Running head: COMMUNITY OUTREACH 1

Community Outreach: Nurse Family Partnership in Practice

Yuliya Moroz

NURS 305

11/19/16
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Community Outreach Paper: Nurse Family Partnership in Practice

On October 25th, 2016 our team visited the Nurse-Family Partnership(NFP) in

Bellingham, Washington. The visit lasted approximately an hour and a half as the coordinator of

the program, Judy Ziels, described what NFP does and answered our questions. This agency is

located in Whatcom County which spans from the Canadian border south to Skagit county on the

West Coast. Prior to attending this meeting, the team did some research through online databases

such as the Whatcom County website and the Nurse-Family Partnership web site. From the NFP

website we were able to learn about the mission and goals of the program. We learned about the

passion this program has to help moms navigate through having a child. This program serves

women that lack support through this journey. The program includes about 64 visits throughout

two and a half years time period. During this time specially trained registered nurses to help

form special relationships with the mom and her family to provide a positive environment for the

child and mother to thrive in. In Whatcom County about 35% of the population is of childbearing

age (based on a population statistic for Whatcom County in 2015). This is the population that the

NFP will be able to serve.

NFP began in 2012 in the Whatcom County area. It initially began with only two home

visit nurses and now has expanded to three with the partnership NFP has made with Lummi

Nation. NFP is primarily funded through the Whatcom County Behavioral Health Fund. It also

gets funding from two grants; Thrive Washington and Home Visiting Services. County General

Fund dollars also contribute to the funding of NFP. Research has shown that the clients in this

program who are first-time mothers are able to transform their own lives and their childrens.

During this research process prior to our visit to the facility I was intrigued. I have never

heard of a support group such as the NFP. This After doing some online research about this
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agency I found an interesting article in the Bellingham Herald which made me more passionate

about this agency. This article described a story of a teen who had a baby at an early age, wasnt

supported or educated through this journey which later resulted in the death of the infant

(Farrar,2013). This was a disinheriting article that cried for change and support in the community

of unsupported mothers. It was written in 2013 when the Health Department was thinking of

cutting funding for this agency, which then persuaded the council to not cut the funding. NFP is

passionate about helping women engage in good preventative health practices early on such as

prenatal visits, stopping cigarette, alcohol, and illegal substance use, and improving their diets.

They help parents provide competent care and help them develop a vision for their future.

Nurse-Family Partnership Population

My impressions of the online presence of the agency were accurate with the real life

program. We were not able to follow nurses on home visits with mom and baby due to the

importance of building a relationship that won't just last one day. The agency promotes that same

nurse visit the same patient that way they can establish rapport and trust with the patient. In our

meeting, we spoke with Judy Ziels who was kind, assertive and passionate about the work they

do at NFP. An observation I noticed about the agency was that they are passionate about helping

new moms. They strongly believe that early support can greatly impact a child later on in their

life.

This agency serves about 101 clients currently. The median age served is 20 with ages

ranging from 14 to 38. About 90% of the population is unmarried, 99% are Medicaid

participants, and 45% are without a high school diploma. The demographic population mostly

served is Hispanic and Native. The top schools that this program serves in Whatcom County are

Mt. Baker High School, Lynden High School, and Bellingham High School. The Nurse-Family
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Partnership has close ties with the school counselors and will get referrals quite frequently from

them. This is how some of their population gets connected with them. If a teenager in a high

school was to get pregnant the counselors from that school would recommend and refer them to

NFP. These mothers are not made to create this partnership against their will but are highly

encouraged. NFP will reach out to them once the teen or new mom agrees to the program with

the person making the referral. Referrals are also made by OB/GYN professionals, Women

Infants and Children (WIC), and Planned Parenthood. The requirement for enrollment is that the

mother must be low-income, first birth, and enroll before 28 weeks of pregnancy. The priority

enrollments are to teens and moms with substance abuse. Currently, there is a waiting list for this

program with at least 15 women on it.

Prejudice and Discrimination

NFP has been a support for many mothers, one of the conditions that creates the need to

seek assistance is the risk for depression which can negatively reflect on the upbringing of the

child. In a systemic study done, Young parents reported unhappiness, rather than poverty in

itself, as the most significant aspect of their childhood experiences that related to becoming a

parent, although unhappiness went hand in hand with adversity and material disadvantage in

their accounts (Harden, 2009, p.1). This unhappiness is what led some young teens to become

parents at a very young age. What was shown then was this was at a disadvantage to them to

raise a healthy, happy baby. NFP is able to partner with mothers and fathers to support them

through their first child as young teens.

Many times young teen moms are prejudiced and discriminated against which can cause

them to be secluded, lonely, depressed, and unsupported. Teen pregnancy has many prejudices

around it, Prejudice manifests in attitudes about an individual, but is based on our ideas about
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the group to which that individual belongs (Sensoy & DiAngelo, 2012 p.29). These prejudices

give us false assumptions about an individual. When going through High School I had a

classmate who got pregnant at the age of 16. Many of her friends turned away from her. She was

talked about and ridiculed. This led her to withdraw from school and raise the child on her own

while she completed her education through homeschool. Thankfully she had a strong family

support who helped her through this difficult time and helped her raise the baby.

A prejudice also formulated about young moms is that they are at fault, somehow the

male who takes a large place in the conception of a child is ridiculed or talked about. Sensoy and

DiAngelo (2012) talk about What women deserve is always tied to their relationship to men,

whether she be killed by a man if she is bad, or get the man is she is good (p. 87). In general,

the belief is that some women deserve to be ridiculed because she is sexually promiscuous and

unintelligent (Sensoy & DiAngelo, 2012). These young moms are left alone to care for the child

majority of the time, unsupported and pushed aside. NFP realizes this and comes to the aid of

these women, to break down these lies of prejudice and sexism. They stand side-by-side through

this journey empowering these women to be strong.

Conclusion: Applying in Nursing Practice

A barrier that I now understand around this population served by NFP is prejudice and

discrimination. Many times women are blamed for the pregnancy and the way they cope. They

are unsupported and are punished for smoking or drinking. Although all of these unhealthy habits

are not good for the upbringing of the child, the scolding doesnt fix the problem. These women

are more than their labels, more than the prejudice around them. Instead of being discriminated

NFP teaches to embrace these women and help them through their journey as a first-time mom.

This empowers them to become great mothers that rear up great children. I will take this
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understanding back to my workplace. Although I do no work with pregnant mothers I do

encounter women of many ages going through addiction, abusive relationships, and loneliness. If

I do encounter women along my journey as a nurse who are in need of support through their

pregnancy, I now know where to refer them to. Instead of seeing the person as their problem

NFP has inspired me to look to the ways I can support my patients and connect them with

resources that are found in our community. I am inspired by NFP to empower these women to

believe they are more than the sexism centered around them. Women are to be celebrated,

encouraged, and uplifted.

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References

Farrar, B. (2013). Nurse-Family Partnership program saves young lives. Retrieved November 20,

2016, from http://www.bellinghamherald.com/opinion/article22215603.html

Harden, A., Brunton, G., Fletcher, A., & Oakley, A. (2009). Teenage pregnancy and social

disadvantage: systematic review integrating controlled trials and qualitative studies. BMJ, 339,

b4254. https://doi.org/10.1136/bmj.b4254

Sensoy, O., & DiAngelo, R. (2012). Is everyone really equal? An introduction to key concepts in

social justice education. Teachers College Press.