Caring + Education = Healthy Beginnings

Traveling the far corners of Centre County in her Toyota 4Runner to provide advice and answer personal questions, Linda Yastro visits the homes of new and expecting parents.

A maternal child nurse and case worker for The Healthy Beginnings Plus program, Yastro visits her patients on a weekly basis. Her personalized home care begins during the first three months of a woman's pregnancy and continues until the baby is six weeks old.

Deanna Dugan greets Yastro at the door and tells her she is feeling better since her 14-hour labor that resulted in a Caesarean section three weeks earlier. Yastro weighs Deanna on a scale next to the refrigerator that displays a sign saying "Welcome home honey, I love you," from her husband.

Yastro proceeds, examining baby Hunter on the couch -- she checks his heart, weighs and measures him while his mother looks on cautiously.

"I'm sorry," Yastro tells Hunter, as he screams and cries.

"When I see the babies I do a physical assessment on them," Yastro explains. "And they don't like it one bit. The best part of my job is that I get see these cute kids."

The Dugans anxiously ask Yastro questions about their newborn concerning feeding habits, bathing, hiccups, his skin and his eyes.

"I just answer their questions," she said. "I give them the reinforcement and reassurance they need after becoming parents. I see these people every week. I know when I was a first-time mother I was always nervous and wondering if I'm doing a good job."

Basically, Yastro says, she teaches her patients how to take care of themselves while they are pregnant and makes sure they and their babies are staying healthy after they are born.

"I get to know these people really well," Yastro says, referring to her entire clientele.

Besides teaching clients how to stay healthy, Yastro also reinforces prenatal care, helps them with the process of labor and tells them what to expect during the childbirth.

Yastro gave the Dugans a list of items they would need for Deanna and the new baby, Deanna said.

"She told us everything from packing a hospital bag to ideas of what might happen," she said. "She gives a more realistic view of what's happening and what will happen."

Yastro's examination shifts from Hunter to assessing Deanna's health since her surgery. After Deanna tells Yastro she has been getting daily headaches, Yastro checks Deanna's blood pressure and discovers high blood pressure may be the cause of the headaches. Yastro tells Deanna she will alert her physician.

"Linda spends at least one hour with us," Bob said. "Doctor visits are quick -- in and out. This is a lot more personal."

Before Deanna returns to work, Yastro suggests she start preparing Hunter for bottle-drinking.

And before ending her visit with the Dugans, Yastro throws in some personal suggestions to the couple.

"I think it's important for the two of you to go out and have an adult night," she tells the Dugans with a smile. "You'll feel much better once you get out of the house for a little while."

After scheduling her next visit with the couple, Yastro gives a last piece of advice to them before leaving. She alerts the Dugans about sickness around the house, and tells them not to let sick people handle the baby.

The couple graciously says good-bye to Yastro.

The Healthy Beginnings Plus program, run by Centre HomeCare Inc. in Bellefonte, provides expectant mothers with information to insure good health, a normal delivery, healthy children and successful child care skills.

Aside from the weekly home visits Yastro provides, the program also offers services such as childbirth education, physician care, drug, alcohol and smoking counseling services, family planning, transportation and parenting classes.

Basically the program is a "preventative health care program designed to head off health problems for pregnant women and newborns," said Michael Brand, director of community affairs.

The program caters to "high-risk" pregnancies, such as those involving low-income families, young, single mothers or any other high-risk circumstances, said Susan Wallace, clinical director.

"The main focus of the program is education and prevention," she added.

Sponsored by the Pennsylvania Department of Health and private contributors, the Healthy Beginnings Plus program has been in existence for about three years, Brand said.

Centre HomeCare Inc. is a community-based, nonprofit institution, Brand said, which is governed by a community volunteer board. The institution was created by the people of Centre County in 1965, Brand added.

Yastro's participation in the program keeps her busy and constantly on the road.

With the 25 to 30 patients that she visits, her week usually results in five to six home visits a day across Centre County. She also spends one day a week visiting patients during their doctor visits at Centre Community Hospital. Yastro said she is referred to her patients by doctors and the WIC program, which provides assistance to low-income women, infants and children.

The main benefit of her job, Yastro said, is the self-satisfaction she receives after her patients have healthy babies, she said. Another source of enjoyment for her is the ability she has to get personal with her patients.

"I get to visit people in an informal setting." she said. "Individual teaching makes it real personal."

Another positive aspect of the program, Yastro said, is that her patients receive "continuity of care" because they often visit different doctors from a group of five who participate in the program.

Many participants of the program agree it is extremely beneficial.

"I highly recommend this program to anyone," Deanna said, "especially to a first-time mother."

Deanna says Yastro's visits give her "peace of mind."

"Linda lets me know about anything I'm experiencing," she said, "whether it's normal or abnormal."

Deanna added that Yastro has given her helpful references to doctors and hotlines.

"I think she does a fantastic job," Bob said. "We were going into this clueless, we really needed her help."

"I've always wanted to help people," Yastro said, adding that she has wanted to be a nurse since she was six years old.

And according to her supervisor, Susan Wallace, Yastro picked the right career. Besides possessing an abundance of clinical knowledge for her job, Wallace said, Yastro has many personal qualities to contribute.

"Linda's a very compassionate, mature, strong and understanding person," she said. "The younger moms feel very comfortable with her."

After receiving a registered nursing certification in obstetrics from Philipsburg State General Hospital, Yastro spent 19 years as an obstetrical nurse at DuBois Regional Medical Center before joining Centre HomeCare Inc. in October 1996.

Yastro then decided she wanted to spend more time with her family. After seeing an advertisement in the classifieds, she thought the Healthy Beginnings Plus Program was similar to her previous job and "the same kind of work in a different setting."

"I like the idea of home health nursing," she said. "It is a lot different from a hospital setting."

One aspect of home care that Yastro is exceptional at is her ability to avoid being critical, Wallace said. Judging people and their homes is something home healthcare workers must be very careful to avoid, she added.

"Linda's ability to provide care in a non-judgmental way fosters a very open dialogue for the learning of her patients," Wallace said.

Working for Centre HomeCare, Yastro said, gives her free evenings and weekends to take part in her favorite hobby -- spending time with her family: a 12-year-old daughter, 9-year-old son and her husband.

"To me, my children are the best hobby," she said. "I love coming home from work and seeing my kids."

Reading, bicycling and working out in a gym round out Yastro's hobbies, she said -- all of which she incorporates with spending time with her children.

"My kids take turns coming to the gym with me," she said. "We love to read and take bike rides together."

And no future life changes are in the cards for her, Yastro said.

"I'm content where I am right now," she said.

"Actually," she said jokingly and with a hint of sarcasm, "I want to be a singer in rock 'n' roll band."