Sue Mercer, Family Nurse Supervisor from West Sussex, blogs about her experience of taking the tool from paper to practice.
It’s fair to say that initially I was concerned about introducing the New Mum Star into practice; I was worried about how clients would feel discussing their very personal journey of change and how they would manage having challenging conversations about areas of their lives.
Yet it soon became clear that the New Mum Star helps practice by laying a foundation for an open and honest discussion. It makes those difficult conversations easier to have and improves client confidence in understanding not only where their needs are but also their strengths lie. The New Mum Star is made up of nine points and we discuss aspects of the client’s life, such as their baby’s development, safety and stability, as well as the goals and aspirations they hold for themselves.
The New Mum Star has definitely changed my practice. It’s made it easier to handle challenging and complex conversations about smoking and safeguarding and has provided a platform to approach other sensitive subjects such as anxiety, relationships and how confident clients feel about making decisions for themselves and their babies. Before the New Mum Star tool was created, we assessed clients using both observational and communication skills derived from learning and professional judgement. This technique can produce a certain degree of variation, due to the nature of individual nurse judgement, whereas the New Mum Star provides a structured framework with which to base decisions on and articulate the reasons for professional decision-making.
Perhaps the most helpful aspect of the New Mum Star is that it is a holistic assessment within a collaborative process. It allows me, as a family nurse, to use my professional judgement and expertise to adapt and tailor the programme. Using my expertise in the programme and the client’s expertise in herself, it allows us to make plans together and to prioritise aspects of the programme that require more time for that particular client at that particular time.
It is really heartening to see clients who are anxious and lacking in confidence and who are reassured by the changes and progress made when undertaking review stars. I’ve seen clients feel positive and confident in their parenting when they can visually see their progress and achievements represented on the New Mum Star.
As with any programme change, there have of course been challenges, and also some surprises. As part of the process, clients are able to ‘challenge’ when they score themselves highly for one of the nine star points. If nurses are finding it difficult to complete alongside clients, there is the option of completing a “nurse only” star which can be brought to discussion in supervision sessions, where we as nurses have the opportunity to reflect on the differences in our scoring and use this to form the base for a plan of care.
The New Mum Star has reinforced the point of digging a little deeper and the importance of respectful challenge. There have been occasions when nurses have felt that they know their client really well but during the process of completing the New Mum Star together, the client has disclosed to them that they have been struggling emotionally or that they feel stuck in an unhealthy relationship when nurses hadn’t previously seen cause for concern. The New Mum Star does really help open up discussions. Each point on the star gives the client the opportunity to voice their experiences and concerns which they may have previously struggled to articulate.
The New Mum Star is now fully embedded in our team’s practice and I couldn’t imagine not using it. It really gives an overall view of where the client is currently in her life. It helps shape practice and allows the family nurse to use all of her skills to deliver the FNP programme to best meet the needs of the client and her baby.