The Importance of  Having a Written Agreement with your Christian Science Nurse

It’s important to have a written agreement with your Christian Science Nurse. It is important to know and agree upon the essential terms of your arrangement with the Christian Science Nurse, including but not limited to, the scope of their services, what Christian Science nursing care includes and does not include, what the hourly or daily rate of compensation is and payment terms, and other important terms.  During one of your preliminary phone calls, ask for a copy of their Agreement.  They should send you one by email or regular mail so you can become familiar with it before you sign it.  Below is provided a sample Agreement which provides for some things that should be considered in an Agreement.  This sample Agreement is provided for illustration purposes only. You should consult with your own personal legal adviser regarding any questions you might have. 

Both the Christian Science Nurse and the Patient (or their agent) should sign an Agreement before any services begin and provide a signed Agreement with a signed copy of the Agreement to each other.

 Every home and every situation is different. Therefore, different arrangements can always be agreed upon to meet the needs of all concerned.  Please feel free to discuss your individual needs with the Christian Science Nurse.

 Please do not make oral agreements.

 

 Here is a sample for illustration purposes. You may download it to study & use it in its entirety.

 

  Private-Duty Christian Science Nursing Care Agreement

I agree to engage ________________________________, a Christian Science Nurse, in my home with the understanding that only Christian Science Nursing care will be provided.

I agree to retain a Christian Science Practitioner during the time of this care. 

Practitioner: _______________________________    Phone:_________________________

The Patient (or Agent) agrees to provide, as soon as possible, a copy of the Patient’s Advance Health Care Directive, or a Power of Attorney for Health Care Decisions, or inform the Christian Science Nurse of the location of his/her Health Care Directive in their home.

Records of the basic care provided to the Patient will be kept confidential and only shared with permission of the Patient (or Agent).

For further information regarding care provided, please see the provisions “Christian Science Nursing care includes”  and “Christian Science Nursing care does not include”  below, the terms of which constitute a part of this Agreement and are in compliance with the November 2018, Scope of Services from The Mother Church at: http://www.christianscience.com/member-resources/christian-science-nursing

Charges for Private-Duty Christian Science Nursing care are due and payable upon receipt of weekly invoice:

• $ ______ per hour of Christian Science Nursing care (1 hour minimum) unless there is a daily charge.
• $ _______ per day (24 hours of care) Refer to provisions below for 24-hour care description.
• $ _______ per hour travel time by car (1 hour minimum) or air.  If the Christian Science Nurse purchases her/his own air ticket, an invoice for such will be presented (and due upon receipt) when the Christian Science Nurse arrives on the case or with their first invoice.
• Reimbursement for all forms of transportation (Airline tickets, shuttles, taxis, etc).
• Reimbursement for care products and groceries purchased for Patient care and the household.

Other arrangements agreed upon:

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Christian Science Nursing care includes:

• Accepting a case with the expectancy of complete and quick healing;
• Giving care that is consistent with the theology and ethics of Christian Science;
• Loving reassurance of God’s tender care, ever-presence, and omnipotence; faithfully and consistently acknowledging each individual’s spiritual perfection;
• Christian encouragement of a patient’s appropriate expression of activity and vitality;
• Reading to or with an individual from the Bible, Science and Health with Key to the Scriptures and other writings by Mary Baker Eddy, and additional literature published by The Christian Science Publishing Society;
• Communication: maintaining an ethical, moral, and loving manner in all communications with the Patient, family, friends, Christian Science Practitioner, and others; observing ethical and legal requirements with regard to private information about the Patient;
• Surroundings: maintaining an atmosphere that is conducive to spiritual healing and supportive of harmonious care;
• Personal care and bathing: assisting with all necessary care to meet the needs of cleanliness and comfort;
• Mobility: assisting with mobility, including assisting with standing, walking, moving, and settling with or without mobility aids or comfort items;
• Nourishment: preparing and modifying food; assisting with feeding; giving appropriate encouragement to eat;
• Cleansing/bandaging: cleansing, covering, and bandaging, to provide for cleanliness, protection, support, and comfort;
• Instructing the Patient or others in providing care for meeting individual needs;
• Being obedient to the laws of the land.

Christian Science Nursing care does not include:

• Making a medical diagnosis or prognosis;
• Assuming responsibility for making healthcare decisions for the patient;
• Administering medication, drugs, or using medicated, herbal, or vitamin-based products and remedies;
• Using and administering medically oriented techniques or technology; including, but not limited to, administering food or liquids with medical equipment, e.g.— intravenous feeding;
• Manipulation, massage, physical therapy
• Assuming responsibility for a Patient’s financial or household business transactions;
• Intruding on the private relationship between the Patient and the Christian Science Practitioner, or between the Patient and his or her family;
• Giving personal advice and counsel.

For 24-hour, Private-Duty Christian Science Nursing Care in the Home:

• The Private-Duty Christian Science Nurse can manage the care, bringing in and sharing the case with other Christian Science Nurses, as needed.
• Generally, a Christian Science Nurse can work for 2-3 weeks straight (24/7), then a second Christian Science Nurse can be secured for another 2-3 weeks, if needed.
• The Christian Science Nurse shall be allowed 8 hours of sleep time (during which time she/he will be on-call) and a 4-hour break during each 24-hour period.
• The home should provide adequate sleeping and bathroom accommodations for the Christian Science Nurse.
• If the Christian Science Nurse is called 2 or more times/night on a regular basis, the need for another Christian Science Nurse for night duty will be discussed by Patient/Agent/Family and the Christian Science Nurse.
• Meals are provided for the Christian Science Nurse unless she/he has special food requirements.
• A car should be available to the Christian Science Nurse if they fly in from out of town.
• It is helpful to establish a Petty Cash fund to provide necessary funds to purchase nursing supplies, household needs, and groceries for the home.
• An invoice will be provided weekly by the Christian Science Nurse to Patient (or Agent) for services rendered, including purchases for the Patient that were not covered by Petty Cash.

 Every home and every situation is different. Therefore, different arrangements can always be agreed upon to meet the needs of all concerned.  Please feel free to discuss your individual needs with the Christian Science Nurse.

 Please join me in signing this Agreement and return your signed copy via email.  It’s also acceptable to send an email to the Christian Science Nurse, confirming your acceptance of the terms of the Agreement.

Patient or Agent/Guarantor:                                                         

__________________________________ Date_______________       

Christian Science Nurse:

__________________________________ Date_______________      

The Importance of Having an Advanced Health Care Directive (AHCD)

An AHCD is a protection for you, your family & the Christian Science Movement. 

As a Christian Scientist, if it is your desire and choice to radically rely on Christian Science treatment for healing, it’s important that you explicitly detail the Christian Science treatment you desire.

An AHCD is a way to make your healthcare wishes known if, at some future time, you are unconscious or otherwise unable to speak for yourself in making a healthcare decision.  An AHCD can serve one or both of these functions:

Power of Attorney for Healthcare (to appoint an Agent)
Instructions for Health Care (to indicate your wishes)

AHCDs will vary from state to state according to each state’s laws, including the required statutory language to be included in the document, and the statutorily mandated manner of signing (i.e., witnesses, notary public, etc.). 

Consult your own personal attorney to advise you regarding the laws and requirements for your state’s AHCD.

FOR ILLUSTRATION PURPOSES, we’ve included a sample Advance Health Care Directive (AHCD).  It gives examples of specific Christian Science treatment and care a Christian Scientist may desire to consider.  Again, you are the one that makes the decision of what treatment you desire.

This form and the statements made herein do not constitute legal advice. You must consult with your own personal attorney regarding your own personal desires and your state of residence’s AHCD requirements regarding the form, nature and content of the AHCD and how same is signed and executed to be legal.

CLICK HERE TO DOWNLOAD THE SAMPLE AHCD FORM SO YOU CAN REVIEW IT IN ITS ENTIRETY.

Knowing your HIPAA rights

HIPAA stands for Health Insurance Portability and Accountability Act. 

The following is information on your rights to privacy regarding your health care.

Passed in 1996, HIPAA is a federal law that sets a national standard to protect medical records and other personal health information.

The rule defines “protected health information” as health information that:

1. Identifies an individual and
2. Is maintained or exchanged electronically or in hard copy.

If the information has any components that could be used to identify a person, it would be protected. 

The protection would stay with the information as long as the information is in the hands of a covered entity or a business associate. 

The protections apply to individually identifiable information in any form, electronic or non-electronic.  The paper progeny of electronic information is covered (i.e., the information would not lose its protections simply because it is printed out of a computer), and oral communications are also covered.

Information is also available at: http://www.cdc.gov/privacyrule/privacy-HIPAAfacts.htm.

Knowing what a Do Not Resuscitate form is

When a Patient passes on in the home, any medical personnel dispatched to the scene are legally obligated to perform resuscitation measures in an effort to revive the Patient. If a Christian Scientist does not want CPR or any other form of resuscitation, they need to provide explicit language in their Advanced Health Care Directive, Living Will, Durable Health Care Power of Attorney or Do Not Resuscitate Order. 

Do Not Resuscitate orders require a signature from a medical doctor. Most Christian Scientists do not have a medical doctor.  Several Christian Science Nurses have found that these forms, signed by the Patient (without a Doctor's signature) and accompanied with a Christian Science oriented Health Care Directive, have been honored by emergency medical personnel from attempting resuscitation of a Patient who has passed away in the home.

A Do Not Resuscitate form will be different for each state, although they all include similar information.  Consult with your own personal legal advisor.

 

The following information is from the formswift.com website:

What is a DNR form (Do Not Resuscitate)?

A Do Not Resuscitate order (DNR) is a medically related document that instructs medical personnel to cease performing life-sustaining treatment such as cardiopulmonary resuscitation (CPR), endotracheal intubation, and defibrillation. Most patients who initiate a DNR are terminally ill. People may also use them if they want to stay off life-support in the event of a coma or other serious injury or illness.

A Do Not Resuscitate form will be different for each state, although they all include similar information.

Who should have a DNR order form?

Anyone who feels strongly about not being resuscitated or intubated once their breathing and heart stops should consider having a form.

How do I get a DNR form?

Each state has different legal requirements about what must be included in a DNR.  Verify your state’s laws to make sure that your DNR complies with all requirements.

Do Not Resuscitate orders  are usually one-page documents that are fairly simple to prepare and execute.  They can be included as part of advance directives or advanced healthcare directives.  A DNR can also be included in a living will.

You can create a DNR online with a template or seek legal counsel to draft one for you.

Free Sample Do Not Resuscitate Order from formswift.com website

DO NOT RESUSCITATE (DNR)
IMPORTANT INFORMATION

The following instructions provide important information about the types of Do Not Resuscitate (DNR)
requests that will be honored in the field by paramedics, and emergency medical technicians (EMTs) and
hospital physicians and medical staff.

The Do Not Resuscitate (DNR) Form has been developed for the purpose of informing and instructing
paramedics, EMS, hospital physicians and medical staff to forego any resuscitation attempts in the event of
a patients or Declarant's cardiopulmonary or respiratory arrest. Resuscitative measures that will be withheld
shall include chest compressions, assisted ventilation, endotracheal intubation, defibrillation, and
cardiotonic drugs. However, this form shall not affect the provision of other emergency medical care,
including palliative (pain relief) treatment for pain, dyspnea (labored breathing), major hemorrhage, or
other medical conditions.

The Do Not Resuscitate (DNR) Form must be signed by the patient ("Declarant") or by an appropriate
guardian/surrogate decision-maker in the event that the Declarant is unable to make or communicate
informed health care decisions. The guardian/surrogate should be the patient's legal representative (e.g.
spouse, parent, other family member, Durable Power of Attorney, or a court appointed conservator) if one
exists. The patient's physician must also sign the form, affirming that the patient/surrogate has given
consent to the DNR instruction.

Once paperwork is completed and signed by all required parties, three copies of the form should be
disbursed as follows:

1. One copy of the form should be retained by the patient, as resuscitation attempts may be initiated until such
   time as a copy of the DNR Form or medallion is presented and the identity of the patient is confirmed.
2. A second copy of the form should be retained by the physician and made part of the patient's permanent
   medical records.
3. Finally, a third copy may be used by the patient to order an optional wrist or neck medallion inscribed with
   the words "DO NOT RESUSCITATE – EMS."

In the event that a decision is made to revoke the DNR, the patient should immediately notify their
physician and all copies of the existing DNR form should be destroyed, including any copies which may be
on file with the Medic Alert Foundation or other EMS Authority approved supplier. Medallions and
associated wallet cards should also be destroyed or returned to the supplier.  

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Do Not Resuscitate (DNR)
By way of a discussion with my health care physician, _N/A_ and after thorough consideration of the
implications of this Agreement, I,  ________________________________ hereby request and make it known that in the event should my heart or my breathing cease, no person nor medical procedure shall be initiated or attempted to restart or resuscitate breathing or heart function.
This order shall remain in effect unless otherwise revoked solely by my written request.
I understand that this decision shall not prevent me from receiving other emergency medical care by prehospital
emergency medical care personnel and/or medical care directed by a physical.
I give permission for this information to be given to the hospital emergency care personnel, doctors, nurses,
or other health personnel as deemed necessary to implement this directive.
Being of sound mind, I voluntarily execute this order with full and complete understanding. Therefore, I
hereby agree to the "Do Not Resuscitate Order" (DNR) order.
______________________________________________Declarant/Guardian Signature __________________________________Date

PHYSICIAN ACKNOWLEDGEMENT
I affirm that this Declarant/Guardian is making an informed decision and that this directive is the expressed
wish of the Declarant/Guardian. A copy of this form is in the Declarant's permanent medical record.
In the event of cardiac or respiratory arrest, no chest compressions, assisted ventilation, intubation,
defibrillation, or cardiotonic medications are to be initiated.
______________________________________________Physician Signature __________________________________Date

ATTESTATION OF WITNESSES
The Declarant executing this order appears to be of sound mind and under no duress, fraud, or undue
influence. I attest that I am of the age of consent (18 years or older) and that I have witnessed the giving of
consent by the above Declarant.

______________________________________  Date ________________________
(First Witness Signature)

______________________________________
(First Witness Printed Name)

______________________________________Date__________________________________      (Second Witness Signature)

______________________________________
(Second Witness Printed Name)

Rights of those Passing On in-home

Many people prefer to have all of their health care needs taken care of in their home, even if that includes Passing On.  The peace and dignity that people experience when they are in their home is undeniable.  Most Christian Science Nurses are  happy to extend this service to those in need.  Here are a few things that might be helpful:

1. Every county and even township in the United States has different protocol for handling passings in the home.  As Christian Scientists, we expect that the dignity and privacy of our Patients can be preserved, even after they pass on.  Our metaphysical protective work for the dignity of mankind and our Movement will pave the way for a peaceful transition for our Patients.
   
2. If a Patient in the home seems to be showing signs of Passing On, the family or the Christian Science Nurse should call the local Police Department asking for the non-emergency Police phone number.
3. Also ask the Police if there was a passing in the home, can the non-emergency Police number be called and a request for no siren or lights on the vehicle dispatched to this passing.  Of course, no personal information or details would be given at that time as the expectation of healing is still very much present.  If stated professionally, it should be expected that law enforcement will be happy to comply with this request.
   
4. In respect of the Patient, when there is a passing, notify the Christian Science Practitioner and then family at once. Ask for a phone call from the Practitioner when the Patient is released.
   
5. If an agreement has been achieved with the Police regarding protocol for a passing in the home, DO NOT CALL 911.  CALL the NON-EMERGENCY POLICE NUMBER that you were given to report the passing. They will give any pertinent instructions.
6. Have the Patient's Advanced Health Care Directive (showing specific Christian Science treatment only instructions), Living Will (if applicable, with do not resuscitate instructions) and Do Not Resuscitate form (if applicable) available, if needed, when the authorities arrive.
   
7. If there is a passing in the home, both the Christian Science Nurse and/or the family should have appropriate readings from the Bible and Mary Baker Eddy's writings available to read to the Patient (for 30 minutes or until the C.S. Practitioner releases the case) to allow for prayerful resuscitation and to assure a peaceful transition as the Golden Rule would dictate.
   
8. Christian Science Nurses are not qualified to diagnose . When the authorities arrive at the home, do not be tempted to diagnose the Patient's condition or reason for passing.  A description of symptoms is absolutely UNNECESSARY and not expected.  Simply answer the exact questions the authorities ask. Do not elaborate because it makes a reality of the dream and disrespects the efforts of the Patient's prayers.