Mercy Health team cautiously resumes parish nursing program

December 1, 2020


Knowing how skittish some people have been about returning to hospitals and clinics with the threat of COVID-19 lingering, the parish nursing team at Mercy Health — Lorain Hospital in Ohio decided to be deliberate in how they went about restarting a parish nursing program that had been put on hold for months because of the pandemic.

Nurse Donna Sims, second from left, hands off supplies for medical screenings to Linda Capers, a volunteer with the parish nursing program, at an event at Second Baptist Church in Lorain, Ohio. Sims is part of the parish nursing team at Mercy Health — Lorain Hospital.

First, the team reached out to the pastors of the participating churches to see if and when they would be ready to resume the screenings and exercise programs that are offered mostly free to the public through the program. Based on the issues raised, the team set up video meetings to provide open forums between the pastors and the Lorain County Public Health director, an infectious disease doctor from Mercy Health — Lorain Hospital and other experts.

"It allowed them to be totally vulnerable, to ask whatever questions they wanted," Catherine Woskobnick, who leads the parish nursing team as part of her job as Mercy Health — Lorain director of community health, said of the forums.

The parish nurse team got a grant from the charitable Community Foundation of Lorain County to stock "COVID boxes" with masks, gloves, thermometers, cleaning supplies and precaution-related signage. After they had distributed the boxes — actually, large plastic bins — to the churches, the team, working with their volunteer counterparts at each of the churches, began the program's relaunch in June.

By mid-September, the team — Woskobnick, two registered nurses and an office coordinator — had overseen nine of the screening events that are the core of the program, making sure that COVID-related precautions such as social distancing, hand sanitizing and masking were in place. Those first nine screening events drew more 200 people for blood pressure checks, blood sugar tests and other wellness assessments.

"In this time of COVID, what's been one of our biggest barriers is that people are afraid to come to the hospital," Woskobnick said. "But they trust their churches and they've always trusted their churches, where the word of God is spoken and where their pastor is guiding them and using God and Jesus as an example. That's where their hope and inspiration is."

Safe spaces
Sharon Wyckoff, a registered nurse who has been part of the parish nursing program for nine years, sees that trust in faith-based institutions as key to the success of the program. "Even if it's not their church, they feel safe before they walk in the door," Wyckoff said of those who come to the screenings.

The Sisters of the Humility of Mary, foundresses of Lorain Hospital, started the parish nursing program there in 1994 with health care outreach to just a few Catholic churches. It has since expanded to 92 churches of various denominations, including Baptist, Methodist and United Church of Christ. In 2019, 12,000 people took advantage of the screening events. The 350 fitness classes that also are offered annually under the auspices of the program have drawn about 17,000 people. Some of those classes have been moved to the virtual realm, others have resumed in-person with COVID precautions in place.

The specific offerings of the program vary from church to church, depending on the congregation's preferences. "There's a needs assessment that we can go through with them to find out what they think they need," Wyckoff said.

The assessment might lead to the creation of a smoking cessation program, mental health screenings or suicide prevention outreach.

Empowering others
Although team members have been attending the screenings to ensure that pandemic precautions are in place, the events normally are handled by church-based volunteers. Those volunteers – some with medical backgrounds and some not — are trained to do the health assessments and explain the results, such as whether someone's blood pressure level indicates the need for immediate medical attention.

"It's not about us doing all the work," Woskobnick said. "It's about us empowering them and then teaching them so that they feel that they have that ability but yet they have Mercy Health as their support system."

At the screening events, blood draws are done by licensed phlebotomists and sent to a lab for testing. The results are shared with the patient and their primary care physician. Woskobnick said that while every person screened is asked about whether they have insurance, the screenings are done without charge for everyone and insurance is not billed.

Lisa Schneider, the program's office coordinator, said that while most of the people who come to the screenings have either private insurance or Medicare or Medicaid, often they face co-pays and deductibles that are unaffordable. Lots of people turn to the program for the convenience of getting the free lab testing done and the results sent to their doctors, who can then issue or renew prescriptions.

For patients who don't have a primary care physician but may need follow-up care, the nursing team will make a referral to a doctor within the Mercy Health system.

Donna Sims, the other registered nurse with the parish program, encourages the people who come to screenings to "know your numbers" — including blood pressure, blood sugar level and body mass index — and how those number figure into overall health.

"Some people don't even realize that they are diabetic or hypertensive," said Sims. "We get these stories like: 'I'm a success. You helped me catch this, so I am safe.'"

Working in sacred spaces
Sims and her colleagues see the nursing program as a companion piece to the sacred experience that churches provide. "The clergy is there for the spiritual and we are there for the physical," Sims said.

Visiting the churches of various faith communities, as Sims has done for two years as a parish nurse, has given her a window on different faiths and diverse people. "I've learned that you reverence their sacred space," she said.

One thing that's common at all of the churches, the team members say, is the gratitude that people express for the parish nursing program and the care that it brings into communities. Some of the churches that held screenings over the summer weren't yet open for in-person religious services, but they were nevertheless eager to see the health program resume.

It came as no surprise to the nursing team that the turnout at the screenings, while solid, wasn't as high as it was pre-COVID. At one event in early September, 30 people showed up. A year earlier, the same event had drawn 45.

"We are seeing lower numbers," Wyckoff said. "But the people who are coming out are extremely appreciative, so it is very, very needed. We understand that."

'United in Glory' inspires better health practices

The $10,000 grant the Sisters of the Humility of Mary gave Mercy Health – Lorain, came with instructions that the funds be used for a community project related to COVID-19.

The parish nursing team at Mercy Health — Lorain Hospital founded the United in Glory program to help people of color confront health challenges. The team includes, from left, Sharon Wyckoff, a registered nurse; Marilyn Chavalia, a volunteer; Donna Sims, a registered nurse; Lisa Schneider, coordinator; and Jade Larkins, an intern with a leadership development program called Leadership Lorain County.

Edwin Oley, chief executive and market president for Mercy Health – Lorain, turned to Catherine Woskobnick to ask what should be done with the grant. "I knew that Ed was going to expect that whatever we were going to do with these dollars, it was going to impact lives," said Woskobnick, the Ohio health system's director of community health.

She and her team came up with a plan to use the money for a program to help people of color who have health challenges improve their health status, since COVID has proven especially dangerous for that group. They named the program "United in Glory."

In October the program enrolled its first cohort of 29 adults with the goal of educating them on how diet and fitness relate to health and inspiring them to make changes that might stand them in better stead should they contract coronavirus.

All of the participants will undergo an initial assessment so they will "know their numbers" — including weight, blood pressure and body mass index. They will all get a goody bag of tools such as tape measures, cooling towels and a journal to record their progress. They also will get gift cards for walking shoes or other needs. They'll take part in monthly Zoom discussions with physicians on topics like how proper nutrition and exercise relate to overall health.

Woskobnick and her team worked through community groups including the Lorain County Urban League and El Centro De Servicios Sociales, a nonprofit agency that supports the Latino community, to distribute applications. In the end, everyone who applied was accepted.

The program got underway in mid-October with a virtual gathering that included the participants, some of the hospital's leaders and a pep talk from Dr. Robert Thomas, a Black physician who will serve as the group's physician coach.

Once the program concludes in May, Woskobnick plans to award prizes to those whose numbers reflect the most progress, such as a lower body mass index and a higher level of good cholesterol. And, if this first session of the program goes well, she hopes to expand it.

"It's about increasing activity, knowing their numbers, giving them the tools and then celebrating," she said.




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