On the first Sunday of the month, parishioners at Christ the Redeemer Roman Catholic Church in Sterling meet after Mass in Atonement Hall to enjoy fellowship, coffee and doughnuts.
But not everyone heads straight for the caffeine and sugar. A line forms outside the library as a small crowd waits to see the church's four parish nurses, who will check blood pressures and answer health-related questions. Many hold cards filled with blood pressure results dating back two, three or even four years.
"They come to think of us here as family," said Shirley Balding of Leesburg, a retired registered nurse in charge of the parish nurse programs at both Christ the Redeemer and St. Francis DeSales Catholic Church in Purcellville. Balding is also the unofficial coordinator of an interfaith program taking root throughout the region.
"With the state of medical care these days, parish nursing is literally a godsend," said Martha Erbach, associate director of the School of Continuing Education for health programs and director of the parish nurse center at Shenandoah University in Winchester.
The 20-year-old program -- recognized as one of the newer nursing specialties by the American Nurses Association -- fuses spiritual well-being with emotional and physical health. Erbach called it a holistic practice -- though she purposely spells it "wholistic."
"We call it 'wholistic' because it involves the whole person -- mind, body and spirit," said Danna Grimm, who runs the parish nursing program at Holy Trinity Lutheran Church in Leesburg. "It's not your typical arm of nursing."
At the heart of parish nursing is a faith-based commitment to educate congregations on health matters, to offer advice and, on occasion, to serve as health advocates. What parish nurses don't do is hands-on nursing care. Those services, Balding said, are provided elsewhere in the community.
"So if Aunt Suzy in the congregation comes home and has a dressing that needs to be changed, the parish nurse isn't the one who is going to do that," Erbach said. "But if 88-year-old grandma has cataract surgery and her 90-year-old husband comes to the hospital to bring her home, then the parish nurse is there to help with the discharge planning, to make sure the follow-up appointments are put on the calendar."
Parish nurses also may accompany someone deciding among nursing homes for an elderly relative, or they'll help find resources and information when there's a diagnosis of breast cancer or Alzheimer's disease in a family.
Though Grimm noted that a parish nursing program can be started without funding -- a car and a telephone are the only basic requirements -- not everyone with a degree in nursing can be called a parish nurse. Special training is required, and many of the parish nurses in the area have taken the nine-day Interfaith Parish Nurse Educational Program at Shenandoah University.
"Actually," corrected Erbach, "it's not training. You train monkeys. We educate nurses."
Some of the subjects covered in Shenandoah's program include humor in healing, music and healing, grief and loss, family violence, and ethics and legal considerations.
"What I do is visit people or make phone calls to be supportive, to provide information and education in any way I can," said Carolyn Balcom, who runs the four-year-old parish nurse program at Arcola United Methodist Church. Balcom, like many other parish nurses, volunteers her time.
"My contract says I'll work eight hours a week, but it's not something I keep track of," she said. "I do what I can do."
The program run by Balding at St. Francis is much larger. There are nine volunteers, not all of whom have completed the formal parish nurse education program. They include an administrative assistant, a physical therapist, a nutritionist and an emergency room nurse.
"At St. Francis," Balding said, "we do things like provide the first-aid kits for work camp" for teens traveling to the Erie Canal region this summer to repair homes for elderly people and low-income families. "We have workshops on heart disease, stroke and sun damage. We bring supper to the staff of the Loudoun Free Clinic on the second and fourth Thursdays of the month."
Last winter the group obtained hard-to-come-by flu shots. "We can't give the shots," Balding said, "but the hospital mobile unit will come and give them."
Balding's informal network of parish nurses has nurtured cooperation and sharing among different faiths in the region.
"Shirley's an inspiration to me," said Paige Roberts, one of four nurses in the program at Round Hill United Methodist Church. Roberts, a registered nurse who is "temporarily retired" to be at home with her children, said she goes to St. Francis once a month to "share what's going on with our church. We're offering a babysitting course which we've opened up to the St. Francis community."
Roberts said that in return, Balding shared with her the idea for a project she started at St. Francis to collect such durable medical equipment as walkers, crutches and wheelchairs to loan to parishioners to help defer some medical expenses.
"I think the program is a real service and a point of contact because the parish nurses get to know the parishioners and hear their stories," said the Rev. C. Donald Howard, pastor of Christ the Redeemer. "They give me information, as well."
Many of the nurses speak of God's hand in guiding them to the work they do.
"I was floundering a little bit, and then this opportunity presented itself," Roberts said. "It was a chance to use the nursing gifts of caring and compassion along with sharing your faith in God."
Balcom discussed the importance of reminding people of the connections among body, mind and spirit.
"Even with a broken leg you've got the mental and the spiritual side of healing. When you get to the more serious things -- heart problems, cancer -- you just can't separate it. We need God's help. It's our relationship with God that is going to get us through whatever we're experiencing."