Faith Community Nursing Survey



To participate in the Health Ministries Association survey of Faith Community Nurses please complete and return this survey. To return the survey you can:

Fill out the electronically using MS Word and EMAIL your survey to sonbkl@gwumc.edu

Print the survey, fill it out, and POSTAL MAIL to:

Beverly Lunsford, Ph.D., R.N.

Associate Research Professor, School of Nursing; GWUMC

Director, The Washington D.C. Area Geriatric Education Center Consortium

900 23rd Street NW; Suite 6187

Washington, D.C. 20037

Faith Community Nurse Survey

Parish Nursing was designated a specialty by the American Nurses Association (ANA) in 1998 and the Parish Nurse Scope and Standards for Practice were published by Health Ministries Association[1] and ANA in 1998.  These were revised in 2005 to reflect the ANA revision of the Nursing: Scope and Standard of Practice (ANA 2004) and the evolving practice of Parish Nursing (PN) to be inclusive of all faith communities with dissimilar faith traditions, practices, beliefs. The definition of Faith Community Nursing (FCN) is: “the specialized practice of professional nursing that focuses on the intentional care of the spirit as part of the process of promoting wholistic health and preventing or minimizing illness in a faith community.”[2]

Please answer the following questions to help us understand more about the current practice of Faith Community Nursing (FCN) and to determine the needs of FCN for education, networking, and support.

Section A. Characteristics of Faith Community Nurse

1. In your work as FCN, what do you call yourself

a. Faith Community Nurse

b. Parish Nurse

c. Other ______________________

2. As FCN, do you practice according to the ANA Scope and Standards for Faith Community Nursing?

a. Yes _______

b. No _______

c. Uncertain ________

3. Do you maintain Health Records on the clients you serve according to the Faith Community Nursing Scope and Standards for Practice, and the Nurse Practice Act of the state in which you practice?

a. Yes _______

b. No _______

c. Uncertain ________

4. Have you attended basic preparation for FCN or PN?

_______Yes _______No.

5. If you are a registered nurse, and do not practice according to the ANA Scope and Standards for Faith Community Nursing, please explain why ________________________________________________________

__________________________________________________________________________________________

6. How many hours/week, paid or unpaid, are you scheduled/contracted to work as FCN? __________

7. In addition to your scheduled hours as FCN, approximately how many additional hours do you work in the same position? _________

8. As an FCN are you: a) paid hourly ____ b) salaried____ c) unpaid____ d) Other: ____________________

9. As an FCN, do you receive benefits? Yes __________ No _____________.

If yes, what benefits do you receive? Please check all that apply.

_____Health Insurance

_____Vacation

_____Mileage Reimbursement

_____Continuing Education

_____License Renewal

_____Liability Insurance Reimbursement

_____Retirement Plan

_____Other: _______________________

10. Please estimate the percentage of overall time you spend in the following functions as FCN by assigning a percentage to each category. The total number of % should =100%. You may leave a blank or write “0” in the functions that do not apply to your ministry. This question applies to the entire faith community – all ages.

_______ Health Assessments

_______ Health Educator (e.g., classes, articles, bulletin boards, pamphlets)

_______ Personal Health Counselor (e.g., individual health information, home

or hospital visits, screenings)

_______ Health Advocate (e.g., advocate for seniors with healthcare

professionals &/or institutions)

_______ Community Resource Liaison/Referral Agent (e.g., placement assistance for

Assisted Living, caseworker consultations, referrals to Arthritis Foundation)

_______Collaborator with other healthcare professionals

_______ Volunteer Coordinator or Trainer of Volunteers

_______ Support Group Developer

_______ Integrator of Faith and Health (e.g., spiritual assessment, prayer, scripture

sharing, worship or healing services, referral to clergy)

_______Other __________________________________________________________

11. Please indicate what skills you believe are most necessary to do your job well? Circle your response.

| |Least Necessary | | | | |Most Necessary |

|Clinical Expertise |1 |2 |3 |4 |5 |6 |7 |

|Interpersonal Skills |1 |2 |3 |4 |5 |6 |7 |

|Spiritual Maturity |1 |2 |3 |4 |5 |6 |7 |

|Knowledge of community resources |1 |2 |3 |4 |5 |6 |7 |

|Knowledge of PN role and functions |1 |2 |3 |4 |5 |6 |7 |

|Time Management Skills |1 |2 |3 |4 |5 |6 |7 |

|Knowledge of Denominational Doctrine |1 |2 |3 |4 |5 |6 |7 |

|Other: __________________________ |1 |2 |3 |4 |5 |6 |7 |

12. What are the advantages of being an FCN? ___________________________________________________

___________________________________________________________________________________________

13. What are the disadvantages of your role? ____________________________________________________

___________________________________________________________________________________________

Section B. FCN Model Characteristics

1. What model of Faith Community Nursing do you follow?

______ Congregational (faith community)

______ Institutional (Please estimate the size of your institution in the categories in B. 2, 3, or 4 below

______ Other:

2. If you serve in a congregational model, what is the approximate size of the faith community you serve?

a) Under 250 b) 251-500 c) 501-1000 d) 1001-5000 e) Greater than 5000

f) Other ______________________

3. If you serve in a school or outpatient facility, what is the approximate TOTAL number of clients served in a year ?

b) Under 250 b) 251-500 c) 501-1000 d) 1001-5000 e) Greater than 5000

4. If you serve in a hospital facility, how many beds are in your facility?

c) Under 250 b) 251-500 c) 501-1000 d) 1001-5000

e) Greater than 5000

5. Check the following geographic classifications best describes the area in which your services are located?

___ Rural (open country or places/villages with population less than 2,500)

___ Small town or small city (2,500-49,999 population)

___ Urban area with a population 50,000 -250,000

___ Urban area with a population greater than 250,000

6. Please estimate the socioeconomic distribution of the faith community or institutional setting you serve by assigning a percentage to each category. The total number of % should = 100%

_______Poor

+_______ Low income

+_______Middle income

+_______Upper income

= 100%

7. What is the year of your birth? ____________

8. What is your gender? a) female ___________ b) male ____________

9. How many years have you been a registered nurse? ___________

10. In what nursing specialties do you have experience? Please check all that apply.

a) Critical Care/ED _____ b) Medical/Surgical _____ i) Other _________________

c) OB/GYN _____ d) Pediatrics _____

e) Mental Health _____ f) Hospice _____

g) Gerontology _____ h) Community Health _____

11. What is your highest professional degree?

a) Diploma _____ b) ADN _____ c)BS _____ d) MS ____ e) PhD _____ f) Other ________________

12. How long have you been an FCN? ____________________

13. Do you have a health cabinet or wellness committee? a) Yes _____ b) No _____If no, skip to Section C. 1

14. If yes, what is the occupational make-up of your health cabinet/wellness committee?_______________

________________________________________________________________________________________

15. If you have a health cabinet or wellness committee, what role do you serve?

a) Member _____ b) Chair _____ c) Other: ____________________________

16. Do you find the health cabinet or wellness committee helpful to your ministry?

a) Yes _____

b) No, please explain: ____________________________________________________________________

______________________________________________________________________________________

Section C. Characteristics of Clients Served

Please tell us about the number of clients served and/or visit volume during 2009.

| TOTAL number of unduplicated clients[3]? | |

| Total number of client visits | |

Beginning on line C3, please indicate the number of unduplicated clients by each demographic group (the sum of each category should not exceed the total number of unduplicated clients reported in line C.1.

| |Number of unduplicated clients |

|Gender |

|Males | |

|Females | |

|Ethnicity |

|Hispanic | |

|Non-Hispanic | |

|White | |

|Black/African American | |

|American Indian/Native Alaskan | |

|Asian | |

|Native Hawaiian/Pacific Islander | |

|Two or more races | |

|Other (known) race | |

|Unknown ethnicity | |

|Age |

|Infant ( ................
................

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