County’s Nurse-Family Partnership program provides support for first-time mothers
–The Nurse-Family Partnership of San Luis Obispo County (NFP), is a tremendously successful maternal and childhood health programs for low-income first-time mothers. As a national evidence-based program, it provides first-time moms with mentoring, emotional and practical support throughout their pregnancy and until their babies reach two years of age. The Center for Family Strengthening is the community advisory board to NFP. The program has a big reason to celebrate, thanks to five dedicated and compassionate nurses: Melissa Lovett-Adair, Jamie Peterson, Nancy Goldsmith, Nakia Wheeler and Carol Martin (the supervisor). Each has a Bachelor of Science in Nursing and has earned a Certificate in Public Health. Public health training includes a myriad of tools: medical care, social work, parenting skills, coping skills, confidence-building, safety, family dynamics, and career and dietary training. Some nurses have also earned a Master’s Degree in Nursing, Public Health or other related fields like Psychology or Sociology. All have also spent several years in a hospital working with patients.
The nurses become “true life coaches” and a consistent force in the lives of the mothers. They draw from their highly technical training as well as their life challenges including motherhood, facing adversity and building resilience in their own lives. They win their client’s trust by being non-judgmental, showing warmth and compassion, and being forthright and honest. Since the nurses don’t know what to expect when they first enter a home, each must assess the situation and use the palette of all their training and education as well as their life experience to help these new mothers.
First-time mothers are referred to the program through WIC (Women, Infants, and Children), their doctor, obstetricians, pediatricians, hospitals, community clinics, or they can directly contact the Nurse-Family Partnership of San Luis Obispo County (NFP). The only program requirements are low-income and first pregnancy before 28 weeks. The nurses each work with a caseload of 25 Moms, scheduling in-home consultations either weekly or bi-weekly based on the needs of the mother. Consultations are customized to achieve the goal of maintaining a healthy pregnancy and also achieving the mother’s aspirations and goals for her baby and their future life.
Peterson said, “All moms when experiencing their first pregnancy are at a unique and critical developmental stage in their life. The biological changes brought about by pregnancy, present the mom-to-be with a unique recognition and emotional understanding and acceptance that she is being given an opportunity for a fresh start, an exciting opportunity to create a wonderful change in her life and her baby’s life. Every mom-to-be wants a better life for their child than they had for themselves.”
“Many moms do not have a good support system,” said Wheeler. “We support them by listening, establishing a relationship based on trust, and helping them achieve their goals. I often hear moms say ‘I want better for my children’; as public health nurses, we can help them decide what ‘better’ looks like and how to get there.”
Most of the mothers coming into the program range in age from 14–40. Some have other risk factors including intimate partner violence or substance abuse. Some have low self-esteem and lack parenting skills and knowledge of child development. A few may be homeless. Some have bachelor’s degrees while others are still in high school. No one characteristic defines them or applies to all. What is amazing is that these mothers can sense and grasp that they are at a point in life where with the guidance of their nurse, they can truly build a much better life. Nearly 96% succeed in bringing a healthy baby and better life into our community.
Working as a public health nurse with mothers in their home is very different than working in the controlled environment of a hospital. As Peterson put it, “You are alone out there and need to be comfortable in your skin with the right attitude. To be invited in and invited back you need to earn the mom’s respect.”
All progress to goals is acknowledged and celebrated. For example, with Peterson’s help, one 19-year-old mother burdened with low self-esteem and dependent on a controlling partner, managed to rethink her choices and leave her partner. The mother researched opening her own business and today has her own taco restaurant. Another mother, who achieved an engineering degree in Mexico, came to the United States with her husband and could not find work. She did not speak English. She has the determination to support her family and created income by cooking for migrant farm workers.
Positive outcomes are higher than in other health managed programs. Ninety percent of the women who start the program complete the entire program. Seventeen percent of the women in the program without a high school diploma or GED returned to school by 12 months postpartum. Seventy-seven percent of clients are working at 24 months. Positive outcomes for the babies are phenomenal: 92.4 percent of the babies reach full term, 93.1 percent are born at a healthy weight, and 96.7 percent of the babies receive breast milk.
Each nurse in the program has a unique view about the benefits of the program.
Goldsmith believes having a child is an amazing gift and it is an incredible blessing to have the opportunity as a parent to guide, encourage and love your child. Guidance from an NFP nurse provides a valuable opportunity to change negative behaviors and break cycles. It gives parents positive alternatives for encouraging and promoting their child’s physical, mental and emotional well-being. Goldsmith supports and recognizes the value of preventative health care and also emphasizes that self-care is a very vital and important aspect of parenting. She sees the work as an NFP home visitor as a very challenging, comprehensive and rewarding aspect of nursing. She is very touched to hear from and see clients that have graduated from the program who are thriving and accomplishing much.
Peterson and Wheeler agree that the career is both challenging and extremely rewarding. They are thrilled to see their clients make progress.
Martin adds that the nurses give mothers hope that they can succeed and always looks for something positive in mothers’ interactions with their babies. Martin provides positive feedback and encourages them to talk and play with their baby as much possible. Martin is delighted when she runs into her clients years later and finds that mothers and children are doing so well.
Lovett-Adair focuses on bringing out the best in clients and celebrating their strengths and teaches mothers to manage a child’s behavior in a loving, healthy way. “It’s about empowering moms to learn ways to take care of themselves. The NFP career is a great opportunity to have a positive impact on people’s lives. You never forget them. It’s a privilege to support women making changes in their lives.”
All the NFP nurses agree it would be wonderful to have this program for all first-time mothers. NFP nurses are truly hero-nurses for SLO county first-time mothers.
San Luis Obispo County is currently hiring nurses for other departments. For more information about NFP visit the program website.