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Faith Community Nursing Aligns with New Trends in HealthcareJan Erlenbaugh Gaddis, BSN, RN-BC, Faith Community Nurse

2019 Convention ISNA

JEG2

How will this presentation help attendees?

�To increase awareness of faith

community nursing and health

ministries across the state of

Indiana and the nation for

partners in healthcare

Faith Community Nursing

Integration of:

� Faith and Health

� Nursing and Spiritualty

� Personal and Professional

� Pastoral care and nursing care

� Spirituality and Health

� Local and Global

� Prayer and Work = Contemplative

� Non-Action and Action = Being and Doing

� Prophetic and mystic

Slide 1

JEG2 thank you for invitngJan Erlenbaugh Gaddis, 8/31/2019

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My FCN journey and mission/vision…

� Pediatric Nursing at Riley & VNS peds & Hospice peds)

�Wishard’s Child Assessment Clinic

� Parish Nurse – Holy Cross, supported by Franciscan Health

� School Nurse part-time at IN School for Blind and Visually Impaired

�Complemental jobs – health and wellness + clinical skills

� Expanded to St. Philip Neri and work with Hispanic population

� RN-BSN program – explore FCN formally thru Transitional Care

Capstone project

� Currently to Palliative Care program at Franciscan Health with FCN

to bridge a gap in spiritual care

My FCN journey and mission/vision:

�Celebrate 44 years of nursing, 22 as parish/faith community

nurse at Holy Cross Catholic Church

�Show up, Be present (Mindfulness), & Be the best can do

� Build relationships – trusting, faithful, non-judgment

�Make connections – partnerships and collaboration

� Be of service by

�Offer hospitality and generosity

�Being a healing presence of Christ for others

Faith Community Nurse (FCN)

Scope and Standards of Practice (2017)

� ANA recognizes faith community nursing as a nursing

specialty in 1998.

� Faith Community nursing acknowledges spiritual care as a essential component of a specialized body of nursing

knowledge and competencies.

� FCN provides care to individuals, families, groups,

communities, and populations (healthcare consumers) with emphasis on promoting whole-person health.

American Nurses Association & Health Ministries Association. (2017). Faith community nursing: Scope and standards of practice.

(3rd ed.). Silver Springs, MD: Nursebooks.

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Goals of an FCN:

� Protection, promotion & optimization of health & abilities

� Prevention of illness and injury

� Facilitation of healing

� Alleviation of suffering through the diagnosis and

treatment of human responses and

� Advocacy in the context of values, beliefs , and

practices of a faith community, such as a church,

congregation, parish, synagogue, temple, mosque, or

faith-based community agency

American Nurses Association & Health Ministries Association. (2017). Faith community nursing: Scope and standards of practice.

(3rd ed.). Silver Springs, MD: Nursebooks.

FCN and whole-person care

� Intentional care of the spirit

� Practice caring relationships that promote trust

� Understanding that health as a dynamic process that

embodies the dimensions of the person:

�Spiritual

�Physical

�Mental

�Social

Mind-Body-Spirit

American Nurses Association & Health Ministries Association. (2017). Faith community nursing: Scope and standards of practice.

(3rd ed.). Silver Springs, MD: Nursebooks.

FCN ~ partnerships and collaboration

� FCN Professional organization is Health Ministries Association (HMA) (hmassoc.org)

�Collaborates with ANA for scope and practice

�Partnered ANCC for board certification by portfolio (2015-

2017)

� Westbeg Institute for Faith Community Nursing (WestbergInstitute.org)

� A ministry of Church Health in Memphis, TN to provide curriculum

for Foundations of FCN and many innovative resources and education

� Indiana Center for Parish Nursing (ICPN)

and Health Ministries (IndianaCenterforParishNurses.org)

� Franciscan Health and other health systems

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� Blood pressure screenings

� Health fairs and vaccinations clinics

� Home visit, hospital and extended care facilities visit

� Church and office visit

� Educational and health promotion program

� Partnership and collaboration with other health agencies to bring services

and programs to community and congregational settings

� Document the journey

Health Ministries –

congregational health activities

RN-BSN Capstone Project – 2017

�“Faith Community Nursing Bridging

the Gap in Transitional Care”

�Based on the Faith Community Nurse

(FCN) Transitional Care Model (Ziebarth & Campbell, 2014)

Faith

Community

Nursing

bridging

the gap in

transitional

care

Step 1

FCN provides community based care with whole person approach

Step 2

Develop pilot program to assist Franciscan Health

decrease readmission rates

•Comes full circle to expand continuity of care in the community setting to increase quality living and decrease hospitalizations and palliative care needs/support

Step 3Implement pilot program and gather data for transitional care

Gaddis (2017)

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Faith Community

Nursing

bridging

the gap in

transitional care

•Review of literature - how FCN bridges the gap in transitional care.

•Evidence based practices and FCN model for continuum of care

•Identify stakeholders and work with preceptor to cultivate ideas for Franciscan Health

Step 1FCN provides

community based care with whole person

approach

•Pilot program with FCN partnership with palliative care and Accountable Care Organization (ACO)

•Identify referral process, criteria for referrals, and patient eligibility (live within 46201 zip code area)

•Make contact with patient/caregiver within 48 hours of referral received to set up home visits

•Utilize nursing process with intentional care of the spirit

•Referrals to community resources, education, health coaching

Step 2Develop pilot program to assist Franciscan Health decrease readmission rates

•Collaborative, interdisciplinary team approach

•Key interventions: Medication review, self-care education, spiritual care, critical contacts, care coordination, and resource coordination

•Document the program to tie diagnosis to dollars

•Share new information

•Comes full circle to expand continuity of care in the community setting to increase quality living and decrease hospitalizations and readmission rates

Step 3Implement pilot

program and gather data

Gaddis (2017)

FCN Interventions in Transitional Care

Transition from hospital to home

Transitional Caare Training Guide for Faith Community Nurses (2017)

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Faith Community Nurse Interventions and

Transitional Care Approach based on NICsProvide interventions which help reduce readmissions

Priority transitional care interventions

provided by FCN:

� Coping Assistance

� Communication Enhancement

� Patient Education

� Information Management

� Health system mediation

� Physical comfort promotion

� Lifespan Care

� Behavioral support/therapy

� Activity and exercise

Management

� Cognitive support/therapy

� Self-care Facilitation

� Childbearing Care

� Drug Management

� Nutrition support

� Community Health promotion

Transitional Care Training Guide for Faith Community Nurses (2017)

Transitional Care Training Guidefor Faith Community Nurses

Faith Community Nurse Interventions Transitional Care6 Key Interventions

* Spiritual Care

* Critical Contacts* Care Coordination* Resource Coordination* Medication Review * Self-care Education

Evaluation of project:

Strengths� Cultivate positive relationships

� Trusting relationships with patient/healthcare consumers

� Professional conversations

� CM/CCC was supervisor with ACO

� Nurse expert with FCN practice

� Overwhelming positive response

� Multiple community resources

� Share best practices of FCN

Weaknesses� No consistent congregational

support for non-medical needs

� Comprehensive medication reconciliation lacking

� Time constraints of FCN

� Need is greater than availability

� Only one part time FCN

Gaddis (2017)

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Summary of Project - FCN offers:

� Intentional Care of the Spirit for healthcare consumers

�Attentive listening, prayerful presence, grief support

� Hope instillation, caregiver support

� Increase quality of life and lower health care cost

� Identify gaps in spiritual care support

and advance care planning

� Leadership in nursing and spirituality

� Self-care support/advocacy

Gaddis (2017)

AS24

Next steps with Transitional Care

towards Palliative Care� Completed BSN December 2017

� Invited to work part-time in Palliative Care Outpatient department

� Aligns with whole person care and intentional care of spirit

� Continue to expand to interested FCN in community for added support

� Take extra course/certification program in spiritual care for nursing

� Obtain Certification as Spiritual Care Generalist

� December 2018 leave parish work

� January 2019 expand FCN work in palliative care to bridge a gap with spiritual care (Domain5) Center to Advance Palliative Care, Capc.org

FCN Trends toward Palliative CareBridging a gap for spiritual care …

� Provides interdisciplinary care that aims to relieve suffering and improve quality of life for patients with advanced illness

and support for their families.

� The emphasis of Palliative Medicine is on the control of pain

and symptoms, meeting physical, emotional, spiritual, social,

cultural, and bereavement needs

� Faith Community Nursing aligns with this whole person

approach for healing and wholeness

� FCN supportive care with intentional care of spirit, attentive listening, giving permission to talk, acknowledging the Sacred,

being a healing presence of Christ for others

Palliative Care model at Franciscan Health (2019) and CAPC

AS25

Slide 19

AS24 goodAnita Siccardi, 9/8/2019

Slide 21

AS25 changing topic here to another trend; either include another slide

to introduce it or make that transition in what you say because this

is important.Anita Siccardi, 9/8/2019

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Nursing and Spiritualty

� FCN and Westberg Institute partnership with Spiritual Care Association and HealthCare Chaplaincy Network to create learning modules in spiritual care for healthcare professionals

� “Spiritual care is integral in all of nursing practice”(Nursing Scope &

Practice, 3rd ed. ANA, 2015)

� Spiritualty is universal in each person/being

� Nursing is relationship based care, integrative and Presence

� Spiritual history & assessment tools: FICA & H.O.P.E.

� F – Faith and Belief H: Sources of hope, meaning, strength

� I – Importance O: Organized religion

� C – Community P: Personal spirituality and practices

� A – Address in Care E: Effects on medical care & end of life issuers

SpiritualCareAssociation.org/Nursing

FICA Spiritual History Tool, Copyright, Christina Puchalski, MD (1996)H.O.P.E. Questions for a Formal Spiritual Assessment in a Medical Interview (2001)

AS27

Nursing and Spirituality

FCN spiritual care support in Palliative Care

Fills as void, bridges a gap in spiritual care domain for extra support:

� Ministry of Presence – Being a healing presence of hope

� Formal prayers vs prayerful presence – find what is most comfortable

� Attentive listening – Meet them where they are

� Be attentive to them, Listening to stories is a spiritual act

� Caregiver support – Pay attention to the family and how they are impacted too

� Anticipatory grief and loss, build trusting relationships

� Community resources for caregivers

� Give permission to talk/share/think about end of life issues

� Advance care planning and goals of care discussions

� Assist with health care representative forms (HCR)

� Peace and calm, non-judgmental

� Let go of outcome – a healing principle

Palliative Care/FCN model at Franciscan Health (2019)

FCN support Self-care in Nursing Church Health Model (churchhealth.org)

� Self-assessment & self-care plan

� Sabbath care principles

� Create an environment of well-being

� Assess “compassion satisfaction”

� Compassionate care for self Whole person care = Wholistic

� Find a balance work and home

� Reduce your stress load daily

� Move outside of the box of formal/rules

� Creativity and mindfulness

� Art as Meditation

� Meaningful relationships

� Cultivate resilience

� Celebrate life of joys and hopes

� Get Moving!!

Slide 22

AS27 maybe this needs to be in your references or resources at the endAnita Siccardi, 9/8/2019

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Self-Care and Sabbath Care…(creative expressions)

JEG1

Slide 26

JEG1 Jan Erlenbaugh Gaddis, 8/18/2019

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PRAYER OF ST. FRANCIS

Lord, make me an instrument of your peace.

Where there is hatred, let me show love;

where there is injury, pardon;

where there is doubt, faith;

where there is despair, hope;

where there is darkness, light;

and where there is sadness, joy.

O Divine Master, grant that I may not so much

seek to be consoled as to console;

to be understood as to understand;

to be loved as to love.

For it is in giving that we receive;

it is in pardoning that we are pardoned;

and it is in dying that we are born to eternal life.

Amen.

Reference listAmerican Nurses Association and Health Ministries Association. (2017). Faith community

nursing: Scope and standards of practice. (3rd ed.). Silver Springs, MD: Nursebooks.

atom Alliance (2017). Retrieved from http://atomalliance.org/initiatives/coordination-of-

care/

Campbell, K. (2017). Transitional care training guide for faith community nurses.

Memphis, TN: Church Health Center.

Dyess, S. M. (2012). Sustaining health in faith community nursing practice. Holistic Nursing

Practice. 26(4), 221-227. doi:10.1097/HNP.0b013e3188258527c

Lentz, J. (2018) An innovative role for faith community nursing: Palliative care. Journal of Christian Nursing. 35(2). 112-119.

Ziebarth, D. (2015). Factors that lead to hospital readmissions and interventions that

reduce them: Moving toward a faith community nursing intervention. International

Journal of Faith Community of Faith Community Nursing 1(1). Retrieved from

http://digitalcommons.wku.edu/ijfcn/vol1/iss1/1

Ziebarth, D. & Campbell, K. (2016). A transitional care model: Using faith community

nurses. Journal of Christian Nursing, 33(2), 112-118. doi:10:1097/CNJ.0000000000000255

AS30AS31

Franciscan Health Out-patient Palliative Care Department317-528-6298

Jan.Erlenbaugh.Gaddis@franciscanalliance.org

Slide 29

AS30 articles published on palative care or hospital readmissionsAnita Siccardi, 9/8/2019

AS31 anything recent?Anita Siccardi, 9/8/2019