As one of the first parish nurses in Alabama, I often found myself simultaneously exhilarated and exhausted. The excitement of developing an innovative parish nurse program frequently dwindled into weariness as the realities of secular employment and family responsibilities inevitably emerged. While struggling to overcome fatigue and burnout, the voice of Jesus spoke with a definitive word….
Parish nurses offer hope, health, and healing to parishioners and the community by implementing wholistic health ministries. Wholistic health is imparted by parish nurses who embrace spirituality for themselves and others as the central component of health and wellness. By uniting the body, mind, and spirit, parish nurses instill a spiritual view of wellness that transcends the tangible and becomes a way of life. Parish nurses embody wholism and thus serve as wholistic caregivers, personally and professionally. Because parish nurses understand wholism to be lived and practiced, characteristic parish nurse behavior is caregiving that permeates the human experience and is inviting. The world is hungry for whole person medicine; thus, the healing touch of the parish nurse is always in demand.
CAREGIVER ROLE STRAIN
It is not uncommon for parish nurses to assume multiple caregiving roles. Parish nurses are recognized as dependable and are approached for and typically accept multiple roles of responsibility. Providing care for family members is a natural role for all nurses. By definition, parish nurses are caregivers to the faith community family (International Parish Nurse Resource Center, 2012). Parishioners recognize parish nurses as a valuable resource for wholistic caregiving and desire this support, especially in times of need. Because a key component of successful parish nurse programs is accessibility, parish nurses typically provide parishioners with several modes of communication including phone numbers and messaging systems. A part-time parish nurse program without boundaries can quickly blossom into a 24/7 counseling and support service. Some parish nurses have difficulty setting boundaries, especially as requests come in from church staff, friends, and the church family.
Parish nurse programs frequently extend beyond the church walls and become a source of community outreach. The wholistic viewpoint of the parish nurse makes him or her an obvious leader for community projects including health fairs, vaccination drives, food banks, blood drives, cardiopulmonary resuscitation (CPR) classes, and exercise classes. The weight of these events can fall on the volunteer or part-time parish nurse who can become overwhelmed and frustrated. Ministerial expectations to direct current projects while simultaneously initiating new ministries can be stressful and result in emotional and physical exhaustion.
Parish nurses often are volunteers who continue to maintain other jobs or are retired. For parish nurses who work at other nursing jobs, advances in technology, conflict in the work environment, and ongoing short staffing contribute to job dissatisfaction and fatigue. Recent cost containment measures, increased patient acuity, and decreased length of stay have heightened the level of nurse burnout. Because nurses are caregivers by nature, a decrease in one-on-one patient time is stressful and can result in frustration and guilt (Hertel, 2009). Frustration in another job drains energy from the parish nurse's capacity.
Nurses are providers of physical, emotional, and spiritual care. The beauty of parish nursing is that wholistic care can be enacted instead of remaining theory. Since spirituality is central to wholistic health, parish nurses must be prepared to provide spiritual care in any circumstance. For the parish nurse, preparing to provide spiritual care is accomplished by envisioning life as a spiritual journey in which all events have meaning. Parish nurses can be wounded healers, providing spiritual care to others while struggling to cope with personal hardship. They recognize that life events, both good and bad, must be interpreted. Helping people in the faith community to frame both wellness and illness in a spiritual light allows purpose and meaning to arise. Although faith and hope are integral components of faith, parishioners need guidance in “making sense” out of life events through reflection and moving forward with clarity. Parish nurses accept the challenge to walk alongside parishioners on a journey that values spirituality as the first and true measure of health and wellness. This is accomplished as parish nurses first accept the challenge to view spirituality as applying to all of life.
Caregivers in any setting are subject to exhaustion. However, parish nurses are at an increased risk for role strain because they can be seemingly never “off duty.” Without boundaries, some parish nurses postpone self-care measures such as adequate sleep, routine exercise, and preventative health care screenings. A lack of definitive personal boundaries can result in role conflict and stress. The resulting sense of helplessness and lack of control provokes anxiety, irritability, and depression. Spiritual health is negatively impacted when tired parish nurses neglect to spend time in solitude, prayer, Bible study, and self-care. Without personal spiritual direction, parish nurses lack guidance for the successful management of their numerous caregiving roles. Without sufficient boundaries conflicts arise; personal and professional relationships suffer. The result of this vicious cycle is compassion fatigue and burnout that are not conducive to effective ministry.
SELF-CARE PRACTICES OF CHRIST
The life and death of Jesus transformed the meaning of caregiving. Jesus was sent to care for the world through acts of selfless love and by providing salvation. The caregiving role portrayed by Jesus required continual personal sacrifice to overcome hardships and live a victorious life. Jesus did not shy away from his duties; he always was passionate about caring for others. A closer look at the life of Jesus, however, provides more than a model of how to care for others; Jesus' life also reveals patterns of self-care that are imperative for maintaining wholistic health and wellness. By examining Jesus' model, caregivers can better understand strategies for staying healthy and avoiding burnout and fatigue.
He did not do it alone
God included ordinary people in Jesus' divine caregiving plan beginning with his birth. Mary and Joseph were selected to provide care to Jesus as a baby and child. Jesus' earthly ministry was initiated when he was baptized by John the Baptist (Mark 1:9). Twelve disciples were selected by Jesus to assist with his mission (Luke 6:12-16). Jesus placed the responsibility of spreading the Good News in the hands of ordinary people commissioned to “make disciples of all nations” (Matthew 28:19).
He prepared others to help him
Jesus prepared others to engage in caregiving. During the Sermon on the Mount (Matthew 5-7), he educated the crowd about the beatitudes, declarations of blessedness congruent with sacrificial living, as well as moral and ethical standards for life. He taught followers how to seek God's will and direction by leading them in the Lord's Prayer (Matthew 6:9-15). Through his miracles and healings, such as Peter walking on the water (Matthew 14:28-32), Jesus encouraged followers to trust in God, even during the most difficult times.
He had a close group of carefully selected friends
Jesus carefully selected 12 disciples to share in ministry as well as provide wholistic support to one another. This group of close friends spent untold hours working, traveling, and relaxing together. The level of commitment was so great that Jesus trusted them with his life and the success of his worldly mission. Even when Jesus discovered that one disciple had betrayed him, he said, “Friend, do what you have come for” (Matthew 26:50, NIV).
He exercised regularly
Jesus' ministry took him from city to city, often traveling for days on rough terrain between locations. Exercise was done consistently because it was not optional; walking was the primary means of transportation.
He rested and slept regularly despite difficulties
Jesus and the disciples routinely separated themselves from the crowd to sleep and rest. After sending away the multitudes, Jesus was found going into the mountains and also out in a boat (Matthew 14:22-23). He encouraged the disciples to rest saying, “Come with me by yourselves to a quiet place and get some rest” (Mark 6:31, NIV). Jesus recognized the human need to rest when saying, “Come to me, all who are weary and burdened, and I will give you rest” (Matthew 11:28, NIV).
He ate healthy, natural foods
Jesus consumed a diet high in fish, bread, vegetables, and fruits. An example of Jesus' diet is found in Luke 24:42 where Jesus is found eating broiled fish. A common practice of the day was consuming figs from fig trees (Mark 11:13). Special occasions, such as the Lord's Supper (Matthew 26:17-30) and the wedding at Cana (John 2:1-11), found Jesus drinking wine. Bread and fish were shared when Jesus and the disciples dined with the multitudes (Mark 6:41). Meals were simple and relaxed, taking place during times of rest and fellowship.
He prayed often
Jesus initiated his earthly ministry with prayer when he was baptized by John the Baptist (Luke 3:21-22). Frequently, Jesus withdrew from the disciples to spend time in prayer (Matthew 14:23; Mark 1:35; Luke 5:16). He prayed for direction in important decisions such as selecting the 12 disciples (Luke 6:12). He routinely prayed for others with powerful results, even raising the dead (John 11:1-44).
He practiced solitude
As Jesus spent time alone resting and praying. His time in solitude refreshed him and prepared him for the tasks ahead. Jesus spent time alone in the desert and afterwards he was tempted by Satan (Luke 4:1-13). Jesus often went to a quiet place after times of teaching, healing, and miracles (Luke 4:42-44, 22:39). Luke 5:16 (NIV) states, “Jesus often withdrew to lonely places and prayed.”
He trusted God
Jesus trusted God to provide for all he needed. He instructed us in Matthew 6:25-34 not to worry about what we will eat or drink or be concerned about what clothes we will wear. He reminded us to “seek first his kingdom and his righteousness, and all these things will be given to you as well” (Matthew 6:33, NIV).
He carried out God's will for his life
Jesus' entire life was one of obedience to his Father, God. Jesus was born into the human world with a divine purpose. His travels and interactions told the story of unconditional love and sacrifice. When the time arrived for the ultimate sacrifice, Jesus prayed “...not as I will, but as you will” (Matthew 26:39, NIV). The enormity of his obedience transformed the world.
He loved unconditionally
Jesus loved and accepted others regardless of past mistakes. In John 4:1-42, Jesus interacted with an outcast Samaritan woman and offered her “living water.” Luke 23:39-43 records Jesus offering unconditional love and acceptance to the thief also being crucified with him even as Jesus was at the point of death. His entire worldly existence represented an unconditional love for humanity that transcends space and time and offers eternal hope to all (Solari-Twadell & McDermott, 1999).
A ROLE MODEL
Jesus incorporated self-care practices into his ministry. These practices serve as a model for all nurses. By adopting Christ's self-care practices, parish nurses can maintain enthusiasm and strength for the daily tasks associated with multiple caregiving roles. Specific self-care practices consistent with Jesus' model are given in Table 1.
Table 1: Self-Care P...Image Tools
Managing stress as a caregiver is important for maintaining a positive mental outlook and for avoiding stress-related illnesses. Following Jesus' example, finding consistent time for solitude enhances both overall mental health and the ability to stay focused. Empowering others to complete delegated tasks minimizes stress by spreading the workload. Following the above recommendations for sleep, diet, and exercise improves wholistic health not only by addressing physical needs but also by reducing levels of stress (Walsh, 2011).
Building strong personal relationships is critical for parish nurses so that a supportive base is present during difficult times. Just as Jesus carefully selected the disciples after time spent in prayer, relationships should be carefully considered and entered into with God's guidance. Poor relationship choices create additional physical and emotional strain. In addition, parish nurses need to develop supportive relationships with ministry partners. Selecting a group of parishioners to assist with health ministry activities not only encourages participation but increases the number of parishioners served. Networking with other parish nurses nurtures collaboration and naturally evolves into long-lasting friendships.
Engaging in spiritual self-care practices should be a first, not last, priority for parish nurses. As caregivers parish nurses cannot provide spiritual care if they themselves are spiritually empty. Jesus routinely set aside alone time for prayer. He began each day by seeking God's plan. He studied and knew the Scriptures. His model suggests we do likewise. By studying the life of Jesus, parish nurses can identify spiritual practices with timeless application. Just as parish nurses promote spirituality in parishioners, they can engage in spiritual self-care practices that keep them fit for service.
FINDING MEANING, PURPOSE, AND RENEWAL
By incorporating wholistic health practices demonstrated by Christ, parish nurses can be transformed with a holy energy that enables them to serve. When the parish nurse is healthy, a sense of meaning, purpose, and renewal arises from parishioner interactions. A circle of care emerges that invites parish nurses not only to care for others but also to be cared for. If this is to happen, parish nurses must embrace the fact that caregiving includes caring for oneself. Adopting personal wholistic health practices is not selfish; on the contrary, Jesus modeled specific self-care behaviors. By following Jesus' example, the body, mind, and spirit of parish nurses can strive for maximum health. Serving the church, family, and community in the caregiving role without a healthy model would naturally produce burnout; parish nurses must embrace the life of Jesus to find strength and health for the journey.