Parish Nurse

From Your Parish Nurse

Caring and Sharing Ministry
All of us have experienced some type of “DIS--EASE” in our life. Wouldn’t it be a blessing if we could share our survival techniques and experiences with those going through similar painful or difficult times.

Well, soon you will be able to. As parish nurse and with the help of our clergy, a Caring and Sharing Ministry is beginning just for this purpose. Why not help bring some comfort, peace and understanding to a parishioner going through a similar painful or difficult time that you have been through such as dealing with a cancer diagnosis, (name specific cancer area) recovering from a heart attack or stroke, trying to heal from the death of a loved one, divorce, a severe accident, or other challenging experiences.

If you are the individual experiencing the painful or difficult time, why not talk to a parishioner who has already experienced a similar situation and be comforted and possibly get some ideas of how another person has dealt with this type of challenge.

Another person who might want to utilize the Caring and Sharing Ministry would be the spouse or family member that is sharing the painful, difficult experience with their loved one.

So, what do you do? How do you connect with the Caring and Sharing Ministry?
If you are seeking a listening ear or desire to share with another the challenging experience you have been through, E-mail the parish nurse at ellen@allsaintsw.org or leave a message at church 508-752-3766 ext 24 or talk to her when you see her. Leave your name, phone number and what challenge you have been through or the challenge you are currently facing. If possible, I will connect you with an appropriate person.

Confidentiality is a major expectation for all concerned.

May God’s peace, love and blessings be with you and the Caring and Sharing Ministry.

Ellen Paquette, Parish Nurse

Some physical illnesses can be a real challenge and mentally challenging as well. They can make us fret about how we are going to manage living this way. They can make us feel helpless, even hopeless. Some individuals question whether God has done this to them.

The church teaches (and it is also my personal view) that God doesn't cause these things to happen but that God can bring helpful lessons and good out of any situation. In a quiet time with God, we should ask “what am I to learn from this experience?"

If, during our challenges, we look for our special small blessings and give thanks to God for these, the promise is that God's healing and loving grace will bring comfort in both mind and body. -Ellen Paquette, Parish Nurse

It is the beginning of a new year. Why not health yourself and arrange for a “faith lift.” You might wonder how to do it or even why you would want to do it. Many of us suffer from low self esteem and getting a “faith lift” can help remedy this condition.

All you have to do is, “SIT QUIETLY AND LET GOD LOVE YOU,” daily. After receiving God’s unconditional healing love for a period of time, start loving yourself by thinking of your achievements of the day and giving thanks. Also counting your blessings and giving thanks for them will bring you to a more positive state of mind and help you feel better about yourself and your life.

Another thing you can do is to visit the Healing Team on Sunday mornings. We are blessed at All Saints Church with a Healing Team and the Healing Team is now available each Sunday at all three services. The greatest benefits people who have visited the team have experienced, are comfort and peace of mind. These are two very valuable health benefits.The Healing Stations can be accessed before and after communion. The station on the right side of the church will be open. Occasionally the station on the left side will also be available.

Do yourself a favor, especially if you feel stressed, and visit the Healing Team. Allow them, with God’s help, to bring you peace and healing through the laying on of hands and praying for you. Ellen Paquette, parish nurse

This time of year can be very exciting and wonderful. For some though it is a time when they feel blue or get depressed. The following is a list of activities you can use, or share with another, that can help lift one out of these uncomfortable feelings. First, put a smile on your face, even a fake smile will help you. It will also help you perform the following activities.

1. Appreciate the good and beautiful things in your life, daily. This will lighten your mood instantly. Another way of saying this is: develop an attitude of gratitude for all the positive things in your life.

2. Eliminate the negative. Turn off the news that causes you stress. When possible, stop interacting with negative people. If rainy or cloudy weather brings you down, brighten up your space with light and block out the outside view.

3. Distract yourself. When you find yourself in the downward spiral of negative self talk, do something startling such as splashing cold water on your face or slamming your hand on a table and say “stop.” Put on some of your favorite music, do an enjoyable activity, read uplifting material or visualize a pleasant event.

4. Exercise for twenty minutes. Take a brisk walk, put on some exciting music and dance around your house or visualize a beautiful place as you walk on your tread mill.

5. Be of service to someone. Helping someone else helps you. Cook a meal, take the neighbor's children to a movie, do volunteer work. Pick some service that interests you and is likely to make you happy.

6. Communicate appropriately. If you find yourself feeling grumpy, review what has been going on in the past few hours. Have you set good boundaries? Speak your mind in a kind way.

7. Challenging negative thoughts. Does your inner critic cause you grief? Sit quietly and let God love you. Accept yourself as lovable..

8. Have a buddy, someone you can talk to and who supports you.

Some of this information was taken from an article by Jacqueline Hale, What To Do When You Are Feeling Blue. Go over the list. Make yourself a list of the activities you can do daily to help you feel more comfortable and at peace with yourself and your life.

Have a Merry Christmas and Happy New Year.

Ellen Paquette, Parish Nurse

The following is a short story that Alden Flanders told in a recent sermon and he has given permission for use in this article:

One evening an old Cherokee told his grandson about a battle that goes on inside people. He said: "my son, the battle is between two wolves."

One is Evil. It is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other is Good. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion and faith. The grandson thought about it for a minute and then asked his grandfather: “which wolf wins?” The old Cherokee simply replied: “the one you feed.”

I wanted to share with you, for health and wellness of body, mind and spirit, the importance of knowing how and what to feed the “good wolf.” Positive thinking, meditation, prayer, affirmations, and an attitude of gratitude and love, will do much to 'feed and satisfy the good wolf'.

However, life’s challenges cause us to slip into thoughts and wander toward feeding the “evil wolf.” Our thoughts can lead to ill health. Try not to get stuck in this type of thinking. Use these challenges as a signal to think more positively. Ask God what good can be gained and learned from these challenges. Ask yourself, “What would Jesus do in these situations.” Ask God to help you journey through difficult challenges. This is a health producing affirmation you can use daily: “thank you God for loving me and guiding my thoughts and actions.”

Bless yourself with health by feeding your “good wolf” through all of your thoughts and actions.

Ellen Paquette, Parish Nurse

It is so important for our emotional health, which definitely affects our physical health, to feel God’s presence in our life. Our beliefs and perceptions are major factors; don't be like the man in the following poem:
WHISPERS

“The man whispered, “God, speak to me” and a meadow lark sang. The man did not hear.

So the man yelled, “God, speak to me!” and the thunder rolled across the sky but the man did not listen.

The man looked around and said, “God let me see you” and a star shone brightly but the man did not notice.

And the man shouted, “God, show me a miracle!” and a life was born but the man did not know.

So the man cried out in despair, “Touch me God, and let me know you are here!” whereupon God reached down and touched the man.

But the man brushed the butterfly away and walked away unknowingly.

— Author Unknown

Add to your emotional health, “Sit quietly and let God love you.”

Blessings, Ellen Paquette

It is a well established medical fact that every emotion we have triggers biochemical reactions in the body. Happy and pleasant emotions produce healing chemicals; negative emotions produce stress-causing chemicals which can lead to illness and imbalance in the body and mind.

Scientific studies show that laughter, humor and fun reduce stress, prevent depression, boost immunity, decrease anxiety, relieve pain, rest the brain, inspire creativity, enhance communication, bolster morale, sustain resilience, and help us keep our balance and perspective in all activities.

Can you beat that? All that healthful stuff and it doesn’t have to cost you any money or hours of work. Laugh more, heal quicker, feel better, live longer – and attract more abundance in all arenas of life.

Approaching life’s challenges with a joyful heart is the surest path to success in any venture. Laughter and fun are the best fuel for success because it’s the best food for your body, mind and spirit. You can begin by putting a smile on your face and begin to laugh. Laugh for at least five minutes a day. Find that difficult? Find someone to laugh with. Laugh with your children. This helps to keep each other laughing. Caution, if you laugh at the table with people, just be sure nobody has food or drink in their mouth. Also, you can laugh while driving in a car with the windows open. Just thinking how other people will view you, alone in the care and really laughing. This will help you laugh more. Who cares what they think. You know you are just participating in a health producing activity.

There is a saying, “Laugh and the world laughs with you. Cry and you cry alone.” Encourage others, who are being challenged by life, to laugh with you. Help them heal themselves.

Smile, God Loves You.
Ellen Paquette, parish nurse

Your thoughts grow daily. What type of thought seeds are you planting in your garden of life? You are always planting something with your thoughts – desires, love, hope, blessings, joy or worries, fear, anger, hate etc.

For your health’s sake, you cannot afford to plant bad seeds. Unfortunately some bad seed thoughts come from past negative experiences that are buried in your mind and heart and can cause you ill health.

What can you do to insure better health? Following are just three possibilities.

Fertilize your garden, mind and heart with love and as often as you can, sprinkle love through your seed thoughts by visualizing each thought and surrounding it in a beautiful white light filled with love.
When you are having thoughts, frequently cultivate them with an attitude of gratitude by giving thanks to God.
Meditate. Go within. Holding love in your heart, think about your thoughts stored there. Are some of these thoughts bad seeds (negative thoughts) like fear, anger, hate etc? If so, let God’s love cultivate your beauty within and transform your garden of life to one of health and love. Give God permission to help you and guide you in erasing hate, anger, and fear from your thoughts, with His love.

Love and Blessings,

Ellen Paquette, parish nurse

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Contact Ellen Paquette, parish nurse

Through the courtesy of the Telegram and Gazette, I would like to share several interesting facts for a healthier life, taken from an article in the Parade Magazine on Sunday, March 18th, “You can stop “normal” aging” by Dr. Henry S. Lodge.

Most of our body cells live for a very short time, from a few hours for our taste buds to 10 days for blood cells to 3 months for muscle cells. Whether your body is functionally younger or older is a choice you make by the way you live. Exercise, and your cells get stronger; sit down, and they decay.

You would think that food is the controlling signal, but it’s not. Motion controls your system. When you exercise, your muscles release specific substances that travel throughout your blood stream, telling your cells to grow. Sedentary muscles, on the other hand, let out a steady trickle of chemicals that whisper to energy cell to decay, day after day.

The other master signal to our cells—equal and, in some respects, even more important than exercise—is emotion. One of the most fascinating revelations of the last decade is that emotions change our cells through the same molecular pathways as exercise. Anger, stress and loneliness are signals for “starvation” and chronic danger. They “melt” our bodies as surely as sedentary living. Optimism, love and community trigger the process of growth, building our bodies, hearts and minds.

Change your life. Start today. Exercise and think positive, loving thoughts, your cells are listening. Why not remain “young” for as long as you can.

Blessings, Ellen Paquette

On Sunday, April 30th, I will be teaching the Sunday forum class on EFT, Emotional Freedom Technique at 9:40AM. Many people have difficulty “letting go” of past traumatic experiences that negatively effect their current life.

It has never been this easy to “let go” until now with the development of EFT. Gary Craig, a Stanford Engineer, based EFT on the discovery that the cause of all negative emotions is a disruption in the body’s “subtle energy.” Gary discovered that traumatic memories from the past cause a short circuit in the free flow of the body’s energy and that is what causes current forms of anxiety, nervousness, headaches, phobias and the like.

EFT repairs this short circuit by stimulating precise meridian points via tapping on them with the fingertips. This simple process can be learned and applied by anyone. With EFT you can learn to tap on the key points in just a few minutes with no experience or training. EFT helps to bring lasting results by removing the emotional causes of many illnesses. It can also help you improve your golf score and other sports and activities. There seems to be no end to the areas EFT can create a positive effect.

Better yet, come learn this remarkable healing technique and also how you can help others with it including children and babies by surrogate tapping.
Ellen Paquette, Parish Nurse

I love learning new things, especially relating to health of body, mind and spirit, and I would like to share some of my thoughts and some ideas that I learned recently as Wayne Dyer was being interviewed about his new book, The Balancing Act in Pure Inspiration magazine.

Do you feel lonely or alone? Are you not feeling “good”? Here is a suggestion, sit quietly and let God love you. Next look at the word “good” from a different perspective. Take the “O” out of “good” and make it “GOD”. This puts God in a wonderful place in your life. Allow God to be your senior partner. Knowing God is always right beside you, loving you unconditionally; guiding you (when you let Him) and bringing you comfort as you face life’s challenges, is very healing.

We attract into our lives what we think. Why not “health yourself” and think good/God thoughts of unconditional love, peace, wellness and abundance and attract all the blessings that these thoughts will bring. Remember, attitude is everything so pick a good/God one. When we choose to have a positive, God centered attitude, there’s no end to the miracles and blessings we will experience. It can be so comforting not to have to think of everything ourselves. With God as our senior partner, we can turn to Him at any time we feel the need.
Have a Good/God day.

Peace of mind is one of the healthiest states of mind we can create for ourselves. Forgiveness is one of the healthiest activities we can embrace. Are you aware of the fact that you benefit more from forgiving another than the person being forgiven? Why burden yourself in the present time or after a loved one has died with painful, stressful feelings of not having forgiven. Lent is a season that especially invites us to consider how we may have harmed someone as well as forgiving those who have harmed us.

During my many years of nursing, I have been with a number of individuals who were dying as well as family and friends of these individuals. A saving grace during this period of time, if they have not done so before, is forgiving each other when there has been a negative issue requiring forgiveness. It creates a more peaceful closure and also helps one heal more easily over time.

Because life can be uncertain and fatal accidents can occur at any time, it is best to be current with the forgiveness process with everyone.. If you have not forgiven someone and this loved one dies, it is possible to activate the healing process of forgiveness after they have passed on.

This is accomplished through creative visualization. Close your eyes, take a few deep breaths, ask God to be with you and help you during this time and visualize yourself sitting on a bench in the country. See your loved one walking toward you with a smile on their face. They come and sit down beside you on the bench. Express your joy in seeing them and your love for them. Just “Be” together for a few minutes. Then express your forgiveness or ask for forgiveness on whatever issue(s) that remain between you. Experience the person responding in a positive way and after this conversation is completed, embrace in a loving hug. Thank them for coming and suggest that you meet again. Take a few more deep breaths and open your eyes. Now thank God for His help and loving presence in this healing experience.

I would also like to share this information gleaned from my experience as a nurse: If you are staying by the bedside of a dying loved one and have to leave, even for ten minutes, tell them you love them and give them a hug if possible. It frequently happens that while you are away from the bedside, the person passes on. At least you will know that you expressed your love as you left them,
Ellen Paquette, Parish Nurse

Stress and negative thinking takes its toll on our body, mind and spirit. One way to get rid of excess stress is to change our thinking because that changes our life. Most of us do not comprehend the effect our thoughts have on the way our life goes. We do not fully realize the power our thoughts have in creating our life by drawing to us what we think, be it positive or negative. If we think our life is stressful and a hassle, guess what we draw to ourselves?

Here is an easy technique to use to sooth ourselves and bring love and blessings into our lives. Sit quietly with your eyes closed and breathe deeply. Put a smile on your face. Now, thank God for His love. See God’s unconditional, healing love flowing around you and through every cell in your body in the form of a white light.

Next, using your name say, “your name, I love you.” Repeat this phrase three times and try to feel loved. Then say, “your name, I forgive you,” thinking of a time when you had thoughts about yourself or another that were less than loving. Do this three times. Repeat the “I love you, I forgive you phrases several times while breathing deeply.

Use this technique daily especially if you are feeling hassled by life, and see what a difference it will make for you.
Peace, Ellen Paquette

Much of the time we are so busy looking for the “Next Big Cure,” we ignore the simple solutions. Following are two easy, simple solutions to improve your health:

Chew your food well, at least twenty times before swallowing. Dr. Nan Kathryn Fuchs said the most dramatic changes have occurred when her patients have chewed their food well. She said her patients have had: a dramatic reduction in food allergies, nutritional deficiencies completely go away, the complete elimination of heartburn, gas, bloating, and constipation, and they eat less food, when they follow her suggestion to chew their food well. Can you beat that?

Digestion starts in your mouth. By chewing food into small particles it can be more easily digested and prevent a critical condition called “leaky gut syndrome” caused by clumps of partially digested food. This condition creates more health problems and can lead to chronic fatigue and autoimmune conditions such as rheumatoid arthritis and lupus.

Good oral hygiene. Dr. Formicola, Dean of the Columbia University School of Dentistry says, “It is critical that the public becomes aware of the fact that without good oral health, you can’t have good general health.” Recent studies from the National Institute of Health show that the dental infections, periodontitis and gingivitis, can be associated with chronic disease and widespread systemic problems including cardiovascular disease, stroke, diabetes, pneumonia, etc. and even accelerate aging and arthritis.

It has been suggested that to create and maintain your oral health: visit a dentist, at least twice a year, to have your teeth cleaned, gently brush them with a soft toothbrush two to three times a day, floss at least once a day, and rinse your mouth with a mouthwash or a natural oral guard rinse to combat bad breath and help reduce plaque.

Did you realize that your mouth was a major center for keeping you healthy? Keep smiling!

I hope you had some fun times this summer. Thoughts are powerful; they affect everything in our lives. The saying “Change your thinking and you’ll change your life” is true.

Recently I read an articleabout the power of thought that intrigued me. You can tone your body without moving a muscle according to an article in the August 8, 2006 issue of Woman’s World. When you think about exercising, the brain sends stronger signals to certain muscles which increases their strength. For good results, picture yourself exercising certain areas of your body for about one minute, ten times a day. It will take time, about three months, but isn’t this an easy way to get and keep yourself in shape?

Another article in the same magazine explains how you can “outsmart the blues without medication". Anytime one can gain positive results without using medication is great. Did you know that taking a thirty minute walk can help ease depression, anger, fatigue and tension? It also eases stress and makes it easier to multitask and to solve problems . Can you beat that?

Just a word of caution. If your doctor recommends exercise and/or has given you medication for depression, please consult your doctor before changing or discontinuing anything.
Peace and Blessings,

I don’t know what type of weather we will experience this summer but I would like to share with you several conditions that can occur during hot weather. Dehydration, frequently due to excessive perspiration and not consuming enough liquid, needs to be prevented. The symptoms to watch for with Moderate Dehydration are: thirst, very dry lips, dry mouth, flushed skin, fatigue, severe irritability, urine becomes dark yellow, sunken eyes, stiff and/or painful joints and severe headache. One should call a medical professional if they have these symptoms.

Including all the above symptoms along with the following ones which constitute Severe Dehydration: blue lips, blotchy skin, confusion, lethargy, cold hands and feet, rapid breathing, rapid weak pulse, dizziness, fainting, high fever and you now have a medical emergency. Call 911

Heat Exhaustion is another condition that occurs in hot weather. With heat exhaustion one has: difficulty breathing, headache, feeling hot on head and neck, dizziness, heat cramps, chills, nausea, irritability, vomiting, extreme weakness or fatigue. With these symptoms, immediate and professional medical attention is needed, call. 911.

Lyme disease has nothing to do with the conditions just mentioned but, in our area, it is a situation that can also occur in the summer months. Caused by a tick bite, Lyme disease frequently doesn't show immediate symptoms. If you know you have been bitten by a tick, early removal of the tick is extremely important because it takes more than 24 hours for a tick to transmit the bacteria.

To remove a tick, use fine-tipped tweezers, grasp tick as close to the skin as possible and slowly pull it straight out. The mouth parts may stay attached, but don't be alarmed as these will not cause Lyme disease. After removal, apply antiseptic or alcohol to the bite area.

There are three stages of symptoms with Lyme disease. I recommend contacting your doctor if you experience any of the following symptoms which can occur from one to thirty days after the bite: fatigue, muscle and joint pain, chills and fever, headache, swollen lymph nodes, Erythema migrans (a circular red rash that continues to grow).

The Lyme disease article on my bulletin board includes the second and third stages of this disease which can be quite severe such as numbness in arms or legs, Meningitis, nervous system problems, including memory loss etc. With these symptoms, contact your doctor right away especially if you have the rash. There is a blood test, called ELISA that can be done

Checking yourself and your children and pets for ticks, after being outside, is a good preventive measure.

May your summer be healthy, happy and safe.

Ellen

There was an article in the Telegram & Gazette on April 27th about “Study shows Death is Painful.”
One thing mentioned in the survey was that “there showed more satisfaction with care among people who had appointed a health care proxy to make decisions for them.”
In the “Be Prepared” information packet that has been available since last year at All Saints,there is a health care proxy. It is called “5 Wishes.” If you are interested in having “5 Wishes”, they will be available in the Parish Office during blood pressure screening on Sunday, May 21st from 8:15AM to 12noon. I strongly recommend that anyone 18 years or older, have one. One never knows when an accident or sudden illness might make you unable to speak for yourself and need the help of a health care agent you have appointed.

I would like to comment on “death is painful” suggested by the article in the paper. I have been a nurse for almost 44 years and with many people as they were dying and family members after a loved one has died. Dying itself is not painful. If a person has a painful physical condition prior to death, the pain usually stays with them until death. If they did not have pain, the process of death itself does not create it.

One thing I have learned in talking with people who were dying and family members afterward is that “death should not be feared.” Yes, there is the pain of loss experienced by those left behind but the person dying need not be fearful. Armed with faith and the right information about death and the Larger Life, one can create the courage necessary to pass through this life into the next with relative ease

If you are fearful or interested in hearing about people’s experiences around death and the after life that I have heard, please feel free to ask me to share them with you. Perhaps my sharing the information I have received from people over the years, will help ease your fear.

Peace and Blessings,

On Sunday, April 30 th , I will be teaching the Sunday forum class on EFT, Emotional Freedom Technique at 9:40AM. Many people have difficulty “letting go” of past traumatic experiences that negatively effect their current life. It has never been this easy to “let go” until now with the development of EFT.

Gary Craig, a Stanford Engineer, based EFT on the discovery that the cause of all negative emotions is a disruption in the body's “subtle energy.”
Gary discovered that traumatic memories from the past cause a short circuit in the free flow of the body's energy and that is what causes current forms of anxiety, nervousness, headaches, phobias and the like.
EFT repairs this short circuit by stimulating precise meridian points via tapping on them with the fingertips. This simple process can be learned and applied by anyone. With EFT you can learn to tap on the key points in just a few minutes with no experience or training. EFT helps to bring lasting results by removing the emotional causes of many illnesses. It can also help you improve your golf score and other sports and activities. There seems to be no end to the areas EFT can create a positive effect.

Gary Craig provides a free manual, which you can download, explaining all about EFT. To obtain it go to http://www.emofree.comfreestuff.htm For his free newsletter which has success stories and articles from all around the world go to http://www.emofree.com/email.htm
Better yet, come learn this remarkable healing technique and also how you can help others with it including children and babies by surrogate tapping.
Ellen Parish Nurse

Most of us know that a healthy diet and exercise are very important in maintaining a healthy heart. There are other factors that are needed as well to have a healthy heart.
We are not just bodies. We are body, mind and spirit and in order to be completely healthy we have to fulfill the needs of mind and spirit in a healthy way.
Some of the activities that can help keep a mind healthy are positive thinking, an attitude of gratitude, counting our blessings, smiling and peace of mind.Some ways to feed our spirit are connecting with God and learning to love ourselves. Love is the greatest healer of all and many of us fall short of this goal of loving ourselves. Some do not even feel worthy of God's love. Why not provide yourself with the most powerful health tool possible. “Sit quietly and let God love you.” Feel God loving you and let God's love help you to love yourself. Then, in your thinking and actions, come from a place of love and you will be utilizing the greatest power on earth and in heaven.
Warning, if you aren't perfectly healthy yet, don't fret. God's not finished with you.

The Prayer Shawl Ministry is turning into a blessed ministry. Those doing the knitting are feeling blessed as they knit in God's presence with thoughts of love and healing prayers for others.
Those receiving the shawls feel blessed and comforted by the love and prayerful thoughts knit into the shawls. Those who present the shawls feel blessed to be able to bring love and prayers from the knitters to others.

Now, everyone is being given the opportunity to participate in this blessing if they choose to. The first Sunday of the month a shawl will be brought into the service. It will represent all the shawls to be distributed and provide an opportunity for those present to pray and send love to the people who will receive the shawls.
As a reminder, the prayer shawl knitters meet the first Thursday of each month at 10:30 a.m. to 12 noon and 6 -8 p.m. Feel free to attend whichever time is more convenient for you. Some individuals may not be able to attend either meeting. You can knit at home and send your completed shawl to the main office addressed to Ellen Paquette. Please include your name. If you need knitting directions, contact Ellen.

As of November 6 th , thirty-three prayer shawls have been given away. The grandchildren of one gentleman who received a prayer shawl call his shawl a “holy blanket”.

Please keep the shawls/holy blankets coming. If we end up with more than we need, we will expand out into the community.

Love and Healing Prayers to all of you.
Ellen Parish Nurse

Parish Nursing