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FREQUENTLY ASKED QUESTIONS (FAQs)

Common questions (and answers) about community and parish nursing. Please contact us if you don't find the answers to your questions here.

1. What is a Community Nurse/Parish Nurse? 
The American Nursing Association defines the parish nursing—also termed faith community nursing—specialty as the practice of professional nursing that focuses on the intentional care of the spirit as part of the process of promoting holistic health and preventing or minimizing illness in a faith community (ANA Scope and Standards of Practice. 2005). The nurse is able to look at the individual as well as the community from the perspective of protection (from injury), promotion and optimization of health, prevention of illness in the context of the individual, and the community’s spiritual values and beliefs.

2. Why have a nurse in this role?  
Nurses are accustomed to viewing the individual and the community in a holistic manner. They are able to bring their experience at the bedside and in the community to the position. Their assessment ability and knowledge about options for appropriate interventions will assist them in addressing complex problems. They are familiar with health care systems and have experience in working as part of a team.  They understand the course of an illness, the functional consequences of that illness and the impact on the individual and the family. They also have a global familiarity with community resources that are necessary to support the individual during a crisis.  They also have the capacity to initiate interventions for the larger community based on needs that arise.

3. Does the nurse need to be currently licensed?
Yes, a current license is necessary for individuals in this position. A nursing license indicates that the nurse does not have a criminal record and has been “active in practice” and has maintained a level of professional accountability related to continuing education.

4. Does the nurse have to be licensed in VT and NH (relevant to parish nursing)? 
Yes, if the congregation consists of individuals from both NH and VT and the nurse intends to make home visits in both states, it is essential for the nurse to be licensed in both states. Otherwise there could be an accusation that the nurse is practicing nursing without a license.

5. What kind of educational preparation should the nurse have to be successful?
This nurse benefits from a bachelor’s degree in nursing. While not an exclusive determinant of success, a bachelor’s program with its liberal arts requirements gives the nurse a broader view of factors that influence human behavior. Additional specialty training in the area of home health/ community / parish nursing is highly recommended but not mandatory.

6. What does this nurse do?
The nurse can do any of the following:

• health education
• health counseling
• referral agent/care coordination for vulnerable members of the congregation and their families
• health advocacy
• volunteer education/facilitation
• facilitate support groups
• integrator of faith and health
• care management
• medication reconciliation
• initiate advanced directives

The nurse does not do direct care (e.g., wound care, IV administration). Direct care needs for homebound individuals can be referred to the area home care agencies. Assessing the needs of the  frail elders in the congregation or community setting is a good way to begin a practice.

7. How many hours a week do they work?
Nurses work anywhere from 4-20 hours/week. with an average of about 10.

8. How do congregations and communities pay for the position?
Communities pay for this position through funding from grants (e.g., Byrne Foundation, Bank Foundations), community donations, and town support.

9. Which states and countries have these nurses?
This nursing specialty can be found in all 50 states in the US and in other countries around the world.

10. Must the nurse be a member of the congregation or community they serve?
It is highly recommended that a community or parish nurse be a member of the town or congregation. If the parish nurse is not a member of the congregation, it is critical that there be a significant and predictable presence during times when the congregation is present.

10. Can several congregations or communities “share” a nurse?
Yes, especially if the groups are in close proximity to one and other (see Models of Faith Community Nursing).  

11. What kind of clinical background should this nurse have?
A diverse clinical background is helpful. A minimum of 5 years of experience is highly recommended with some experience in medical / surgical nursing.  Home care nursing (VNA and/or hospice) is a great asset. The ability to view the community or congregation as a client is beneficial as the nurse becomes more settled into the position and is able to focus on the health education needs that might be present.

12. Why does the nurse need malpractice insurance?
Any time a nurse supervises others (volunteers), monitors an individual’s reaction to treatment and medication, renders counseling or advice, or provides a professional service that is considered to be within the nurse’s scope of practice, the nurse is at risk for being sued. When the nurse is working with people, both professional and otherwise, experience is being tested and conditions may be stressful, and it is always possible that things could go wrong. A malpractice suit could end an individual’s career, which is why liability insurance is recommended.

13. Will the nurse come and change my mother’s dressing?
No, these nurses will not provide direct care or personal care services. Direct care needs are most often appropriately addressed by the visiting nurse organizations or other skilled home care organizations. Elders who have difficulty getting out and who have medical needs that must be addressed by a skilled professional are  often eligible to use their Medicare benefit.

14. What resources are available in the Upper Valley to support a nurse?
In this region, the Upper Valley Community Nursing Project provides regular group support meetings with clinical experts who discuss medical, social, ethical, and spiritual issues of concern. These meetings provide opportunities to discuss topics that relate directly to the nurses’ roles and management of individual programs and patients. The group provides a source of support and professional information exchange. 

15. How religious does the community / parish nurse program have to be?
The response to this question depends on the individual assuming the nursing role and the context. In parish situations, the nurse takes direction from the parish leadership. For example, it is never assumed that the nurse would introduce herself with a prayer.  Prayer would only be offered if appropriate or requested by the parishioner.  It is critical that the nurse be clear as to the spiritual expectations of the pastor prior to accepting a parish nurse position. In towns or other community settings, the role of religion may not be applicable.

16. What is the difference between the services offered by visiting nurse associations (VNAs) and the services provided by a community nurse?  
VNA home care and hospice services are skilled direct care nursing or rehab services provided to an eligible individual by a licensed professional under the orders of a medical provider. These services are often reimbursable by Medicare, Medicaid, or private insurance. Community / parish services do not require a physician’s orders nor are the services direct hands-on care. These services are not reimbursable by Medicare, Medicaid or private insurance at this time.  Community and parish nurses work in collaboration with the VNAs.

17. Does an individual still need the VNA and hospice if they have community or parish nursing visits? 
Yes, an individual may need VNA or hospice services. It is not unusual for the community / parish nurse to make the referral to the VNA or hospice based on the needs of the parishioner or community member, and then to work collaboratively to ensure needs are met.

18. Can the nurse take care of people outside of the community or congregation?
Yes, the nurse can take care of individuals outside of the community/congregation if that is consistent with the philosophy of the program.

19. How do we evaluate the performance of the nurse?
A performance review should be done annually. The review should consider each of the different roles of the nurse. Feedback can be obtained from the many individuals and groups with whom the nurse works.

20. How do we know this is a good investment for our congregation or community?
Evaluation can be obtained via satisfaction surveys. Specific questions can be asked about educational events and activities. Individuals who have used the services of the nurse can also be asked to comment on the value of the services.  

21. What nursing organizations support community and parish nursing?
The following professional organizations support this work:

• American Nurses Association
• Health Ministries Association
• International Parish Nurse Association

22. What steps do we take to start a program?
If you are considering this program for your congregation or community, it is important to assess the level of interest and the level of need within your congregation or community. Part of the survey should include exploring the willingness of members of the congregation or community to participate in a volunteer program. An exploratory committee can be formed to discuss the information and develop a process for proceeding. The Upper Valley Community Nursing Project can provide some documents that are helpful in organizing a plan.

23. What about continuing education for the nurse?
Continuing education is critical for professional growth. Local conferences should be pursued, but a regional or out-of-state conference should be encouraged once a year. Educational opportunities could be included in the benefit package.

24. Does a Community/Parish nurse only take on elders as clients?
​No, in most community and parish situations the nurses are more than willing to address the needs of all age groups. The needs of elders has been the focus of the UVCNP because that was where the demand for care was at the outset of this project.

Community Nurse with the child of a patient, 1964

Frontier Nurse, 1924

First District/Community Nurses, Melbourne, 1904

Community Nurse, 1890