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Kittleson's retreats use journaling extensively, and she gives attendees handouts they can use back on the job, such as a "grief bill of rights" that outlines what grieving people have a right to expect and plan for.

Baker worked for several years in the ICU and also saw firsthand that nurses don't always have healthy ways of dealing with grief. This can be a particular problem with parish nurses, because so often they are involved in grief ministry, keeping families informed, providing them with support and resources, even being part of funerals or memorials.

Yet they may not have the support and resources that, say, hospice nurses do. Retreats help fill that gap.

Refresh and restore

Baker said one of the key ingredients for a successful retreat is a restful setting. "You need a place where tension drains out and you feel refreshed and restored. We turn off our cell phones and get away from the rat race. We talk about the stories; it's like a debriefing. We talk about how it feels when you don't know what to say, or you can't pray with a family or spend time with them."

Retreats could be beneficial for all kinds of nurses, she said. "You could arrange one through a pastor and have a church host it for a day. It could even be just a meal together."

"The benefit of a retreat over a workshop setting is the time and the activities to step back and regroup before learning something new," Kittleson said.

A concept developed in the mid-1980s, parish nursing was designated as a specialty by the American Nurses Association Congress of Nursing Practice in 1997 and has grown to as many as 6,000 nurses around the country, most of them BSN-prepared with more than 10 years of experience in nursing. A variety of denominations-Catholic, Lutheran, Presbyterian and others-are involved in supporting and providing parish nursing service in their communities.

Last year, a program in Memphis trained about 170 RNs from 80 churches in 27 denominations. More than 1,500 have been trained through a program at Marquette University in Milwaukee.

The Catholic Diocese of Memphis' Community Health Ministry has a basic preparation course that 172 nurses from 30 different denominations and faith groups have completed since 1998. Some nursing schools, like the one at Union University in Memphis, offer parish nursing as an elective clinical experience.

The practice of parish nursing has a variety of models, too. Many nurses are volunteers, Baker said, working five hours a week or more, depending on whether they need income from another job. Some parish nurses are paid, supported either by individual congregations, groups of churches or health systems. MeritCare Health System, for example, supports about 28 nurses in the Dakotas and Minnesota.

"Parish nursing looks as different as does every congregation," Baker said. "It is probably one of the most diverse nursing practices there is."

Contact Melissa Gaskill at gaskill@dbcity.com