Faith community nursing in congregations
Pastors attending a health ministry team building class were asked, “What does the ideal church
look like?” The responses were encouraging. One pastor said, “A place of healing.” Another: “A
vital place, full of life.” Still another: “A place where we reach out to the community.” These
comments provide a vision for the church today and might easily have described the early
church. The book of Acts presents the church as a place where members “devoted themselves to
the apostles’ teaching and to the fellowship, to the breaking of bread and to prayer. Everyone
was filled with awe, and many wonders and miraculous signs were done by the apostles” (Acts
2:42, 43).1
Scripture records the results of such a faith community: “the Lord added to their number daily
those who were being saved” (v. 47).
Christ commissioned the apostles to preach the kingdom of God and to heal (Luke 9:2). The
apostles formed a community where the Scriptures were studied, people were valued and cared
for, and their needs were met. They created a community where the dynamics of daily living
were intertwined in personal encounters with the power of the Lord Jesus. The result? “[T]he
Lord added to their number daily those who were being saved” (emphasis added).
The Greek word translated as saved has been used to describe Christ’s ministry of healing. It has
a multidimensional meaning, relating both the salvific aspect of Christ’s ministry, “to save,” and
also “to heal” or “to make whole,” which revealed His work of complete healing. Scriptural use
of this word helps us understand that the work of the apostles was to make people whole.
How does the church today create this apostolic model? How does the church demonstrate God’s
plan for redemption and reconciliation and adopt a godly perspective for the complete restoration
of the believers and, in doing so, become a witness for the greater surrounding community?
A deeper mission
Clearly, the church has an established role in the community for sharing the message of God’s
plan of salvation. The church should also function as a place where broken relationships with
God can be restored and fractured personal relationships can be reconciled and healed. While the
church has maintained these established positions for spiritual revival and renewal, what has
become of its role to make humanity whole?
Science and medicine have made great strides in dealing with disease and trauma; in the midst of
this medical model, however, we have become dependent and passive, content to wait until
illness forces us to change our lifestyle. As a result, the church responds to those who suffer from
the effects of a hazardous lifestyle and/or chronic illness. A great deal of time, in fact, is spent in
ministries that focus on visitation of the sick and crisis response. Though it’s important that we
minister to those in need, how do we reconcile the work of the church with Christ’s words, “ ‘I
have come that they may have life, and have it to the full’ ” (John 10:10; emphasis added)? Shall
we, as Christ’s church, be content with only comforting the suffering or is there an additional and
historic role of Christ’s ministry of healing that we need to reclaim?
Part of Christ’s mission was to address human needs. “Our Lord Jesus Christ came to this world
as the unwearied servant of man’s necessity. He ‘took our infirmities, and bare our sicknesses,’
that He might minister to every need of humanity. The burden of disease and wretchedness and
sin He came to remove. It was His mission to bring to men complete restoration; He came to
give them health and peace and perfection of character.”2 For the church to reclaim its New
Testament role as the center for healing in the community, and for the members to experience
full restoration in Christ, the messages of health and methods of becoming whole must become
an intentional ministry of the church equal to its work for redemption and reconciliation.
For starters, the pastor must understand the healing ministry. Because this is not well defined
during seminary preparation, many pastors have come to rely upon health-related events. Often,
when the event ends, the ministry also ends. To assume that the pastor has current knowledge
beyond a general level of the physical, mental, and emotional principles for the well-being of the
congregation is unrealistic. Yet, understanding how these areas intersect and impact a person’s
life may be key to spiritual growth and healing. The pastor needs support from a colleague who
also was called to ministry, has knowledge of holistic health principles, and can implement an
inclusive health ministry process that functions year-round. The Faith Community Nurse, a
holistic health colleague, can be the catalyst for the development of a healing ministry.
The Faith Community Nurse
The Faith Community Nurse (FCN), a specially prepared registered nurse, provides the pastor
with the missing link in ministry preparation. Working within a health ministry team, which
includes members with a variety of backgrounds and gifts, the FCN seeks to help meet the health
needs of church members. The health ministry process includes a strategy, implemented
throughout the year, to help members understand health principles and disease risks prior to
encountering a crisis. It empowers people to obtain knowledge of their body, mind, and spirit; to
gain control over (with the help of others) unhealthy habits and lifestyle; and to access
professionals who assist in managing the issues of life.
Because Faith Community Nursing is a specialty practice of the nursing profession, the roles and
duties are governed by the Nurse Practice Act of each state and by the Scope and Standards of
Faith Community Nursing (published by the American Nurses Association). The laws that
dictate the nursing practice may vary between states and countries, but generally the functions of
primary health care are similar and can be adopted by any culture. (The International Parish
Nurse Resource Center offers more information on establishing a FCN. Their Web site,
www.parishnurses.org, offers information and global leadership contacts to assist in establishing
a FCN ministry. The Center for Community Health Ministry, a Florida Hospital Web site,
www.communityhealthministry.net, provides additional information and a video for viewing
online.)
A demonstration ministry project
In a recent faith and health project in Winter Park, Florida, three interfaith congregations worked
with Winter Park Memorial Hospital, a facility in the Florida Hospital system, to develop a
health ministry and implement the role of a FCN within the leadership of the congregations. A
fourth congregation was included as a control group and did not have a parish nurse or a health
ministry team.
As part of this medical-religious partnership, the hospital provided project participants with an
annual health risk appraisal (HRA), including biometric measurements and comprehensive
lifestyle questionnaires, in order to determine baseline health risks and measure health behavior
change over time. A variety of health and lifestyle change courses were provided in order to
address the health risks and needs—nutrition, fitness, exercise, weight loss, grief recovery, etc.
The FCN’s role included working with the pastor to integrate faith and health in the services,
develop a health ministry team, and respond to holistic health needs for both individuals and
groups.
This project demonstrated that congregations often reflect the culture in which they live. From
947 total project participants, 221 participated for three years consistently. Of these 221, more
than 60 percent were identified as having an elevated risk for cancer and heart disease (with
elevated blood cholesterol levels and blood pressure), poor nutrition, low fitness levels; many
were overweight too. At the end of the project, the participants’ blood cholesterol levels
improved by 28 percent, nutrition improved by 20 percent, and their cancer risk was reduced 12
percent, weight and elevated blood pressure was reduced by 10 percent, and overall fitness
improved by 8 percent.
Participants were also asked about their spiritual health. When asked about their belief in a
higher power as a source of direction, 99 percent responded affirmatively. In response to a series
of questions about the influence of faith on their meaning and purpose in life, their joy and
harmony, their comfort during crises, their strength to deal with problems, and their reason to
help others, the responses, between 86 percent to 93 percent of the time, were “Yes, very much”
and “Yes, very often.” Faith, obviously, played a big role for most of them. One question,
however, scored lower: how faith influenced their life as a support and motivation for a healthy
lifestyle. Responses to this question showed only 69 percent responding, “Yes, very much” or
“Yes, often” in the first year. After three years, affirmative responses had increased by 14
percent, which indicates that though a substantial number of people within a congregation may
tend not to associate their faith to healthful living, when intentional interventions were
implemented throughout the years, their thinking changed.
The control church did not request any follow-up for project participants following the health
risk appraisal, nor did they hold any health courses. At the end of the first year, they declined
participation in the project. This outcome was particularly interesting; it was an indication that,
despite the pastor’s willingness, if the church does not share a passion for wholeness and there
are no health ministry leaders to guide and direct the process, the interest and commitment soon
dies.
The personal journey
Many people touched by Christ recognized the changes that had occurred in their bodies and
lives. They became witnesses for Christ and wanted to share their encounters of how He healed
them. Here is one story of a participant in Project HOPE, just prior to her second year
measurements: “I can hardly wait for this year’s measurement results. Last year, I found out that
I was at risk, and so I began to work on my health. I took a class here at the church called Fitness
for Life, and I learned how to make simple changes—it’s not a diet, it’s about lifestyle. Now, my
husband and I get up and walk every morning at 5:30. I have lost weight and feel great!” Then
she added another unexpected comment with excitement, “And, I’m attending church three times
a week.” The last comment is a surprise because usually people do not share their church
attendance details. Out of curiosity, the staff person asked her how often she had attended church
before this, and she replied, “Oh, about once a month.”
This story is an example of holistic health behavior change. The project participant was made
aware of certain health risks. She made a decision to change. She attended a class offered by the
church and made adjustments in her lifestyle by altering her diet and adding a simple exercise
program. She lost weight, had more energy, and admitted to feeling “great.” Thus, her health was
positively affected. In addition, she had a positive influence within her family as her husband
also joined her in walking. Finally, in concert with all the other changes taking place, her ability
and desire to participate in her church increased. The work of the church resulted in a personal
journey toward wholeness and, as if her personal experience wasn’t enough, she wanted to tell
someone else about it. Health is truly the enabler, because it gives people the capacity to become
involved.
Preaching as community building
majority of church leaders are increasingly focusing their worship service on building a sense of
community as well as encountering God. Hence, members stand to greet one another—visitors
too—during a welcome and announcements period; music teams use songs that encourage
audience interaction with one another as well as active participation in movement and singing;
and prayer times invite people to unite as a congregation in prayer or let members pray in small
groups throughout the sanctuary.
Can sermons focus on the same sense of community building? Yes!
Preaching often consists of the pastor’s exegesis and study to understand a passage or topic, a
search for illustrations and stories, and then a presentation to an audience. The exegesis and
illustrations usually come from study sources, not from interaction with the membership.
An interactive sermon creates a climate of community—helping members connect with one
another as well as with God. Interactive preaching not only parses the passage and teases out the
topic, but also involves members in creating the content.
Preaching content that builds community
The most common preaching content that builds community includes stories that feature
members. The stories are real and local. Audience members listen more closely because they
know the person in the story. Pastor Michael preached on 1 John 2 about the apostle John’s
message to those young and old. An 11-year-old asked to share with the church that week, and
Michael let him share what it means to be a young person in an old-person-dominated
congregation—and what this passage meant to him. Church members listened in rapt attention—
and learned about another person in their church community.
Equally compelling is an interview during the sermon. Pastor Kermit asked a member to come
forward one Sabbath and tell the story of how he lost a watch he treasured and how he searched
for it. The story illustrated a sermon on Luke 15—and made the desire of the Savior to find us
real.
But member participation in preaching content also can stretch to the message. During a series
on the three angels’ messages, Kermit asked members to share with him, in 25 words or less,
what each angel’s message meant. He started each sermon by quoting several members’ brief
descriptions—which helped the audience to know each other better. Kermit then shared his own
understanding of each message over the three-week series to highlight his insights into the
angels’ messages.
Michael asked members to share their interpretation of the story of Zacchaeus—but in a far more
immediate context. He had children come forward to act out the scripture passage, with an adult
sitting near the front serving as the tree. The younger children found themselves immersed in the
message. Michael also asked members to text message him while he was preaching to respond to
the question: what would you do if Jesus came to your house today? Michael shared those text
messages with the congregation at the end of his sermon. Every teenager listened to that
message! In fact, one 13-yearold gave Michael a high-five on the way out of church, stating that
he was going to make sure he came to church from now on. The teenager saw his text message as
a part of the collective worship experience.
We have found that members have keen insights to Adventist doctrines, and people appreciate
hearing what their fellow members have to say on the topic.
One last idea: ask members what they want to hear you preach about.
Kermit did a series at Easter called “Cross-eyed Christians,” stories of people who saw Jesus die
on the cross. Kermit picked four of the five sermons in the series, but asked members to suggest
who should be the fifth person in the series. (He also didn’t reveal who the person was until the
sermon started, which helped to build a stronger sense of community participation as well. And
now, thanks to the diverse set of suggestions, Kermit will preach “Cross-eyed Christians II”
during another Easter season!)
Creating content that builds community
Stories and other content that build community don’t just happen but must be planned in
advance. We have found that the following three techniques can do wonders to help find the
community-building content.
Pastoral visitation has been a cornerstone of pastoral ministry for centuries, and the experiences
uncover content that builds community in sermons. They can procure stories from the members
to share during a sermon (after obtaining permission to share the stories in a public sermon) and
seek insights to the passages on which you will preach.
Technology has opened new ways to create the content. Emails to members, Web-based
newsletters, Facebook and MySpace accounts,1 and text messages appeal to a wide range of
members and can bring stories and insights to pastors that can help create community through
the sermon itself.
Kermit produces a Web-based weekly church newsletter that frequently asks members to
contribute ideas and stories for sermons. Life@ Beltsville circulates each Thursday and produces
many responses. The ease of replying to the email enhances the response rate. Michael creates a
similar newsletter, not only sent out by email but forms the basis of a pastor’s blog on the church
Web site.
Pastors can quickly disseminate information and solicit sermon topics using MySpace or
Facebook. Pastors can also subscribe to RSS feeds2 from church members and read blog posts—
sometimes even posts about a recent sermon or other church life. This creates interactive
connectivity from which to draw stories from church members. Text messaging has been one of
the more interesting ways of generating content. We both have used text messaging during a
sermon. Kermit and his wife, Ronnalee, were giving a joint sermon on tips for a successful
marriage—and they asked the audience to text message tips to Kermit’s phone. One message
said, “I’m a teenager, and I don’t know much about marriage. But it’s so cool to text message
during church!” Other messages had valuable content, and Kermit shared that content at the
close of the message.
Michael used text messaging in a slightly different way. He read a passage, then posed the
question of what it meant. Congregants texted their thoughts, and Michael shared them—along
with his more studied discussion of the passage.3
Every interactive experience seeks to produce some kind of desired change in the listener. We
both have found that a very traditional technique, a call or appeal, helps create community by
showing that others have been touched by the message as well. Not everyone responds to a call
to stand or come forward; sometimes the call should be to complete a commitment card, create
Thank-you notes among church members, or sign a pledge that people plan to put on the mirror
in their house. Ultimately, the call needs to tangibly affect their lives.
Benefits of content that builds community
We both have found that interactive preaching—using the thoughts, stories, ideas, and
sometimes even exegesis of our members—creates a sense of community that enhances worship
and ties members closer to one another as they grow in connection with God. The participation
may be as slight as simply announcing the passage in advance of the sermon. Members will find
a sense of ownership that strengthens their relationship to the church—and Christ.
A side benefit results as visitors feel the sense of warmth and welcome that comes from the
participation of everyone in the creation—and sometimes the delivery—of the sermon. Preaching
as community building becomes an important part of building a healthy, growing congregation.
Conclusion
Through the addition of a Faith Community Nurse, ministry today can be expanded to reflect
Christ’s ministry of healing. The FCN becomes a resource for every pastor, ministry leader, and
individual member. Membership can be transformed from today’s society of passive people into
a true reflection of God’s active love. The ultimate result of such a ministry is that members
grow to experience what becoming whole means and are empowered to experience the blessings
of God for life in the present. The Faith Community Nurse can be a catalyst as the church
reclaims its role as the center for healing and wholeness in the community.
