Spotlight on Nurses – Gail's story.
North Carolina State Nurse Consultant; former nurse home visitor from Guilford County, N.C.
Whenever I am asked to reflect upon the Nurse-Family Partnership and to share my perspective from having been a part of the program, I am reminded of a keynote speech delivered by Dr. Dudley Floyd, a former Assistant Superintendent of Public Instructions for the State of North Carolina. He stated he loved his job so much he would have done 85-percent of the job for no pay. Later, in his speech he related an encounter with an irate parent. This encounter let him know why the state paid him – to perform the unpleasant tasks he was required to do which comprised about 15-percent of his duties. Until I had the opportunity to be a part of Nurse-Family Partnership his statements were merely an anecdote. Now I understand on a very personal level his sentiments.
I have taken some time to really process my experience at Guilford Child Development, and more so my experience as a member of the Nurse-Family Partnership team. When I came to the agency, I never dreamed my work with Nurse-Family Partnership would become a peak employment experience. First of all, as a registered nurse, I had not worked in this area of nursing, maternal-child health, since I completed my bachelor's degree at North Carolina Agricultural and Technical State University. Nor, had I worked with teenagers, pregnant mothers, or infants. Consequently, I knew I had a huge learning curve to overcome. I would not have described myself as one who would be comfortable doing an intense home visitation program. Boy, was I wrong!
The Nurse-Family Partnership training represented a paradigm shift in my views of infant development. I have worked in many different areas of nursing. Other than the training I received as a surgical intensive care nurse, none has come close to the depth of preparation I received for Nurse-Family Partnership. The program also had internal supports in place to help new practitioners circumvent failure.
During the initial site training, I became acutely aware of what the nurse's visits meant to an inexperienced mother. Throughout the prenatal months, the nurse was a source of support and information that covered the gamut of topics and concerns a new mother might anticipate. Another important program goal was to convey the messages required by the program's protocol in order to give the mother an opportunity to experience a healthy pregnancy. What does experiencing a healthy pregnancy entail? This meant for me, the nurse, that the mother engaged in behaviors that were conductive to a healthy pregnancy. The components of good behaviors during pregnancy included prenatal care, good nutrition, timely physician visits, and good mental and emotional health. The desired outcomes were not to deliver prematurely, give birth to a healthy infant, no low birthweights, and participate in timely postpartum care. To the mother, it often meant someone to teach her and her family how to make a healthy pregnancy possible. To impart information in order to alleviate fears of the unknown abyss of childbirth, breastfeeding, and the day-to-day care of a newborn. Oftentimes, this process required dispelling myths on pregnancy and child rearing passed from one generation to another, thus dismantling generations of paradigm paralysis for new mothers.
The paradigm shifts I witnessed in the mothers was a source of gratification for me. To observe the benefit our relationship had upon their infants' social and physical development gave me a sense of accomplishment. For many of the young women learning not to continue counterproductive habits suggested by family members or the culture was a tremendous change. In order for me to facilitate such a major change in their beliefs and practices, a trusted relationship was required. Having someone trust me with one of the most important and sacred events of their life sprung from the strong commitment I had to guard and protect their trust in me.
During the two years I spent with each mother, I witnessed changes that were life altering. Many of the mothers I served were from different countries and cultures. Therefore, ideas I suggested were sometimes directly opposite to information prevalent in their homes and cultures. I was also exposed to new information and customs as I listened to understand their thinking and feelings. The sharing of cultures and beliefs allowed us to decide what was negotiable. This strategy also created an environment in which both parties were given opportunities to learn and share while working toward common goals. Once an infant was born, the structure of the goals changed. At this juncture, not only was it important to teach the mother how to be an informed parent, but also it was important to facilitate self-efficacy. Assisting the mother in finding solutions for positive outcomes was an integral part in the mother's development of self-efficacy. Many times, providing emotional support was essential to mothers experiencing positive outcomes in their lives, which ultimately benefited the lives of their children. For this challenge, it was necessary for me to understand the mothers' dream for themselves. Some articulate their life's vision quite easily, while others were in the formative state of goal setting and exploration was required. It was this experience that separates Nurse-Family Partnership from other programs designed to improve outcomes for low income, under educated, and underserved new mothers. I felt as if I were teaching these young women to fish.
It was not an experience wherein gratification was realized at the end. I had moments of great pleasure throughout the two-year relationship. At first the outcomes were medically based and the goal was the delivery of a healthy full term infant. Then, a positive transition into motherhood, eager to provide a safe environment that would foster physical growth and an infant striving to meet developmental milestones. Once the first objectives were an actuality, the imperative for holistic family development was evident.
As a relationship was coming to an end, I realized I had a very strong feeling of ownership. I was ecstatic to see a two-year old, who had been destined to be physically, emotionally, and developmentally delayed move within the normal ranges of infant growth and development. Even more rewarding was to watch them progress into toddlerhood with flourishing cognitive, motor and language skills. I was impressed with the mothers' commitment to create a nurturing and supportive environment that allowed children to meet developmental milestones. Knowing that there were no unwanted pregnancies for these young women, but instead school and/or work as part of their daily lives was an immeasurable accomplishment for them, but for me I knew I had made a difference in their lives. They were in the position to teach their children and others to fish.
Download Gail's story >>