Opening Doors: A Closer Look Inside Home Visiting

January 18, 2024
Blog Post

At 6pm on a Monday night, I met Abby Goldstein outside an apartment complex in Southeast Washington, DC. She held two large tote bags filled to the brim with supplies, many of which she would leave behind for the family to keep after the home visit. For the next hour, I would observe her home visit with Aujanae and Royalty, a mom and daughter enrolled in Mary’s Center Nurse Family Partnership (NFP) home visiting program. Abby, Aujanae, and Royalty all welcomed me into their experience so that I could gain a first-hand understanding of what makes home visiting such a valuable resource for DC families.

When Aujanae invited Abby and me into the apartment, we took off our shoes and sat together on the couch. Royalty, a bubbly, smiling toddler walked over and greeted us with high fives. She climbed up on the couch with us. She didn’t sit still for long, but walked around the living room playing as Abby and Aujanae watched her and chatted on the couch.  Aujanae has been part of Mary’s Center NFP home visiting program since she was pregnant “with [her] smart, beautiful, and outgoing daughter Royalty,” and when I shadowed Aujanae’s home visit, Royalty was 21 months old. Abby has been their home visitor since Aujanae brought Royalty home from the hospital.

Aujanae is 18 years old and graduated from high school last spring. When I visited, she had been working at a new job for about a month. At the beginning of the visit, Abby and Aujanae talked with ease about the recent holidays and her family support system, about Aujanae’s new job where she was already excelling, and about Aujanae’s progress on getting her driver’s license. Before this visit, Abby had been helping Aujanae apply for the child care subsidy to get a voucher for Royalty to go to child care, so they talked about developments in the application process. The trust and connection Abby and Aujanae had built over the last 21 months was evident. Abby knew what was going on in Aujanae’s life and gave her space to talk about these things and anything else Aujanae wanted to talk about. This trusting and comfortable dynamic allows Abby to identify where and how she can offer support to Aujanae.

“Every time we have a home visit, it’s always positive,” Aujanae said. She said that she works to intentionally express her feelings, and that Abby “is always patient when it comes to talking about how I feel.”

After they finished catching up, Abby moved into the Nurse Family Partnership curriculum. This included looking at what development was normal for toddlers Royalty’s age, and asking Aujanae to reflect on which milestones Royalty had hit and which ones she hadn’t seen yet. Since Royalty was walking around and was an adventurous and playful toddler, they talked about outlet safety and Abby provided some covers for Aujanae to put in the electrical outlets. Next they talked about what signs Aujanae should look out for to know when Royalty would be ready for toilet training. The NFP curriculum also provided resources to help Aujanae know when she as a parent would be ready to potty train and had tips on how to do it, but Aujanae decided to wait to talk through those materials in the next visit. For the time being, Abby gave Aujanae more diapers and baby wipes.

The conversation flowed easily and welcomed the interruptions from the toddler. Throughout the visit, Royalty continued playing, climbing up and down from the couch, bringing us toys, playing with Abby’s glasses, and giving us high fives. When Royalty and Aujanae interacted, Abby watched and affirmed Aujanae’s parenting skills and the connection between Royalty and Aujanae. Royalty was a great listener and wanted to try new things, and Aujanae supported her freedom to experiment and stepped in when developmentally appropriate. When Royalty wanted to put her shoe on, Aujanae explained the steps that Royalty should follow. Royalty did her best to follow these, but couldn’t manage to push the small tennis shoe over her heel. Aujanae stepped in then to help her get it all the way on and secured the velcro strap. Abby actively reflected how great this interaction was. Aujanae said, “I feel like I have grown from where I was at first until now. I have learned to be patient with my child and others.”

At the end of the home visit, Abby took Royalty’s height and weight to make sure her growth was still on track, and Abby and Aujanae scheduled their next visit. The Nurse Family Partnership Program runs until the child turns two, so Aujanae and Royalty are almost ready to graduate from the program.

“I have learned to never doubt myself while working with my home visitor,” Aujanae explained. She has developed goals for herself and Royalty that they have already accomplished, and goals that she will continue to work toward after she graduates from the program. “I hope the next parent can accomplish everything they say they want to like I have so far and am striving for in the future,” she reflected. “I know they can benefit from the home visiting program like I have.”

The Nurse Family Partnership is one of 17 home visiting programs in the District. NFP is the newest home visiting program in the District, first piloted in 2021. NFP brings registered nurses directly to first-time moms in the District. The program has the capacity to support 100 first-time parents and their families each year. It is essential that the District continue to invest in the Nurse Family Partnership and other home visiting programs so that amazing and caring professionals like Abby can continue to connect with and help parents like Aujanae and kids like Royalty thrive.