August 31, 2012
Deborah Patterson knows health ministry. As the executive director of Northwest Parish Nurse Ministries and author of Health Ministries: A Primer for Clergy and Congregations, she works daily with parish nurses, pastors, and health professionals. In this feature, she answers your most pressing or perplexing questions on health ministry. Are you hitting a roadblock with a program in your church? Are you wondering where to start with health ministry? Do you feel like you need a new idea on a specific topic? Ask Deborah!
QUESTION: It seems someone in our congregation is always undergoing surgery, and because people go in and out of the hospital so quickly, we were wondering if you could give us any tips on how faith community nurses and health ministry teams can be helpful?
ANSWER: You are right—given the aging population, congregational members often will be facing surgery. As you know, the bulk of surgery is now outpatient surgery, and even for those folks who have inpatient surgical procedures, the length of stay is often very short. You can be helpful as a faith community nurse and health ministry team in a number of ways.
1. Be sure the parishioner understands the surgery. A faith community nurse can ask if the parishioner has any questions about the surgery, the health condition, or the expected recovery. (Of course, this is only if the parishioner has let you know about it; some people may want to keep some, or all, of their health information private.) Talking with a trusted health professional and friend may help alleviate some of the fears the person faces. While a parish nurse will not have the expertise of a surgeon, she or he can help someone identify if any other questions need to be addressed. This can take just a few minutes or longer depending on the person and the situation.
2. Connect with the health care facility. Ask the person undergoing the surgery to inform the health care facility which church he or she is affiliated with and the name of the clergyperson and parish nurse, even if the facility does not ask. This is the patient’s responsibility. It is the parish nurse’s responsibility to regularly remind parishioners to tell health care facilities where they go to church and give the names of their pastor and parish nurse.
3. Make sure the patient understands discharge instructions. If the surgery is major or turns out to be complicated, inquire of the patient whether you have permission to talk with the case manager in charge of discharge planning so that you can help a patient understand discharge instructions. The parishioner must give you permission to receive this information. It could be as simple as a form that you create which says this: “I (NAME), give permission for my faith community nurse (NAME), to be informed about my discharge and treatment plan.” (SIGNATURE).
4. Be present during discharge. If the patient is cognitively disabled or elderly and alone, you might offer to be with the patient during discharge. Here is a real-life example: an older parishioner had a pacemaker implanted, but didn’t catch the discharge instruction to stop taking the medication she had needed before receiving the pacemaker. The parish nurse later checked on her at home, found her doing poorly, discovered the reason, and was able to intervene. This was a person who medically had no need for home health at discharge, so there were no other health professionals to check on her and she had no other family at home. Again, you will want to have the individual sign a form similar to the one above, giving you authorization to be present (due to HIPAA regulation at the healthcare facility, not at the church).
5. Build a bridge back home. Jeanne Brotherton, NPNM network coordinator with PeaceHealth in Bellingham, Washington, reminded me recently that many faith community nurses can assist with getting someone’s home ready for post-op time. She says, “It’s amazing how difficult it can be to do Activities of Daily Living (ADLs) when one can’t walk well, can’t sit well, gets dizzy with pain meds, and so on. Having ADL aids available, as our church does, or knowing where one can easily obtain items like a shower chair, a commode, specialized pillows, cane, or walker, is an important service. You can also offer to enlarge take-home instructions so they are easy to read for someone whose glasses are not always on their face or even where the person is! Make a list of items someone might think of having at their bedside (or in a tote that can go wherever the person is) for the first few days—water mug with top and straw, cell phone or cordless phone with phone list of numbers programmed, tissues, devotional material, remote control, meds or the daily schedule for those, and so on.”
6. Include the whole health ministry team. Inquire whether the person has someone lined up to help them get to the surgery and home again. Can a trusted friend stay with the patient overnight or for a few days? Who will bring meals for a few days? I may have mentioned this website before, but http://www.lotsahelpinghands.com/ is a free site that helps you build a caring team around a patient. And of course, Caring Bridge (www.caringbridge.org) is great for sharing information about a patient that he or she wants to be shared with chosen individuals.
7. Connect back into the faith community. Particularly if a person has undergone surgery for something like repair of a broken hip, there may be a fear of getting back out and circulating again. And the person may still be in pain. Yet studies show that getting back connected and busy again is helpful both for discomfort and depression that may accompany isolation and pain. A member of the faith community can visit, pick up folks and bring them to church and to fellowship gatherings, and can get them reconnected to others.
It’s basically all about proactively educating.
- Educate parishioners to ask questions of their health care professionals so that they understand what is happening and what they need to do
- Educate parishioners to tell their health care providers that they have a faith community nurse in their church
- Educate case managers and other health professionals about what faith community nurses do.
- Educate your health ministry team about the opportunities to serve and the resources that can help them do so easily and effectively.