Anglican Taonga: September 2015
All manner of things shall be well
Anglican Taonga editor Julanne Clarke-Morris visited Nelson in July 2015 to meet the region's faith community nurses and suss out their ministry.
Sarah met Dave on her parish nursing round.
A very overweight man, Dave was a heavy smoker and drinker and lived in one of "the most dilapidated, unbelievable environments" Sarah had seen. But he was happy there.
"He gave me such a hard time," she recalls with a laugh. "He called me 'Doc' and hassled me for wearing high heels."
Dave's health was fine by him, except for his leg. Even medication wouldn't stop the pain.
"Let's get it checked," said Sarah, "maybe we can find the problem."
But Dave refused to see the doctor.
So to ease his daily shuffle to the shop, Sarah found him a metal walking frame.
It didn't last long. Dragging it across the concrete every day, Dave scraped a foot-length off its hind legs.
"Looks like you'll need a new frame," said Sarah, "perhaps with wheels this time?"
"All right, Doc," he replied. "You work at the hospital don't you?
"How about you go down there and wait in a hallway. When some old lady puts hers down – you can nick it for me."
* * * * *
Sarah didn't follow Dave's plan, but he did get a new frame.
And Dave's story sets the scene on what parish nurses do.
They use their skills – social, medical and spiritual – to help others live more fully, starting from where they are now.
Sarah didn't stand apart from Dave, or try to judge him. She knows he is part of the body of Christ, and good relationships lead to healing.
That was in place before Sarah offered medical advice.
Then she waited for Dave to take his next step.
In time, thanks to Sarah, Dave made it through all the doctor's visits, scans, specialists and surgery he needed to fix that leg for good.
* * * * * *
Anglican parish nurses have worked in Aotearoa since the late 1990s, inspired by the Rev Granger Westberg's US movement, which set off in 1984.
As fully trained, Christian, currently registered nurses, they offer care to church members and parish communities.
While modern parish nursing is still new, its roots reach back to the mid 19th-century. Florence Nightingale's nursing reforms evolved from what she had seen of Lutheran deaconesses nursing the poor in Germany.1
New Zealand's most famous nurse was driven by her Christian faith and invariably prayed with her patients.
Sibylla Emily Maude – better known as Nurse Maude – grew up in a devout Christchurch Anglican family in the 1860s and 70s. She too was inspired to nurse the poor by deaconesses – this time Anglican ones, who later became the Community of the Sacred Name.2
Nurse Maude's pioneering work grew into the Royal District Nursing Service of New Zealand.
So while the title is new, the bedrock of holistic modern nursing lies in faith community nursing.
Today Nelson's parish nurses question whether 'holistic' applies to mainstream nursing.
"Holistic nursing doesn't really exist outside parish nursing, " says Dianne MacDonald, clinical nurse leader for Te Piki Oranga Maori health organisation.
"... Maori nurses can include spirituality from Maori models of health, but in wider nursing practice a referral to the chaplain is all it takes to tick the spirituality box.
"That is not spiritual care."
Evidence from the Nursing Council supports a sceptical perspective.
Every three years, to stay in practice, registered nurses must prove their aptitude across 50 medical, interpersonal and cultural skills known as "competencies." Not a single "competency" mentions spiritual health.
"Spirituality is in the 'too hard' basket for most health professionals," says Rachael Westenra, parish nurse in Awatere and Marlborough.
"Any mention of spirituality conjures up vague ideas about religion. There's a lack of understanding among nurses as to what spirituality means."
"Some people pray to God with words, but others show gratitude for what gives them joy and peace – their garden, a good conversation, or a rainbow at the right moment."
Raewyn Parkes is parish nurse in Blenheim, Picton and Spring Creek. She often prays with people she cares for.
"Prayer is as natural to the work as any other health procedure I follow," she says.
"But it is not about imposing the spiritual side.
"It's about sensing when the time is right."
One parishioner used to say no to prayer, then changed her mind following a traumatic experience,
"As I prayed, the tears welled up in her eyes. ‘I needed that,’ she said."
For the nurses, God's healing presence is palpable.
"There are so many times I think I was meant to be there – that God was in that,"
"That doesn't happen in my clinical practice."
Raewyn remembers a distress call from a young parish dad.
His child had been born with a condition he didn't understand. Hospital staff were speaking a load of confusing jargon, and memories of a bad hospital experience had thrown his confidence.
By the time he got through to Raewyn, he was frustrated and angry.
So she quickly rejigged her schedule and went to his side.
"Nathan looks pretty rough," says Raewyn, "He has tats and doesn't speak the most refined English. But he's a good dad."
Raewyn stayed close through hours of diagnostic tests, quietly explaining each term and procedure. She spoke to the medical staff, but only once.
"This is the baby's father," she said. "He is wondering about the long-term plan for his child's care, once they leave here today."
That was a game changer: staff swung into action, and after a few calls and some paperwork the family were under district nursing care.
By day's end, Nathan could speak to a room full of doctors looking into his child's care. "He said that was his best experience of hospital care," Raewyn says.
* * * * * *
Elaine Tyrell has championed parish nursing around Aotearoa and in the Anglican Church.
Nelson Cathedral's parish nurse from 1998-2003, Elaine and husband Charles Tyrell (then Dean of Nelson and himself a former nurse) helped found the New Zealand Faith Community Nursing Association (NZFCNA).
Today Elaine is national adviser to the association, which offers specialist FCN training through written modules and annual training seminars. In 2015, new models of dementia care and spiritual health are on the agenda, as well as peer reviews.
Val Sirrett followed at Nelson Cathedral until 2009, when Jane Wulff became its current parish nurse, also taking on the Atawhai-Hira Anglican churches.
Care at home
Jane Wulff sees Ivan Taylor and his son and caregiver, Paul, in their home every couple of weeks. As Jane measures Ivan's blood pressure, she chats with the two men.
"That looks good today," she says brightly. "How are you feeling?"
"My nerves are not great," says Ivan. Yesterday's visit to the doctor has tired him out.
Ivan's Chronic Obstructive Respiratory Disease (Emphysema) means he has to take a gas tank everywhere with him so its plastic tubes can supply the oxygen he needs. Exertion makes it tougher to breathe.
So horizons are shorter these days for a man who sailed the oceans in the British Navy before he fell in love with New Zealand. "It struck me and my shipmates as heaven on earth."
Ivan immigrated, married Mary, and they had a family here. By the time he retired in Dunedin, he'd attained the job every kid dreams of – production manager at Cadbury's chocolate factory.
Jane peppers such talk of family and former times with low-key health assessments: "Are you sleeping well?"..."Did you find someone to help while Paul's away?"
Ivan has perked up by the time Jane packs her things away.
As usual their visit closes in prayer.
Alongside the staple of home visits, Jane runs health promotion seminars (on stress, diabetes, arthritis, vision, hearing, WINZ, stroke, funerals, Alzheimer’s and victim support so far) as well as a foot clinic.
She leads the cathedral pastoral team and keeps in touch with five congregations through worship and fellowship.
"Jane's work on the pastoral team gives me real peace of mind," says Nelson's Dean, Nick Kirk (another former nurse)
"With her here, I know the sickest members of the community are receiving good care.
"And that frees me to engage with the wider community.
"I still stay in touch, but I know that Jane is sensible and appropriate – and she can pray with them, too."
Cathedral parish nurses and physiotherapist Maureen Wagg set up a walking group 10 years ago to combine exercise with a midweek get-together. This ensures they win on physical and mental health.
Only the foulest weather wards off this walking troupe on their hour-long Wednesday hikes round Nelson's city centre.
Some walkers volunteer at Jane's monthly 'Living Alone' afternoon tea, too. This social space connects isolated people for conversation and homemade treats.
"People love it. They linger, and never go home by finish time," says Jane.
* * * * *
For five years, Nelson Cathedral parishioner Rosemary Crow has met monthly with Jane Wulff to pray for her nursing ministry.
Rosemary is pleased to support Jane and place her work before the Lord.
Rosemary says life can be fraught, but you wouldn't guess it, seated in her stylish home, where a tasteful morning tea greets Jane each time she comes.
Ten years ago multiple strokes rained down on Rosemary's husband Chris over a whole day. That took its toll, and Chris's long recovery has taken hard work.
But neither Rosemary nor Chris are strangers to toil. Both are retired teachers who ran Opunake High School's English and Social Sciences departments, directed shows, and turned out to celebrate peace at Parihaka.
"Rosemary's support and prayer is a vital part of my ministry," says Jane.
"But it's also good for me to see how you are going."
"Of course it is." says Rosemary, "You are good at keeping an eye on everyone."
* * * * *
Feet are the last thing Rachael Westenra is interested in.
But they have taught her about the soul of parish nursing.
Parish nurses often run foot clinics: to build community, offer foot care, assess wider health needs and pamper people a little.
Jo Grieg attends Jane Wulff's foot clinic at her church, St Peter's Atawhai.
After her nail care is done, Jo relishes the bonus foot and calf massage.
"By the time I walk out of the church, I feel like I'm walking on air," she says.
One couple told Rachael Westenra they felt part of the community only after coming to foot clinic.
"It's the touch," she says. "It does something."
But getting down on your knees does something too, adds Dianne MacDonald.
"Often as health professionals you are above people – standing over them in a bed, or above them because of all this knowledge you have," she says.
"But when you sit on the floor and work at their feet, the power changes.
"Jesus washed people's feet, and so do we."
Title: After Julian of Norwich, from her Revelations of Divine Love, “All shall be well, and all shall be well, and all manner of thing shall be well.”
1. Louise Selanders. 'Nightingale, Florence,' from the Encyclopedia Britannica, URL: http://www.britannica.com/biography/Florence-Nightingale
2. For a time, Nurse Maude lived at the Community of the Sacred Name and ran a health clinic from a room there. Beryl Hughes. 'Maude, Sibylla Emily', from the Dictionary of New Zealand Biography. Te Ara - The Encyclopedia of New Zealand, http://www.TeAra.govt.nz/en/biographies/2m42/maude-sibylla-emily