice through online tools
As with the profession as a whole, flexibility and adaptability has been a feature of Parish Nursing during lockdown. Many Parish Nurses are using online tools to continue clinics and offer individual consultations and personalised health advice and support.
And where service users cannot access online provision, telephone appointments and clinics, and individualised support via phone calls and texts take the place of face-to-face consultations and home visits.
One team, for example, works solely with homeless people and has identified that this population, without access to the internet, has a poor understanding of the pandemic.
These nurses are proving to be an essential source of guidance to some of those most vulnerable to infection. In place of their regular drop-in clinics, they are providing lunch bags and much-needed housing and health-related advice from a designated drop-off point in their parish, in partnership with other local agencies.
Parish Nurses’ expertise is being applied to meet the needs of households that are shielding
Supporting people who have short and long-term health conditions or who are at the end of life are all features of standard Parish Nursing practice and this work has proved to be invaluable to the many people who are now self-isolating or shielded.
And where individuals and families are otherwise unsupported, Parish Nurses are delivering essential medications and food or managing volunteers to provide on-going support in a safe way.
One Parish Nurse describes working with a shielded family where both the parents have serious ongoing health conditions, placing them in the government’s ‘clinically extremely vulnerable’ category.
When they reached the point where they had no food and little money, they contacted their Parish Nurse, who organised emergency and on-going food bank deliveries and gave them benefits advice along with the spiritual support they requested.
Continuity of care is an important feature of the work of Parish Nurses and so regular telephone support continues for this shielded family.
Working in partnership with other agencies and volunteers
Parish Nurses regularly work in partnership with and offer signposting to other services that offer evidence-based provision. They are able to use knowledge of local networks and experience of assessing agencies to provide rapid referral.
In one rural area, nurses have signposted people to local government pandemic initiatives, while inter-agency work with police and NHS services has enabled other Parish Nurses to support homeless people to move into hostel accommodation.
‘The past couple of months have revealed that Parish Nursing – health support and spiritual care that reaches beyond statutory provision – is especially important during the pandemic’
Volunteering has been a feature of the national response to this pandemic. About half of Parish Nurses are themselves volunteers and have expertise in educating and managing volunteers to increase capacity and draw on the tradition of volunteering in churches. This work is underpinned by evidence demonstrating that health and well-being is improved by the act of volunteering.
In just one example, a Parish Nurse volunteer was enabled by their lead Parish Nurse to escort a visually impaired service user to attend an essential GP appointment safely following social distancing rules.
Help to attend appointments or access healthcare services
Efforts to reduce the spread of COVID-19 may have unforeseen effects on otherwise unrelated morbidity as people have been wary of accessing health services with non-COVID symptoms to avoid contracting the disease.
Where essential, Parish Nurses have supported individuals to attend hospital and GP appointments as safely as possible and to access services such as opiate substitution therapy and equipment.
Underpinning Parish Nursing is spiritual care. Parish Nurses regularly provide this support when requested by service users, and now do so by a variety of means such as phone and email.
This is of particular importance because we know that loneliness and anxiety are associated with morbidity and mortality and they are both features of social isolation during the pandemic.
Many Parish Nurses are in regular contact with people now in isolation, providing invaluable contact, continuity and professional health support.
The core practice of Parish Nursing is especially important now
With families having to remain apart from their loved ones at the end of life and during the bereavement process, and limits being set on the number of people attending funerals, the circumstances created by the pandemic are likely to have lasting effects on individuals’ mental and spiritual health and grieving processes. This is likely to influence the work of Parish Nurses long after the immediate crisis has passed.
The past couple of months have revealed that the core practice of Parish Nursing – health support and spiritual care through professionally regulated, flexible, needs-led practice that reaches beyond statutory provision – is especially important during the pandemic.
Due to their unique position as registered nurses working through churches, Parish Nurses are also likely to have a central role in their communities after the pandemic, as longer-term spiritual and mental health issues arise.
However, as the need for Parish Nursing increases during the pandemic and as communities come to terms with its long-term implications, so its charitable funding base is likely to shrink.
It is my hope that support for Parish Nursing will remain strong to enable these nurses to continue their invaluable work.
Anne Taylor is a Queen’s Nurse, newly appointed director of nursing for Parish Nursing Ministries UK and a practice tutor at the Open University. She thanks Ros Moore, outgoing chief executive of PNMUK, for assistance in writing this article
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Nursing and the Mission of the Church (Helen Wordsworth)