SALINA — The children in her Salina preschool had just decorated Christmas cookies, and Marilyn Ericson went to get a beautiful plate to display them on.
But as she carried the plate Dec. 17, she tripped and dropped it. She fell on the shards of glass, cutting and bruising her hands.
"It all turned out so much better than it might have, but it wasn't the way I planned it," Ericson said a week after the Dec. 17 accident as she sat at home recovering, still unable to fully use her hands.
A key player in her recovery has been Velma Howie, the parish nurse at Trinity United Methodist Church, where Ericson is a member. Howie arranged for Ericson to receive meals, as she wasn't even able to prepare her traditional Christmas breakfast this year.
After Ericson was whisked to the emergency room at Salina Regional Health Center, where her left hand was stitched and glued, Howie visited her at home and checked on her progress.
The day before Christmas Eve, Howie noticed the wounds weren't healing as they should.
"She said, 'There's something amiss there,' and she has a direct line to the doctor, so that helps," Ericson said. Howie took Ericson back to the doctor, and he found and removed more slivers of glass.
"It had to be somebody with her knowledge and skill to find that," Ericson said. "I remember people saying, 'Well, why do we need a parish nurse?' and now they're saying, 'What would we do without the parish nurse?' She's just been a wonderful help."
Howie, who also serves University United Methodist Church, is one of more than a dozen nurses in Salina who have found a profession or a calling serving members of a church congregation as a parish nurse.
Churches of all denominations have added the position in an effort to attend to their congregations' whole needs — body, mind and spirit. The parish nurse is a person of faith with the professional training to advocate for a patient's needs, Howie said.
"Somebody has to care," Howie said. "That's what I found was missing. People will say, 'Nobody came to see me, so I quit coming to church and giving.' "
Howie, who said she visits about 50 members of both congregations a month at home, nursing home or hospital, said parish nursing defines health as more than just the absence of disease.
"We go out into the community," she said. "We've got to go where the need is, and in the world we're living in, that's more so than ever."
Howie works with a congregational care committee to make sure people have a way to get to church and take people to doctor's appointments, take them food and see that their needs for medical equipment or home health services are met after a hospital stay.
She organizes educational programs and displays about common health concerns, such as how to treat a sick child, exercise, nutrition, common ailments and food preparation.
She also coordinates a rotation of student nurses from Kansas Wesleyan University. Eleven senior nursing students accompanied her in 2009 as she visited church members.
"It's unlimited what you can do in the community and church," she said. "We have to help each other."
As more people are uninsured or underinsured and legislators continue to debate health care reform, parish nurses are visiting sick people and helping to make sure they get the care they need. The services of the parish nurse come without charge to the patient.
In the world of the hospital nurse, there isn't time to sit and listen to people's stories and be there while they are healing, said JoVeta Wescott, executive director of the Kansas Parish Nurse Ministry, based in Wichita. That's where a parish nurse can prove indispensable, she said.
Wescott said she once visited a patient who told her something he'd never shared before — he had been sexually molested when he was 4 years old.
"He'd had problems throughout his life since," she said. "Just to say those things out loud and put them in perspective and recognize the impact they'd had made a difference for him."
Because of the ages of church congregations, parish nurses often deal with end-of-life issues and help families figure out how best to provide for parents who can no longer live safely on their own, Wescott said.
"One of the things I'm finding interesting and we're seeing more and more of is that we have close to 100-year-old people, and their children are maybe 80," she said. "When you think about children coming in to help, their children aren't children. Their children might be needing help themselves."
Wescott said the parish nurse movement was started in 1984 by a Lutheran pastor in the Chicago area. He saw nurses as playing a pivotal role in the healing process and formed a pilot project with six nurses.
Now there are parish nurses in every state, and efforts are being made to get parish nursing recognized as a professional specialization, he said.