The 20th Century: 1990-1999


East Carolina University opened the first Nurse-Midwifery education program in North Carolina.


Legislation is passed in North Carolina allowing advanced practice nurses to receive direct reimbursement from insurance companies.

The North Carolina Nurse Association approved the formation of the Council on Nursing Informatics.


Parish or faith based nursing begins and grows in North Carolina during this decade. In 1999 Duke University offers a new Masters of Science in Nursing Degree in parish nursing.

North Carolina becomes the 6th state to join in the multi state compact which allows Registered Nurses and Licensed Practical Nurses to practice in any state in the compact without having to take another state's registration examination.

Learn More: Parish and Faith-Based Nursing

Excerpt from The History and the Art of Parish Nursing by Anne Packett, RN, MA, FCN:

Parish nursing, or Faith Community Nursing, is a subspecialty in nursing as recognized by the American Nurses Association. It bears its own scope and standards of practice and is a growing field within nursing as a whole.

Parish nursing originated with Dr Granger Westberg 1984. As the Director of Chaplaincy at Lutheran General Hospital, in Park Ridge IL, Dr. Westberg envisioned parish nursing as a partnership between healthcare systems and local congregations. He believed that if nurses were available to congregants, they would be able to attend to and care for the early issues of disease and disability and foster a health promotion/disease prevention approach.

The model of parish nursing evolved as many communities of faith wanted to provide caring ministries but did not have a registered nurse available or perhaps were lead by other medical professionals – social workers care for ONE congregation – otherwise could be referred to as “not a real parish nurse”. Other emerging models included examples of a nurse being shared by two or three churches or a hospital coordinator that might simply coordinate and support a community of volunteer nurses in local churches. Later still developed the model of nurturing Health Ministries where churches were encouraged to offer health promotion and disease prevention activities with any person who felt called to lead such a ministry.

To be called a parish nurse – or faith community nurse – then as now, you had to complete the basic preparation for Parish Nursing that was only offered from few centers around the country. Rosemarie Mattheus was one of the original instructors of Marquette School of Nursing and mentor to many of us in the movement.

Due to the emerging models of team and management, a Coordinators’ Course was developed to support the training for those program leaders needing assistance with budgeting, grant writing and personnel matters related to supervising nurses.

Subsequent to the coordinators’ course, the Duke Caring Communities and Health and Nursing Ministries programs developed a Health Ministries Leadership course, advancing the conversations among parish nurse leaders, pastors, and non-profit leaders in better ways to understand and care for community.

In 1986 The International Parish Nurse Resource Center took on the leadership in the instruction of parish nursing and a clearing house for the work was formed.

In 1989 the Health Ministries Association was formed to provide a membership organization for nurses, clergy and others to join together in a common dialogue for the advancement of the work of Health Ministries and Parish Nursing.

Now, faith community nurses might be employed in any setting where spirituality and health perspectives will benefit others: pain clinics, hospices, community agencies, and other non-profits. Churches will hire parish nurses in lieu of a minister position realizing that the needs of an elderly congregation require more than a pastor might have capability for physicians, etc. The work of “Health Ministries” offered a broader context for understanding faithfulness in the fullness of the Christian story. Defined by the Duke Divinity School, health ministry is the intentional practice of caring for one another within the distinct context of a faith tradition. These practices are not peripheral to the tradition but essential to the understanding of worship and faithfulness to God and its members.

Duke Divinity School lead the broadening context of Health Ministries through its Health and Nursing Ministries and its Caring Communities programs. Directed by Dr. Keith Meador, MD, MTh, MPH, the Duke Divinity School, with the support of The Duke Endowment taught nurses, Divinity students and the broader community that caring was an expression of faithfulness to one’s beliefs and an essential part of worship.

Within North Carolina, parish nursing began in the 1990s with early programs at Presbyterian Hospital in Charlotte, Novant Health Systems in Winston Salem, New Hanover Health Network in Wilmington, and Catawba Memorial, in Hickory and Moses Cone Parish Nursing, in Greensboro . Stephanie Biggers was the Manager of Parish Nursing Services at Presbyterian and one of North Carolina’s first to lead the way for other hospitals to learn how Healthcare Systems could make a meaningful connection into their communities and partner with faith groups for overall health and wellness of their members.