Congregations embarking upon parish nursing ministry must make decisions about insurance coverage for both the church and for the parish nurse. The information provided below will assist the decision making process. It is divided into three sections:

• A discussion of American Nursing Association practice standards (for parish nurses)
• Questions and answers about what parish nurses do
• A list of companies that write malpractice and liability insurance for parish nurses

As advocates, they:

• work as map readers for the health care maze
• assist with values clarification around important decisions (like end of life issues)
• help those in need understand their diagnoses, lab results and medicines
• help those in distress access a physician when medical help is needed
• help explain parishioner concerns, situations or extenuating circumstances to physicians (when given permission to do so).

As referral resource persons, they:
refer parishioners to needed sources of help when they don't know where to turn and collaborate with other members of the health care provision system.

As volunteer coordinators, they:
enlist the help of their congregation(s) in rallying around the need of those in distress.

What do ministers of health do?

Ministers of health may do many of the same kinds of things. The primary difference is an issue of licensure (which implies independent competency). The above interventions fall within the scope of nursing practice but are not confined solely to the realm of nursing. Some states require active licensure as a registered nurse (RN) from all who take the title of "nurse" in community based settings. Only registered nurses are licensed to practice nursing autonomously. Licensed practical nurses (LPN) and RNs who have dropped their license must take the title of "Lay Minister of Health."

Can an LPN be a parish nurse?

No, but an LPN can either serve as a lay minister of health or as a member of the health committee a lay minister of health.

What don't parish nurses do?

• Parish nurses are not free home health nurses in churches, but they do facilitate access to home care service providers when needed.
• Parish nurses do not provide hands on care. They don't give shots. They don't do dressing changes. They don't administer medications, but they do facilitate access to technical care provider services when needed.
• Parish nurses are not free social service caseworkers, but they are licensed to promote well-being or crisis resolution through referral. Professional nurses are bound to help parishioners access needed community services.
• Parish nurses often consult social service providers for situational guidance.
• Parish nurses are not psychiatric counselors, but they listen and guide parishioners through the process of accessing needed emotional and mental health provider services. Often they are part of the community-based after-care support team, but they are not the primary caregivers in complex situations.
• Parish Nurses are not 911 permission givers. They educate parishioners about signs and symptoms that warrant prompt attention, but permission to call 911 is never needed! Parish nurses help people access their physicians when needed, but they are not a formal part of the emergency response team. They are not to be regarded as cost effective 911 intermediaries!
• Parish nurses do not give medical advice. It is outside of their domain to assign medical diagnoses or to recommend prescriptions, but they can interpret medical language, diagnostic meanings, and test findings when parishioners do not understand the meaning of what they have been told. They help parishioners communicate with their physicians more effectively. They offer advocacy when invited to intervene.
• Parish nurses are not a substitute for pastors. As Ministers of the Word and Sacrament, pastors are better equipped to address theological struggles and related self-destructive belief patterns.
• Parish nurses ministries are also spirit-centered, but they focus less on beliefs, and more on issues of functional well-being and resolvable barriers to well-being.

How does parish nursing benefit a congregation?

• Parish nurse efforts help parishioners feel cared about and valued.
• Parish nurse efforts bring healing and reconciliation to parishioner hurts and rifts.
• Parish nurse efforts help parishioners find meaning and purpose (spiritual well-being).
• Parish nurses speak the language of both faith and health care providers. Parish nurses facilitate communication between caring partners. Translations regarding status and plans empower pastors to be more effective as healers and advocates.
• Through parish nursing the church is reclaiming its role in healing, its right to a voice and its right to a place in the health care team.
• Parish nurse efforts spell pastors from the demands of chronic illness support needs.
• Parish nurse efforts catalyze organized congregational responses to widespread needs within the congregation. Thus they build a sense of community.
• Parish nurses create safe opportunities for sharing. Sharing is therapeutic.
• Parish nurses help people realize that congregational membership and faith are health strengthening.

Why would a church want to pay for a parish nurse?

• To demonstrate commitment to the health and well-being of parishioners.
• To affirm the pastoral team member aspect of the role so as to lend permission, stabilization, and acceptance within the congregation
• To affirm and uplift the professional nature of the role and to thereby empower it
• To enhance a sense of accountability and collaborative submission
• To enhance the collaborative possibilities that this kind of affirmation promotes

Why would health care systems be involved in parish nursing?

• Many health care leaders have personal faith-based value systems.
• Parish nursing is an expression of faith-based missions and visions.
• Parish nursing provides collaborative, innovative, cost-effective partnership opportunities and affirmative relationships with the grass roots community echelon.
• Parish nursing role models a system attitude of caring and whole person concern.
• Parish nursing reclaims a historical and presently needed partnership in health care.
• Parish nursing visibly reintegrates the faith factor in health care which is powerfully affirmed by contemporary research.
• Parish nursing is healing the consequences of significant community-wide disillusionment with health care.
• Health care is more than medicine. Health care must be spirit-centered and whole-person focused. Faith plays a significant role in whole person well-being.