by the Rev. Amos Acree, R.N.
Senior Fellow on Congregationally Based Health Care Advocacy
Disciples Center for Public Witness
With the increasing complexity of our health care system, especially, but not limited to, the managed care segment, individuals feel more left out of the loop. Many of us in the early "boomer" segment and older remember a single family doctor who took care of most of our health care needs. That world no longer exists. And for many folk it never did. But for those of us who could rely on a single person to "manage" our care, we knew we had someone we could turn to for answers to questions about need care. But now, even those of us with decent health insurance coverage are often left with no one to turn to for answers—our health care providers often don't have the time, and often the answers to our concerns. With specialization, many of us regularly see several different medical providers, who may or may not be acquainted with the other conditions we have, and who surely don’t know all the side effects and warnings of the many different medicines we take. And who knows what your insurance will cover, or how much, or what conditions must be met.
One of the roles of a Parish Nurse (the more recent nomenclature of the American Nurses’ Association is "Faith Community Nurse") is to help individuals discover options for needed services, be advocates for them as needed, and to help them understand not only their condition, but to find ways to work toward wellness. Many folk feel helpless when they confront the health care system. And as well-meaning as most health care providers are, they are often overwhelmed by the caseload and bureaucratic demands.
One example I have discovered as a pastor visiting folk in hospitals concerns discharge planning. With the need to return patients to their homes or other institutions of care, most people aren’t aware of the right to understand fully their plan of care after discharge. But hospital discharge planners are often overworked, and may not be able to give as much attention to each individual as the patients and/or families would like. And floor nurses don’t always have the extra time either. But no one should be sent home without a plan of care they understand and agree to. Who can make sure the patient and his/her family do understand, rather than just saying “yes” so they can get out of the hospital? Is the needed equipment delivered before the patient will need it? Are the medicines at hand, and do we know what they are for, and do they interfere with other medicines some other doctor ordered? When will the home care nurse be there?
Another problem concerns patients (and often their families) who don’t think they "need" help. We have become so caught up in the "pull yourself up by your own bootstraps" ideology, that it is seen as a sign of weakness to have to accept help. The congregational health advocate can work with individuals and families to show them how this help will assist in their healing process, as well as provide relief for family caregivers. It also reminds us that God did not create us as isolated individuals, who are only fully human if they stand alone against the world. But we are part of a community that cares for one another, and needs each other. This is especially true for those of us caregivers who still must work, as well as take care of loved ones who need increased care and attention. It was truly a blessing for me to have such people when my wife was recovering from unexpected disability due to life-threatening condition. It enabled me to continue to do what I needed to do outside the home as appropriate, and feel that I was not abandoning my wife. It also gave her the opportunity to affirm the work of others with her.
Faith Community (Parish) Nurses can provide the advocacy individuals increasingly need in our health care world. And especially as our congregations grow older (as do the majority of our citizens), the health care needs of our members will increase. For those of us without much knowledge of how our health care system works, an advocate can truly assist in attaining wellness and wholeness.
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