HEALING body and soul.

Parish nurses are just what the doctor ordered.

Kathy Copak gives flu shots, organizes support groups, visits the homebound, takes blood pressures, assesses people's health, and refers people to health care professionals or social service agencies if need be. She also listens to hurting people, prays with them, and helps them see they are still part of their parish community even though they can't join weekly worship.

Copak journeys with people in their grieving. She brings them the Eucharist and talks with them about forgiveness. She connects people who have needs with parishioners who want to help meet those needs.

Copak is a parish nurse.

One pastor she works with calls her a godsend.

Copak, 51, ministers to the people of two parishes south of Gary in Northwest Indiana: St. Michael in Schererville and the smaller, more rural Holy Name in nearby Cedar Lake. She loves her vocation.

"I never know what I'm going to get into in the course of the day," says Copak, a wife, mother of three, and grandmother.

"This morning it was a case of suspected elder abuse.

"There was a phone call from a parishioner who needed to go to a foot doctor, and I was able to arrange for someone to take them. Somebody else called because they had learned of someone who was homebound and wanted to know if the parish had had any contact with them yet. I'll have to follow up on that. Another call was from someone who wanted to start a senior citizens group."

Much of what Copak does as a parish nurse, much of how she serves, is no different from what one might expect from a home care nursing service. It's the adjective "parish" in her title that makes Copak's work a ministry.

Copak sees herself as a "pastoral partner" and as an extension of the pastors she works with at St. Mike's and Holy Name. Parish nursing works best, longtime parish nurses say, when the parish nurse is part of the ministry team, when all of a parish's professional and volunteer ministers work together to care holistically for the spiritual, physical, psychological, and social needs of parishioners.

Father Patrick J. Connolly, pastor at the 2,800-family St. Michael in Schererville, thinks Copak's nursing gifts give her an inside track to getting people to open up about their problems and their hurts. The needs Copak learns about often are spiritual and pastoral as well as medical. "She's so helpful to us because she finds the people who would otherwise slip through the cracks," Connolly says.

Lay ministers who visit the sick often find people reticent to talk about their illnesses and their hurts, the pastor has found.

"There just isn't the same trust level as when Kathy visits in the name of the parish," Connolly says. "The fact that she is a nurse gives her an entree that other lay ministers and even we priests might not have. And then she understands the health situation part that the normal lay minister or priest couldn't be expected to know.

"I joke with Kathy and tell her to slow down," the pastor says with a chuckle in his voice. "She's increased our workload. She is always finding people we didn't even know about."

Growing interest

Copak is part of a relatively recent but burgeoning movement. The idea of parish nursing blossomed less than 20 years ago when, in 1984, the Rev. Granger Westberg developed a plan to link nurses from Lutheran General Health System in Park Ridge, Illinois with six congregations--two Catholic and four in the Lutheran and Methodist traditions.

Today there are more than 3,000 parish nurses serving congregations across the country, and the number is growing. Many parish nurses serve Protestant congregations; Catholic parishes have joined in but have been slower to accept parish nursing programs.

Norma Small can attest to the growth and to the ecumenical nature of the parish nurse movement. Small is a Presbyterian who once created a parish nurse position at a Lutheran church near her employer, Catholic Georgetown University in Washington, D.C.

Small developed a short-lived graduate program in parish nursing at Georgetown's School of Nursing and has been an officer in the Health Ministries Association, a professional organization formed in 1989. She directed the development of standards for parish nurses, which were acknowledged in 1998 by the American Nursing Association.

"Back in the early days, anybody could hang out a shingle and call themselves a parish nurse," Small recalls. "If you were a caring person in a faith community, that was fine."

Today, Small says, most parish nurses are still volunteers, but many are growing in professionalism, and they are increasingly seen as valued members of parish staffs.

"As congregations begin to value the parish nurse the way they value music directors and religious-education directors, they will begin to pay them as well," Small conjectures.

Connolly of St. Michael already has come to that conclusion with regard to Copak.

"From my perspective, I'll get the money from somewhere," he says. "Especially as the priest shortage continues, she's worth every dime."

The early years of the parish nursing ministry prove that it takes time and firsthand experience for congregations to get to the point where they understand and appreciate their parish nurse and are willing to pay for the ministry the nurse provides.

Take the case of St. Mary Parish in Willmar, Minnesota, a 1,300-family congregation in a small town in the south central part of the state. Doris Hennen, a registered nurse, was a member of the parish council when its social-concerns committee suggested St. Mary look into hiring a parish nurse.

"I was very excited about it," Hennen says, "and the pastor thought it would be good, too."

St. Mary, however, just didn't have the budget for another salaried position. When the idea was floated as a volunteer opportunity, no one volunteered.

An ounce of prevention

Parish nursing programs seem to work best--and prove doable--when there is help from the outside, at least for starting up the ministry. In places such as Derby, Connecticut; Parma, Ohio; and Crown Point, Indiana, health care facilities are partnering with faith congregations to make parish nursing programs possible. In many of these situations the health care institutions recruit, manage, and coordinate the parish nurses, see to their continuing education, sponsor support groups, share technology and other resources, and even help share salary costs.

For the hospitals, this kind of support tracks with their community-outreach efforts. Daun Barrett is a parish nurse for a small Protestant congregation and coordinates the Valley Parish Nurse Program in Derby, Connecticut. The program gets sup port from Griffin Hospital and has teamed up with the Yale-Griffin Preventive Medicine department to extend programs and education to the public.

"They have realized that we [parish nurses] are a great way to reach out into the community," Barrett says, "and that we can help to keep the community well.

"Prevention is a big part of our focus. We strive to keep people healthy and to empower them to take responsibility for their own health and well-being."

Treating the whole person

While linking parishes through parish nursing programs helps hospital systems bond with members of religious congregations in an ever-competitive health care marketplace, the evolving health care situation in the United States is one of the factors that makes nurses so needed at the parish level.

Some parishes get involved because they find that health concerns are a priority for their aging membership. But aging congregations are not the only factor. "The trend to health care being a `treat and release' system is scary," Barrett says. "We as parish nurses fill in the gaps left behind by the present-day health care system. People are not just numbers in a computer system. They are real people with real needs, and the needs sometimes extend beyond themselves."

Small, who has taught parish nursing on the college level and now does so on the community level in Johnstown, Pennsylvania, sees parish nurses doing what others in the health care professions are not-treating the whole person and working to keep people well.

"When it comes to medical care we have a wonderful `sickness' system," Small says. "Nobody is trying to treat the cause of why they keep getting sick.

"From a spiritual perspective, we help them probe how they can bring their spiritual practices into creating a sense of well-being. We don't just look at a disease or an isolated, elderly person, but we look at the whole picture. We look at families, not just individuals--how family relationships impact health, the stress of parenting, and teenage issues."

Small remembers a perfect example of what a parish nurse can do for a person and in a church community.

"One person I'll always remember is the older woman who used to come in regularly to get her blood pressure checked, but she had many other issues. Blood pressure was the entree to come in and talk," Small recalls.

"Eventually it came out that she was worried about what was going to happen to her as she got older and her medical condition worsened. I was able to spot when there were definite changes in her situation, and in the long run I was able to keep her out of a long-term care facility, organizing her friends and others in the church to keep an eye out for her. Everybody was involved, including the pastor and different social groups in the congregation.

"I think we did add to her quality of life, but it was a part of her life that may have been overlooked if she hadn't come in and bared her soul."

Faith healing 

Listening as people bare their souls, feeding those souls, and helping the healing of body and soul is what makes parish nursing meaningful for Copak.

She worked in religious education--everything from preschool through high school plus adults--before fulfilling her dream of becoming a nurse. "I waited until my kids were grown then got my associate's degree and bachelor's from Purdue," Copak says. "I worked in a hospital setting, then as downsizing changes came about I went into home health care."

When Franciscan Homes and Community Services in Crown Point wanted to extend its community outreach through a parish nurse program, Copak jumped at the opportunity.

"I wasn't sure what it was, but it sounded like a great idea," she remembers. She found that her background in faith formation and her nursing skills and experience dovetailed perfectly in this new ministry.

"I pray with all the people I go to see. I don't think I ever had anyone refuse," Copak says. "In all of my visits we pray that God will help us to get through in whatever way he wants us to."

Copak will bring Holy Communion to some people. She invites them to thank God for all goodness, to ask forgiveness for anything they may have done wrong.

"I always try to take the gospel from Sunday or some scripture passage and reflect on it. It's a good opportunity to invite them to put forth their petitions, whatever's in their heart that they want to put before God in a special way.

"Often those petitions tell me a lot," Copak says. "They pour out their hearts, share the Eucharist, and we ask God to be with them for that week."

Does she see healing happen?

"Without a doubt," Copak says. "Just to be able to listen to people helps promote healing, to listen to what's going on in their hearts and their struggles--that it matters to someone.

"I find it amazing that, although a lot of people are dealing with horrific problems, they always pray for someone else--the people at work, their families, then themselves."

Helping individuals heal and stay healthy is one benefit of parish nurses' ministry. But another benefit is communal. "It's so important that people get in touch with one another," Copak says.

"Everybody's busy today. Two people need to work in a family. We read so much about terrible things going on, but I find people are so good. We have so many hurting people out there, yet people are so good. If I have a need and I reach out, people are so willing to help one another. It's a wonderful thing to be part of.

"You are able to go about and touch people personally, and of course they touch you. That's what Christ did--he walked with the people and healed them. That's what we are called to be as a Christian community."

RELATED ARTICLE: GETTING STARTED

Kathy Copak could not be part of the ministry team at the parishes she serves in Indiana if there was not a good salary attached to the parish nurse position. She works right now to help put two sons through college. Most parishes cannot afford to hire a professional registered nurse--or don't think they can afford a parish nurse.

Still, parish nursing is possible for Catholic parishes.

The first year Copak was involved, Franciscan Homes in Crown Point, Indiana paid her salary as part of a pilot project. Now her salary is split between the two parishes she serves.

Health care institutions across the country have taken on similar models to test the need for parish nursing programs. Typically, a hospital or health care provider will recruit parish nurses, train them, assign and coordinate them, even provide grants for salaries to help the ministry get off the ground.

Many parish nursing programs work on a three-year plan in which the parish takes on an increasing percentage of the parish nurse's salary. Check with local hospitals and health care institutions in your community to learn if they have such a program.

Contact neighboring parishes and faith communities and solicit their involvement with your parish. Across the country, a model that seems to be most doable has groups of parishes sharing parish nurses. In Connecticut, the Valley Parish Nurse Program in Derby covers 22 congregations from seven different religious traditions, making the program another link in Christian unity as well as health care and spiritual ministry.

Field-testing the ministry allows parishioners to see for themselves how a parish nurse can benefit them and the rest of their faith community.

"It takes about two years for a congregation to realize what parish nursing is and how it adds to the fullness of life," notes Norma Small, a parish nurse educator who runs her own business, Concerned Care Management and Consultation in Johnstown, Pennsylvania.

"The strongest programs are those started from scratch," she says. "A pastor or another member of a congregation hears about parish nursing and researches it and recruits a parish nurse."

Use and acceptance of the parish nurse tends to grow naturally as the parish nurse touches people's lives. Small recalls one pastor doing a telephone survey to see if his parish should continue the program as the trial period was coming to a close. He was amazed by the positive responses he got

"He didn't realize how many people had been touched by the parish nurse ministry," Small says.

Check with the higher-education institutions in your region. Colleges and universities often are part of the parish nursing movement In Milwaukee, for example, Marquette University's School of Nursing offers a Parish Nurse Institute to train registered nurses to work in the parish nursing field. Other colleges offer similar programs.

Get more information on the Web: The parish nurse movement has also spread to Canada and Australia. The International Parish Nurse Resource Center is located on the Internet as part of the Advocate Health Care home page. Find general information about parish nursing at: www.advocatehealth.com. Or write to the center at 205 W. Touhy, Suite 124, Park Ridge, IL 60068; telephone: [phone].

BOB ZYSKOWSKI is associate publisher of The Catholic Spirit, the newspaper of the Archdiocese of St. Paul and Minneapolis.