(This article first appeared in the December issue of the Anglican Journal.)
It takes a while for Amy* to come to the door of her apartment, and when she finally does, it seems she isn’t up for a visit.
“Did you get my message?” she asks Nancy Truscott, parish nurse at St. Paul’s Bloor Street, who has come to see her. “I’m not well today.”
Amy is 69 now, and has suffered from depression since her teens. Once she worked as a nurse; when her mother developed dementia, she devoted herself to taking care of her. But Amy eventually began to suffer from burnout, and was unable to continue. Her mother now lives in a hospital, waiting for a chance to get accepted into a long- term care home. Today, Amy lives alone; to take care of a cat, she says, would be too much for her.
She has arthritis, and uses a walker to get around her apartment. She used to attend services at an Anglican church, but now rarely gets outside. When she moved into her current apartment earlier this fall, her social worker asked Truscott to continue supporting Amy with visits.
At Amy’s door, Truscott proposes just a 10-minute visit, and Amy relents, letting us in. We take our seats in a tiny living room illuminated only by a window.
When Truscott presents Amy with a shawl, she smiles and says thank you. But it’s clear she’s having a rough day. Her doctor has recently taken her off an anti-anxiety medication, and she’s been having trouble sleeping.
Truscott has brought Amy some take-out chicken, and offers her a hot beverage, but Amy declines. Suddenly her face crumples with grief. “I’m really depressed,” she says, straining to speak through her tears.
Truscott listens, and they talk for a little while. Truscott passes along thoughts from well-wishers.
Every few minutes Amy starts to cry again. “I’m awfully sick, Nancy,” she says. “I don’t know what to do anymore.”
Truscott has brought the most church recent bulletin, and offers to read a Bible passage, but Amy declines. She can’t concentrate, she says.
She does join hands with Truscott when Truscott offers to pray for her. She asks God to show Amy the way forward. Amy joins Truscott at the end in a murmured “amen.” “I think you’ll get better, Amy,” Truscott says gently. “You’re a fighter. You really are.”
Truscott, who worked for Toronto Central Community Care Access Centre for 34 years before retiring last year, has also been working part-time as parish nurse at St. Paul’s Bloor Street since 2005. She serves as lead staff member for the church’s health ministry, which includes, among other things, programs on dealing with grief, depression, separation, divorce and cancer.
Elsie Millerd, parish nurse at Church of St. John the Evangelist, Kitchener, Ont.
Photo: Huron Church News
No one knows how many Nancy Truscotts there are in Canada. Parish nurses exist across many denominations and no count is kept even within denominations, says Elsie Millerd, parish nurse at the Church of St. John the Evangelist in Kitchener, Ont., and former chair of the education commit- tee of the Canadian Association for Parish Nursing Ministry (CAPNM). There might be roughly 200 of them in this country, she says, possibly a couple dozen of whom might be Anglican. But parish nursing, she says, has been quietly growing since it first came to Canada a quarter-century ago.
At the heart of it, Millerd says, is a “holistic” approach to well-being-a desire to look at the whole person, providing not just health care as it is commonly understood, but spiritual care as well. “We are spiritual beings as well as physical and emotional, so if our spiritual self is disconnected in some way, then that’s going to affect the rest of our health,” Millerd says. “And also if our physical health is suffering, then that’s going to affect all the other parts of us. We’re just integrated.”
Prayer, for example, can affect physical health by promoting feelings of calm and hope; many scientific studies have shown that people who feel hopeful are likely to heal faster, she says.
But prayer has another purpose apart from any bene ts it may bring to physical health: helping the patient find God. For Christians, she says, this can also be an important aspect of true palliative care.
“Our hope is in God, right? And our hope may not always be for total physical healing. That may not be possible,” she says. “And I just watch one person after the other who dies. But that’s part of who we are, too-our healing may be just in that peace- ful death, in coming to a peace with God, so that we can accept what’s happening in our life.”
In North America, parish nursing traces its immediate origins to the Rev. Granger Westberg, an American Lutheran pastor. Westberg spent much of his life trying to integrate health care with spiritual care, and began organizing parish nurse programs in the 1980s. More fundamentally, Millerd says, parish nursing is really only reclaiming a traditional task of the church; the fore- bears of today’s nurses were nuns.
Parish nursing appears to have spread to Canada at some point in the 1990s, Millerd says. The CAPNM, which, among other things, sets standards and core competencies for parish nurses, was founded in 1998.
Parish nurses are required to take a special course on top of their regular nurs- ing training. Few parishes can afford to hire full-time nurses, so generally, parish nursing work is part-time; Millerd is paid for eight hours of work per week, and donates a few extra hours of work in addition.
Much of her own work, Millerd says, is with the elderly-parishioners suffering from dementia, for example. But the work can be quite varied, she adds. It could include helping young families in the church develop healthy eating habits for their children, hosting mental health events at the church and supporting people undergoing cancer treatment.
Another important part of the work is advocacy-helping parishioners navigate their way through the health-care system and making sure their needs are understood by secular doctors and nurses. Parish nurses can also serve as organizers of “circles of care” around parishioners who are unwell, she says, by mobilizing other members of the parish to take part in visiting them and otherwise helping them in their need.
As Truscott’s visit, which has stretched to about 20 minutes, comes to an end, Amy remains despondent. “I don’t think I’ll ever go back to being myself again,” she says through tears.
I ask her if Truscott’s visiting her makes a difference. “It makes a big difference. It’s something to look forward to, because most of the time I’m sick,” she says.
She starts to cry again when I ask her specifically about the prayer. “It just makes a difference. That’s all. It’s uplifting.”
* To protect her privacy, the Anglican Journal has avoided using Amy’s real name in this article.