On a Tuesday morning with the temperature already over 75 degrees, Paula Welch RN walks to her minivan to start her daily home visits, "I hope you don't mind the AC blasting" she says with a smile. Paula is Pernet's maternal-child nurse. It's her job to visit about 25 families, on a weekly basis, to see how mom and new baby are getting along. Paula tries to cool herself in her car as she is about to meet mothers and babies in scorching apartments that often lack even a single fan. The mother at her first home visit is trying to find relief from the unbearable heat by opening windows and placing cool cloths on her baby's head. Despite the miserable temperature, Paula is greeted with a smile and instant conversation.
Pernet's maternal-child program is a breath of fresh air to families, in a healthcare system that seems to be largely run by insurance companies, consisting of overburdened physicians, and lacking adequate patient resources. Home visits seem to be a thing of the past but not at Pernet, where they make up 100% of the maternal-child visits. There is no better way for an organization to understand the big picture of a family's situation then when families welcome Pernet's staff into their home. Paula visits mothers that are expecting a baby, or have recently delivered. She answers questions, checks the health of the baby, and makes referrals when necessary. The program is preventative medicine at its best.
Paula says that a big part of her role is simply "telling (the mothers) that they are doing a good job." Referrals come from Saint Vincent Hospital, UMass Memorial, and other surrounding health clinics and private doctor's offices. Women are usually referred because someone recognizes that they have some social or mental health issues. Many of the women that Paula sees are young, first time mothers that can use extra guidance. Bringing home a child for the first time can be a stressful situation without social supports. Paula says, "Families have a tendency to come undone" without support. In a city that has one of the highest infant mortality rates in the state, the maternal-child program is well needed throughout Worcester.
The initial visit consists of obtaining background information about the mother and child, taking their "vitals" and weighing the baby. Thereafter, Paula tries to meet with the family on a weekly basis for the first two months of the baby's life. During this time she monitors weight gain to make sure baby is thriving, takes the baby's vitals and head measurements, and has well-teaching visits with the mom. "People want to know how to do the basics. I get questions about sponge baths and feeding as well as if something is serious enough to call a doctor."
Families trust the maternal-child program. The program offers healthcare in the comfort of one's own home to mothers and children who may not otherwise receive it postpartum. The word seems to be spreading through the community about the maternal-child program. Paula just received a new client who was told about the program by her friend who used it and thought it was really great. The feeling seems to be mutual. Paula says "You really get attached to these families."
--Marcy Boucher, 2nd Year Medical Student, UMass Medical School, Summer 2008
