Determined to make a difference in the lives of young mothers

November / December 2017   Comments

Susan Jack’s career transition from public health practice to public health research has given her the opportunity to identify nursing interventions, evaluate them and put them into practice. “It’s another unique way to transform the lives of many.”

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Susan Jack can pinpoint the precise moment she realized a career in research would still allow her to have a tremendous impact on the families she was used to visiting as a public health nurse.

It was a lecture in Guelph, Ont., in 1998. Dr. Harriet MacMillan, a prominent Canadian pediatrician and psychiatrist, was championing the Nurse-Family Partnership (NFP). Originating in the United States, NFP is a home visiting program delivered by nurses for socially and economically disadvantaged first-time mothers and their infants. The visits begin during pregnancy. In the U.S., the program has been shown to improve maternal and child health outcomes, including the prevention of child abuse and neglect.

Jack was doing her master’s degree while in a role as a nursing supervisor in Ontario’s Healthy Babies, Healthy Children program. After the lecture, she walked up to MacMillan.

“I remember saying, ‘I am going to work with you. I want to be the nurse that helps bring this program to Canada.’”

Jack has done just that. Now an associate professor at McMaster’s school of nursing, Jack has taken on lead roles to adapt the program and pilot it in Canada, starting first with a collaboration with Hamilton Public Health Services in 2008. She is involved in evaluating the effectiveness of NFP in British Columbia through a randomized controlled trial, while also leading a process evaluation to document how the program is delivered and what additional adaptations are required to ensure it reflects Canadian public health nursing practice.

Achieving her goal took fierce determination and completion of a PhD and a post-doctoral fellowship at McMaster’s department of psychiatry and behavioural neurosciences, with MacMillan as her supervisor.

Years before, after graduating from the University of Alberta with a baccalaureate degree in nursing, Jack had started her career in acute care and home care. She quickly found her passion in public health practice and continued that work in Guelph, after her husband, Richard, was transferred to Ontario.

While doing home visits, Jack first encountered young mothers who were experiencing intimate partner violence. Often, she’d have a gut feeling that the home was not safe for a mother and baby. But she had no specific training in how to respond.

She remembers one young woman who lived in a dark apartment with tinfoil-covered windows. When Jack visited the woman and her infant son, she talked with her about her depression and isolation. Although she could see the control the woman’s partner exercised, it was difficult to mitigate the emotional abuse.

Eventually, Jack persuaded the woman to enrol her son in subsidized daycare and find community activities for him. These actions reduced the isolation and presented options, increasing the child’s safety.

One of Jack’s first research studies started in the U.S. with NFP. She was given the opportunity to develop a nursing intervention to identify and respond to intimate partner violence. She conducted interviews with NFP nurses and supervisors and with mothers who were enrolled in the program.

Their suggestions influenced her adaptation of the program for the Canadian context some years later. For example, nurses had told her that chatting informally with the mothers built trust and inspired confidences.

Putting nurses’ experiences into policy and practice is a rewarding aspect of Jack’s career. Initially, though, she missed the daily contact with clients when she moved into academia.

“When you are working in front-line care, every day the difference you make is acknowledged, or you get the joy of seeing families make changes in their lives.”

Although she no longer has the immediate results of interactions with clients, she draws satisfaction from implementing evidence and moving it into nursing education and professional development.

“Now I clearly understand that, as researchers, we have the power to identify nursing interventions, evaluate them and demonstrate which ones make a difference.”

Jack’s work is engrossing and demanding. When not in her office, she’s often driving her twin boys, Ryan and Benjamin, to soccer and hockey practices, enjoying the chance to connect en route. When a break appears in her schedule, time on a beach with a good book is how she practises self-care.

As part of the NFP process evaluation, she listens to nurses bear witness to the trauma they see. All are required to debrief with supervisors.

“The program supports nurses through that process of reflective supervision: how to manage their fear, worry for their clients, and frustration when they’re not understanding why clients can’t always just leave an abusive relationship,” Jack says. “We support nurses in understanding the emotions they’re having.”

That support can prevent burnout or compassion fatigue — something she has been able to avoid, she says. Her passion for her research career burns throughout her descriptions of her work.

“To me, it is a very powerful position to be able to listen respectfully to other people’s experiences and share those experiences with the broader world.”


10 questions with Susan Jack

What is one word you would use to describe yourself?
Optimistic

What are you most proud of having accomplished?
Defending my PhD, with one-year-old twins at home

What is one thing about you that people would be surprised to learn?
While I fold laundry on Sunday nights, I watch reality TV

“If I had more free time, I would...”
Hang out with friends and family

Where did you go on your last vacation?
Through Virginia and Maryland, on a family road trip

Name one place in the world you’d most like to visit.
Petra, Jordan

What is your biggest regret?
No time for regrets. I have learned to accept the decisions I have made

What was the last good book you read?
The Nightingale by Kristin Hannah

Who inspired you to become a nurse?
My grandmother, Helen Keogh — the most active 98-year-old I know. She was proud to wear her uniform, nursing cap and pin every day of her career!

What was the best piece of career advice you’ve received?
Be willing to take a risk to take on a new position or role

Laura Eggertson

Laura Eggertson is a freelance journalist in Ottawa.

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