Nurse-Family Partnership: preventing child abuse, neglect through education

Serah Welborn

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Kay Sabine, Brianna Townley and Michele Santolucito, RNs and MSU alumni, hold dolls that they use to demonstrate care techniques to clients. Photo by Serah Welborn.

As April, the National Child Abuse Prevention month, reaches its conclusion, the Nurse-Family Partnership will continue its mission of improved child care outside the spotlight.

Clients of the NFP are taught the basic child-care and parenting skills. Nationally, the program exists in 43 states and among the U.S. Virgin Islands. Citizens may join for free provided they apply within the beginning 29 weeks of their first pregnancy and demonstrate financial need, such as use of food stamps and welfare. Dependents are evaluated according to their own salaries, not that of their parents.

The Community Healthcare Center of Wichita Falls has the capacity for 100 NFP members at any given time. The program was introduced locally during October, 2014, and now assists 30 clients – five of which are MSU students – in their journeys as mothers. According to Leslie Gresham, RN and MSU graduate, Wichita county was chosen specifically for its increased rates of young pregnancy, infant mortality, and child abuse.

“These are some of the benchmarks we look at when we’re enacting change with these moms,” Gresham said.

For a teen girl who does not have the support of her family – or lack good parental role models altogether – the NFP could be crucial for her education in the care, nourishment, and development of her child. But the same is true for collegiate women determined to stay in school despite the rigors of pregnancy. Students may be so far removed from their families that they do not have access to the kind of one-on-one instruction that they will receive with the NFP.

With this in mind, program nurses hope to develop a professional system of support for their clients, objectively aiding them in an attempt to foster healthy, rewarding relationships between new mothers and their children.

“It’s important as one of our components to increase self-sufficiency with these clients. We don’t want to create a co-dependent relationship,” Gresham said. “We want them to be empowered by what we’re going in there and teaching them.”

Young participants can expect to enter into a non-judgmental, helpful partnership with their assigned nurse.

“This is something they’ve never seen before because it’s a strength-based model. The [nurses] go in and say, ‘what is it that you want to learn?’ It’s not a judgmental, ‘you’re fourteen, what have you done with your life?’ kind of thing. We’re going to help you with whatever you need, and the fact that we’re non-judgmental, we’re very accepting – this creates that attachment and bonding, that we’re not going anywhere.””

Brianna Townley, RN and MSU graduate, said that, because the NFP program accommodates to the clients’ specific needs, they tend to be very engaged.

“I really think it gives them that extra boost of courage, in a way, knowing what it is they are going to be tackling or having somebody there to educate them on the things that they want to learn about,” Townley said “…. it’s just having a support system there that they don’t have within their family or their friends when they’re pregnant. They don’t really have anybody to turn to or talk to or lean on. We’re really just a big support group for them.”

Kay Sabine, RN and MSU graduate, likes the program because it gives the nurse and patient the opportunity for a closer relationship. Normally, the demand for care at hospitals causes typical doctor visits to be very brief and do not really allow clients to ask many questions regarding their pregnancy or baby. Through the NFP, nurses are able to spend an hour to 90 minutes instructing clients weekly.

“It gives them plenty of time to think about the things that we’ve talked about, ask questions that have come up since the last time they’ve seen their physicians,” Sabine said. “… this does not replace physician care, it is a supplement to that.”

During sessions the nurses use life-like dolls and other unusual forms of equipment for instruction, including nursing simulations that show the proper way to breast feed. In this way the nurse and the mother can work simultaneously rather than pass a single baby around, and the mother gains the benefit of hands-on learning. Sabine said she enjoys playing a game with silicone models of the fetus at its various stages of growth, challenging the client and her family to guess the age of each. Other tools include “Smoky Sue,” which shows the affect of smoking on an unborn baby, and a “shaking-baby doll,” which demonstrates the harm of rough handling on a child.

“We have a lot of versatility and flexibility on how we get that message across… we’re laying down the foundation,” Gresham said.

Those within the medical profession know that their work isn’t just about earning a paycheck; many enter the field with the genuine desire to help others find relief from suffering and live better lives. For this reason, Townley said that within the NFP “the clients are excited, but we’re also excited.” By working consistently with the same individuals for such an extended period of time, the nurses are able, for once, to have their cake and it it, too.

“It’s that continuity of care: you get to see their journey and take part in helping them reach their goals,” Michele Santolucito, RN and MSU graduate, said. “… Some forms of nursing, you don’t get to see.”

After two and a half years within the program, clients “graduate” with the confidence that they have the skills necessary to raise a child. To Gresham and others, this is the greatest success.

“We see it as a celebration,” Gresham said. “Having a baby for the first time is a huge life event for anyone, no matter what age, so we really want that window of opportunity to engage with those clients… They want to be good parents, I think that’s everybody’s idea, but they don’t know what it looks like: it was never modeled for them.”

As much as NFP benefits new mothers, the nurses take joy in the growth it promotes. After all, healthy families are like gardens – they require healthy roots in addition to continuous loving care to really blossom. It’s one thing to save children from abusive households and another to stop the cycle at its source, and that is what the nurses hope for most.

“We definitely are vested in these people’s lives,” Santolucito said. “We care about them, and we want to see them, as the program says, follow their hearts’ desires. So whatever it is that they want, the goals that they set for themselves – we’re behind them. We’re supporting them and encouraging them. So, that was what was exciting to me coming on to this team, because you can help someone to change [her] life.”

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