By Erica Techo
Brandi Moore is used to loading her car with diapers, formula and other supplies for young new and expectant mothers. But on a sunny Monday morning in late March, she knew the trip would look a little different.
Instead of her usual bi-weekly in-home health checks for mothers and babies, Moore, a nurse home visitor with the UAB School of Nursing-led Nurse Family Partnership of Central Alabama, walks only as far as clients’ front doorsteps today.
At her first stop, Moore drops a package of diapers and wipes on a doorstep in the Ensley neighborhood in west Birmingham before returning to her car to call the client. Before her call is even picked up, the client’s mother comes onto the front port with sanitizing wipes and cleans the package, yelling “Thank you so much!” to Moore.
Stepping out of her car, Moore asks about her client’s baby and sees the child waving from the window.
“This is the hardest part,” said Moore, BSN, RN, “not being able to hold the precious babies.”
While it is hard to not go inside, sit on the couch and talk about the progress of her client and their baby, Moore knows it is what has to be done during the novel coronavirus (COVID-19) crisis.
“A central tenant of the Nurse Family Partnership is building trust and relationships with our clients,” said NFP Director and Assistant Professor of Nursing Candace Knight, PhD, RN. “These women are young, first-time mothers, and in some cases, we are their central support system for health questions, goal-setting and other resources. We have had to change the look of our regular client appointments to keep our nurse home visitors and clients safe, but these drop-offs and regular virtual meetings are crucial to continue to help serve the needs of our clients and a way to stay connected while social distancing.”
The Nurse Family Partnership of Central Alabama is part of the national Nurse Family Partnership and began nearly three years ago. It recently graduated its first class of mothers. Highly educated RNs connect with the mothers early in their pregnancy and visit regularly throughout the pregnancy and for the first two years of their child’s life, providing check-ups for the baby and check-ins for the mother. The evidence-based program has been shown to create positive and lasting behaviors that lead to healthy and successful lives for mothers, babies and the entire family.
Nurses are staying engaged with their clients through telehealth visits using Zoom video conferencing, Facetime and phone calls, depending on the technology available to the client or preferred communication method.
“It has been great to use video calls to stay in touch because we can see the babies and moms and even assess rashes or things that we would normally use our eyes and ears to evaluate,” Knight said.
Diapers, wipes and formula are dropped off when clients let their nurse know that they are critically low and cannot find the supplies or do not have the means to purchase more. These vital supplies are provided through partnering agencies, including Safe Care through the Children’s Policy Council and Jefferson County Committee for Economic Opportunity. Donations to NFP have supported purchasing more diapers, and faculty, staff and others from the UAB School of Nursing have continued to donate diapers as well.
Nurses also guide clients through applying for unemployment and connect them with resources such as food banks, and provide resources for mothers living in unhealthy or unsafe situations, or who may be impacted by intimate partner violence or substance use. Being quarantined may exacerbate those situations, Knight said, which makes Nurse Family Partnership a critical resource at this time.
“So many of our families are not able to have a cushion or buffer in their finances, so losing a job or having their hours reduced really impacts their ability to provide basic necessities,” Knight said. “It is vital for these moms and babies to have the support of their nurse for trusted advice and resources should they need them. We’re also encouraging our moms through mental health and wellness support, especially during this time of increased anxiety and uncertainty.”
Assistant Professor Karmie Johnson, DNP, CRNP, PMHNP-BC, CNE, joined the Nurse Family Partnership in 2019, providing mental health services.. She continues to meet with clients virtually, discussing tools for coping with ongoing changes.
“With one of my clients, we use Zoom meetings to walk together, point out sights and observations and discuss stress and wellness,” Johnson said. “We got in 10,000 steps on our first trip and plan to repeat it every Thursday.”
The changes made by the Nurse Family Partnership of Central Alabama in response to COVID-19 show not only the resiliency and dedication of nurse home visitors, Knight said, but also the strength of the participating mothers.
“Our clients are by far some of the most resilient women I know. The trusting relationships that the nurses have with their clients have been so important during this time,” Knight said. “Even clients that we haven’t been able to contact in a month or more due to the client’s hectic schedule have reached back out to their nurse. I think clients and nurses are really leaning in to check on each other right now, as everyone seems to be craving connection.”
For Moore, her second stop of the day goes similarly to her first. She drops off formula and diapers at a client’s apartment and hears a group shout “God bless you for leaving that,” as she walks back to her car.
Moore smiled, waved and moved on to the next stop.
