Client story – Shanice.
In St. Louis, Missouri, a teenage girl walks along the side of the road, leaning into the wind on a cold, wintry day. Wearing a big puffy jacket, she walks to school, even though it takes an hour each way. Even though she is pregnant.
Her name is Shanice, and she is 17. Her mother is a long-time drug addict. Her father died many years ago. She lives with her aunt who refuses to share food and wants her out of the house when the baby comes. Shanice has few clothes, no income, and her baby's father has just gone to prison. He has yet to admit the child is his. Shanice has nothing and no one, except the new life growing inside her.
Shanice would be the first to tell you, "I didn't have much of a childhood," which is why she wants something more for her baby. Why she trudges back and forth to school every day to earn her diploma. And why, when a doctor tells her about Nurse-Family Partnership, she wants to give it a try. Through Nurse-Family Partnership, Shanice will receive education on pregnancy, parenting, and life skills from a registered nurse. The nurse will regularly visit Shanice at home, from early in her pregnancy through the first two years of her child's life.
Shanice has never had anyone help her. She doesn't know what to expect from the nurse assigned to work with her. As it turns out, her nurse, Lauren Stone, is a little nervous, too. While she has four years' experience as a pediatric nurse, Shanice is Lauren's very first Nurse-Family Partnership client.
When the two women meet for the first time it is a frigid day and Shanice sits at the kitchen table in her aunt's house still wearing her big puffy jacket. She tells Lauren her story – one where food, money, and emotional support are always in short supply, and then becomes very quiet. "I want to be a good mother," Shanice says softly. "But how am I going to do this myself?"
Lauren wastes no time in getting to work. In this first meeting, she teaches Shanice relaxation and breathing exercises to lessen her stress and anxiety. They talk about the benefits of self-care and how stress can negatively affect the baby.
Then Lauren turns her attention to Shanice's other immediate needs. She helps Shanice navigate getting food stamps and connects Shanice with a program in which people donate money and essentials to families in need. This effort provides Shanice with money for rent, bus tickets, and grocery store certificates as well as a hat, scarf, and books for her baby.
At six months, Lauren starts talking to Shanice about her life goals, about her future beyond this pregnancy. They begin a list. "Where do you see yourself, say, in the next three years?" asks Lauren.
Shanice hesitates, never having been asked such a question and responds cautiously, "Have a job…finish school…be a good mother to my daughter." Her voice rises at the end like she is asking a question more than making a statement. "Good, Shanice," says Lauren, looking straight into the teenager's eyes, "I want you to know I believe you will go further in life than you imagined."
"I want to have my own apartment," Shanice adds, writing the final goal on her list. Even though she's already moved five times in the short time she's been part of the program, Shanice is beginning to believe this goal is possible.
Two months later, Shanice graduates from high school, eight months pregnant. A month later, Shanice calls Lauren to tell her she's gone into labor. Lauren, with another client, promises to get to the hospital soon. "Can anyone come be with you?" she asks.
"I don't have anyone," Shanice replies. Her labor is fast and she gives birth to a baby girl with no one at her side other than the attending medical staff. But Lauren arrives soon, bearing a proud grin and a gift for the baby – a tiny little hat and infant socks.
Shanice can't help smiling at Lamiah, her daughter. "Isn't she amazing?" she says to Lauren as both women gaze at the baby's delicate face. Although she's exhausted, Shanice tells Lauren how she used her breathing techniques and how the nurses helped her through the labor. She is eager to try breastfeeding, remembering the practice sessions with a doll that Lauren guided her through.
With a high school degree and a new baby, Shanice is eager to soak up even more with Lauren. They talk about learning how to recognize cues when Lamiah's hungry, tired, or needs a diaper change. The importance of routines for bath, bedtime and waking up in the morning. Lauren teaches Shanice her favorite nursery rhymes – rhymes no one ever recited to Shanice when she was young. And, when Lamiah turns one, Lauren and Shanice sit on the floor with the little girl, playing the one childhood game Shanice does know: patty cake. "You're a very good mother to Lamiah," Lauren tells Shanice.
At their final meeting, two-and-a-half years after they met, Shanice and Lauren again face each other at a kitchen table. This time, the two are sitting in Shanice's own one-bedroom apartment, the realization of one of her biggest goals. Her old lease wasn't up, but she told the landlord that because of gang violence it wasn't safe for Lamiah, and she moved to a more suitable complex. Shanice has been working for the past nine months at a daycare center, where she has never been late and never taken a sick day. She has recently been applying for higher-paying jobs to better support Lamiah.
With Lamiah close by, they chat about the long journey they've been on together and revel in Shanice's accomplishment of so many of her written goals. Shanice has graduated high school, become a good mother to Lamiah, moved into her own apartment, and found a stable job that will help support her and her daughter. During their tearful goodbye after lunch, Shanice hands Lauren an envelope.
"Don't open it until later," says Shanice. But Lauren can't wait. Sitting in her car outside Shanice's apartment, she opens the letter and reads the words of the brave woman she's come to know – her very first client:
Dear Lauren, This is a letter to you from me and Lamiah giving thanks to you… When I was pregnant I felt that I didn't have anybody to lean on…I was so lucky to have a nurse like you…When you met me two years ago I didn't have anything. Now I got everything. You became not only a nurse but a real best friend to me who I was able to talk to about anything…I hate for the program to end with us because we will miss you truly. You have shown me all the ropes to life. Thank you.
This Nurse-Family Partnership program referred to as Building Blocks is implemented through the St. Louis County Department of Health.
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