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Nurses, Advocates and Cultivators of Confidence

Thursday, June 20, 2019   (0 Comments)
Posted by: Roy Muyinza
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Nurse-Family Partnership nurses plant seeds of care and rejoice as clients flourish

By: Mimi Madrid | Nurse Family Partnership

Healthy births, first baby steps and graduations are all milestones that bring joy to many nurse home visitors around the country. Rosemarie Brown and Lucy Romero are two Nurse-Family Partnership nurses in Texas who agree that their greatest joy at work is seeing their clients flourish long-term.

“Over time you get to track that change,” Romero said. “You have the capacity to break inter-generational poverty and change the trajectory of their lives forever.”

NFP nurses give new moms the tools they need to boost their confidence to ensure a healthy start for their babies and envision a life of stability. This includes providing information to enhance their own health and well-being, sharing information and building caregiving skills to support their child’s growth and development, facilitating access to helpful community resources, and assisting clients to see their strengths to support to achieve their goals which guides them to achieve a bright future for themselves and their children. The client-driven program partners new-moms under 28 weeks pregnant with specially trained nurses for two years.


Transformational therapeutic relationships

“In my former positions I would see my patients in 8 to 12 hour shifts over a few days,” Brown said, Houston Health Department NFP nurse home visitor. “But they’d leave, and I couldn’t support them. It’d bother me that I knew they had these needs, but I couldn’t meet them.” 

Nurses complete the core education program designed to provide the knowledge and teach the skills needed to establish successful therapeutic relationships with clients. The education program also includes instruction in the Visit-to-Visit guidelines to ensure that the Nurse-Family Partnership program is delivered with fidelity  across the country so that the goals for each client are achieved.

The core of the program is when nurses meet new moms where they are physically, emotionally and mentally. Nothing builds trust with first-time moms faster than meeting them at home, at school or at shelters. Nurses have the autonomy and flexibility they need to work with vulnerable mothers in authentic ways.

Romero was a public health nurse for 20 years before NFP. Now she is known as the NFP travel nurse, and visits ten families a month on top of supervising eight other nurses with full caseloads of at least 25 and up to 30 clients. Her team, like many others, feel joy through their collective purpose of making a positive change.

“I enjoy the closeness of the team,” she said. “We emotionally refuel each other and make sure everyone has a voice.”

Brown knew she wanted to make a change as a nurse by the age of 10. At 13, her mother who worked as an administrator at an emergency room encouraged her to become a hospital volunteer.

Since then she’s worked as a nurse in home health care, pediatrics, intensive care units, wound care centers, maternal and newborn wards. After 28 years in the nursing field, she finds her work as a nurse home visitor as one of the most rewarding positions.

NFP nurse home visitors collaborate with clients to follow each mother’s instinct to protect her child.  Nurses see the clients as the experts on their lives, eliciting what the client desires so support can be individualized to facilitate success. NFP nurse home visitors make a paradigm shift away from focusing on problems toward partnering with the client to focus on how she wants to move forward with solutions. 


Advocates for mothers

“NFP allows us to wear many hats and I really enjoy that,” Romero said. “Not only are we nurses but we also case manage and we are advocates.” NFP nurses practice the full range of their nursing education and combine it with their skills and passion to serve their clients.  Nurses use their specialized knowledge and skills to assess clients health and wellness needs and advocate to ensure individual clients and their children receive the medical care and community services to address these needs. 

This type of advocacy for pregnant mothers is very important at a time when 60% of maternal mortalities in the U.S. are preventable according to the Center for Diseases Control. Expectant mothers are either rushed through the medical system, don’t feel confident to ask questions or don’t receive the support they need.

"I've seen the difference in how they are treated when I'm with them as opposed when they go on their own," Brown said.

She recalls an incidence where a client couldn’t explain why her baby was referred to a specialist. Brown asked to join her next visit. As a result, the physician came in and sat down with her client, drew a chart and explained everything thoroughly.

“That's just one of many interventions that I've done on behalf our clients,” she said. “Being an advocate is a key piece for me which is a great asset to this program. “

There are many home visitation programs but none like NFP. They believe nurses are the best providers of health for expectant moms and growing children needs.


Michael’s family including his first child Alexandria graduated from the Nurse-Family Partnership in Contra Costa this spring 2019. NFP nurses support first-time parents transform their lives to create better futures for themselves and their babies.

Nurse impact on families

Some NFP outcomes include a 48% reduction in child abuse and neglect, 67% fewer behaviors and intellectual problems at child age six, 72% fewer convictions of mothers (measured when child is 15), 35% fewer hypertensive disorders of pregnancy and 82% increase in months mother is employed.

First-time moms who are visited by NFP nurses receive educational information about their children’s health and development. They also have greater access to resources and programs. The support they receive helps them them break cycles of behaviors that could lead to judiciary interventions and potential convictions.  

NFP nurses also help lift two generations out of poverty while improving pregnancy outcomes and long-term life changes. Every dollar invested in NFP yields $6.40 in return to society.


The need for more tenacious NFP nurses

 NFP is in 41 states and served over 35,000 mothers last year, but the need is ongoing, especially for bilingual nurses in parts of Texas. In Houston, around 33.6% of the overall population in the city are native Spanish speakers according to data from the 2015 Census Bureau.

Today, Brown is the only bilingual nurse home visitor in the entire Houston area. But she maintains an overflowing enthusiasm for her clients as she manages a full caseload. “I just love my clients and helping them to meet their life goals is my inspiration.”

The profound joy of NFP nurses stem from the collective challenge and mission to transform the lives of vulnerable babies, mothers and communities every single day.

For more information, visit the Nurse-Family Partnership site, or email Becky Gillespie

Texas Nurses Association

Texas Affiliate of ANA | 4807 Spicewood Springs Rd., Bldg 3, Suite 100, Austin TX 78759

800.862.2022 | 512.452.0645 |