Authors

  1. Stiles, Mary Anne MSN, RNC-MNN, CBC

Article Content

"Choose a job you love, and you will never have to work a day in your life" (Confucius).

 

I was a teacher before I gave birth to my son, Christopher, 21 years ago. He changed my life in so many ways, but his birth changed my career path. The nurses who took care of me were kind and nurturing. I knew before I left the hospital that I wanted to make a difference for mothers going through childbirth and the postpartum period.

 

I became a registered nurse in 2005 and worked as a bedside nurse in the hospital for 17 years. It has been a privilege to be part of the birth story of so many families. I have never lost the joy of sharing my knowledge with new parents. I continued my education by attaining a BSN, MSN, and becoming certified as a maternal-newborn nurse. Last year, I left my comfort zone and ventured into home care in the Philadelphia area. It is a fine balancing act to be a stranger intimately involved in the inner workings of a family. I want to meet each person where they are-What do they want to learn? How ready are they to learn? How do they learn best? A mom with five children doesn't need to learn about changing diapers but may need support for postpartum depression. A mom having difficulty with breastfeeding needs lactation support. A parent whose baby is having a bilirubin drawn needs education on jaundice.

 

As a maternal-child home care nurse, we are partners with the families' medical providers. We work in close collaboration with pediatricians and obstetricians because we are their eyes and ears in the home. A thorough assessment is needed to ensure an infant is thriving and safe. Checking the blood pressure of a mother diagnosed with gestational hypertension or preeclampsia could prevent an adverse event as these mothers are at increased risk of stroke, seizure, heart failure, and death. These visits serve to decrease disparities in healthcare by providing access to care for women who face transportation and childcare issues.

 

One mother stands out in my memory. Her problems seemed insurmountable. Besides living in an extremely poor socioeconomic environment, she was diagnosed with preeclampsia, had a 34-week-old baby boy in the NICU, four other children at home, and her cesarean section wound opened and needed daily packing. However, the pain and infection was not her priority. She felt guilty about not being in the NICU with her infant while also feeling guilt about leaving the other children at home when visiting the infant. Together we came up with a plan to prioritize her goals. First, we had to get her pain under control by creating a schedule for her pain medication. After assessing her wound and changing her dressing, we made a plan for dad to visit the baby every other day. This allowed mom to be truly present either in the hospital with baby or on her days at home with the older kids. It may not seem like much in the grand scheme of things, but later that day she sent me this text message:

 

The most prestigious award in the world would not mean more to me than this message. I know I won't make breakthroughs like this with every patient, but I try my best each day to care for families like they are my own. Home care nursing allows me to provide patient-centered care that is individualized to meet the needs of each family. Because of my love of maternal-child health I have never worked a day in my life.

  
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