|Author: Carol Devecka|
|Nurse Works to Lower Infant Mortality|
|"I started nursing school after having three children and working as a secretary for 10 years," explains Sharon Rohrbach, RN about her start in nursing. "I am a Christian, and was motivated by the desire to serve the Lord in a greater way than I felt I could as a secretary. As for my efforts toward lowering infant mortality, the fact is, I don't have the skills to do this - I have relied on a huge amount of prayer and the knowledge and good will of many others. I am simply the coordinator."
As self-effacing as that is, without the initiative, drive and effort of Rohrbach there would be no help for underserved newborns and their mothers. She is the Co-Founder and Executive Director of Nurses For Newborns Foundation (NFNF), an agency that serves the needs of a population otherwise without recourse. "I founded the agency with another nurse as a for-profit company in 1989, for the purpose of reducing infant mortality," she says. "Then in 1991, my daughter Robin Kinney and I founded the non-profit agency as it is today. It was she who first saw the need for the change, identifying poverty as one of the biggest risk factors for many who would be unable to afford our assistance otherwise."
After completing her nursing education, Rohrbach worked with the newborn population for a number of years in a hospital setting. It was there that she began to be interested in reducing risks for infants in this country. "I worked for 16 years in a newborn nursery. We were often called to the ER when newborns came in because we had the proper equipment and skills," she recalls.
"Very often the babies were brought in for completely preventable causes," Rohrbach continues. "I began to look at other countries with lower infant mortality rates, to see how they did it. The United States, with all our resources, ranks 25th in infant mortality. When I first began to look at the problem, I thought it was shortened hospital stays that played a big role. I now know it is poverty that poses one of the biggest risks to the nation's newborns."
Rohrbach is proud of the work that has been done through the agency, and describes the NFNF. "We provide home visits to indigent and underserved mothers and babies in 29 Missouri counties, nine Tennessee counties and the metro Washington, D.C. area," she says. "Our special services include nurse home visitation, physical assessment, referral to community agencies and teaching infant CPR. We distribute 1,100 pounds of food each week. We also maintain a donation bank of baby cribs, layettes, car seats, etc. which are distributed to our needy families. We provide four programs, one for mentally limited mothers, one for special needs babies, one for teens and one for pregnant women and the general population whose major risk factor is poverty.
"The clients we serve are desperate. Their average income is $500 a month, many have no heat and no basic necessities," she says. "They know they need assistance for the sake of their babies, and are willing to accept help. All of us think that we will never be in these positions, but many of the clients we see are not any different from you or me. Circumstances have put them into the needy position that they now find themselves in. Sometimes they have lost a job, and, therefore, their insurance coverage. Sometimes other things have happened, but 75% of our clients are Medicaid eligible, and most have other extenuating issues."
While all the efforts of NFNF are unique, Rohrbach shares a little about some of the challenges that face some mothers receiving help. "The program we created for the mentally limited mothers, like our other programs, is their only safety net. There are few other resources for this population at all," she says. "And while they may have limitations, they are certainly capable of bringing babies into the world, and have virtually no skills with which to care for their infants."
She continues explaining "We schedule long-term home visitations for them, and we teach them what they need to know, things that many of us take for granted. They need to learn how to mix formula, wrap babies, and how often to change diapers. Everything has to be consistently taught and retaught. Very often these mothers misinterpret their baby's cues, and stop feeding them before they are done. They sometimes forget to change their diapers altogether, because soiled newborn diapers don't usually have a bad odor."
Rohrbach remembers many individual cases the foundation has helped with, but one that lead to their program for preemies is particularly memorable for her. "Our program called 'Bridge to the Future,' the one that fills the special needs of premature infants, was inspired by a baby named Michael. He was referred to us by a local hospital because they believed we could help him make the transition between his too-short hospital stay and a healthy life at home," she recalls.
"Michael was a preemie, and weighed only four pounds at discharge," she says. "His mother was a Medicaid recipient, and was discharged because the hospital didn't take Medicaid for her case. They told her to bring Michael to see his local pediatrician right away. When she tried to schedule an appointment, the pediatrician's offices in her area were not scheduling any Medicaid patients for five more weeks, and no one would look at him.
"The baby's father had left after he was born, so she had no form of income since she had stopped work due to her pregnancy complications," continues Rohrbach. "She knew that she needed help, and when she contacted the local WIC center, they told her that she had to prove she had a baby by bringing him in before she would qualify for assistance. She had no transportation, and had undergone a cesarean section for Michael's delivery. There was no way for her to get her premature baby there, since walking the five miles would be impossible for her and for Michael, who had trouble maintaining his body temperature."
Rohrbach remembers first seeing Michael. "When we showed up at Michael's house, he was blue and mottled, and had so little body fat that his ribs showed. He was sleeping on the floor because his mother had no equipment for him, and she did not know how to wrap him properly. He had trouble just keeping his body temperature, and could not eat more than a quarter of an ounce at a time. We knew that his problems were never going to be solved in our typical four to five home visits."
That is when NFNF stepped in, and realizing that this case was probably not unique, set up the new program. "We intervened on Michael's behalf with WIC and the pediatrician," she says, "and found the equipment he needed, from sleepers and blankets to a crib and changing table. Since then we received a picture of him when he was about two or three, looking very healthy. But I believe that without our intervention and help, he would not have made it. Because of Michael, we help other premature infants in his position through our 'Bridges to the Future' program."
Work like this is rewarding, but has its difficulties as well. Rohrbach says, "The greatest challenge of my job is finding the two million dollars this year to serve over 3000 indigent families who cannot afford to pay for services. We do not turn away any babies referred to us. Every hospital with a labor and delivery department in our service area refers patients. We accept them all on faith that we will be able to raise the dollars to pay our 35 nurses and our office staff of 12."
Describing the positives is also easy for Rohrbach. "My favorite part of the job is the travel and meeting different people. Last year I received the 'Use Your Life Award' from Oprah Winfrey on her show, a 'Women Who Inspire Us Award' from Women's Day Magazine, and an invitation from Laura Bush to come to the White House. Now that's what I call meeting some interesting people!" she laughs. "My other favorite aspect of the job is the difference we make in the lives of the babies we serve, in some cases saving lives.
"To do this," she says, "my day-to-day responsibilities are quite varied. I am responsible for four separate locations, Rolla, MO, St. Louis, MO, Nashville, TN and Washington, D.C.. I am the 'voice' of the organization, so I make frequent speeches around the state and around the country. I also frequently travel to our offices to meet with community leaders, go out on home visits with the nurses to evaluate their performance and meet with prospective and current funders. Most of my time is spent communicating the needs of the poor to those who have the means to help with our mission."
It is important to Rohrbach to let others know that each individual's work can have an impact. "Even one person can make a difference," she says. "If you just begin to try to make a difference in the world, pretty soon others join you and you aren't just one person anymore. That is what happened to me. Just two of us started out in 1989 to try to decrease infant mortality. Now 169 different community agencies refer to our programs, which serve over 3000 infants each year. Thousands of donors help us to provide our services, and 11 churches send mentors to our clients. Recently, one of the Tennessee Titans, Fred Miller, and his wife Kim, donated $450,000 to bring our services to Nashville, TN and hopefully spread them to Apalachia, TN. Our programs have been successful at decreasing infant mortality, have reduced child abuse and neglect and reduced repeat teen pregnancies. I would like to encourage my fellow nurses to follow their dreams and dare to make a difference!"
Sharon Rohrbach earned her Associates Degree in Applied Science from St. Louis Community College, St. Louis, Missouri in 1976. She attended a Woman Entrepreneur Course at St. Louis Community College as well. She is a member of several organizations, including the Regional Health Commission of St. Louis, MO, the National Perinatal Association, and the Association of Women's Health, Obstetrical and Neonatal Nursing. She is on the Missouri Committee for Prevention of Child Abuse, the Missouri State Medicaid Maternal Child Quality Assurance Subcommittee, and is a past Chairperson for the Children's Health Coalition of the Missouri Association for Social Welfare. Nurses For Newborns can be found at www.nfnf.org, or at 1-800-45-BIRTH.
Carol Devecka is a writer from the Philadelphia area. She is on the editorial staff of NEWS-Line for Nurses.