Case Study: Taking the time to build trusting relationships
A Nurse Home Visitor from Danila Dilba Health Service – Darwin’s only Aboriginal Community-Controlled Health Service, shares her story below of the importance of time to develop a rapport with a young mum.
The Australian Family Partnership Program is unlike any other family support program in Australia. It’s based on time – something most health services have in such short supply. It allows time to get to know a client, their family and their individual circumstances. It allows time to invest in the client’s relationship with their health service through multiple interactions, many of which happen in the client’s home. And because of this, lifelong bonds are created.
Challenges building rapport with a young first-time expectant mum
My Family Partnership Worker colleague and I supported a 19-year-old, first time mother during the perinatal period, and we really struggled to build rapport to begin with.
An AFPP Family Partnership Worker and I began visiting the client during her pregnancy to help with transport to her antenatal appointments. The client lives with her partner and extended family. These initial visits were a challenge – making contact with our client prior to our arrival was difficult and she was often asleep when we arrived. She was very reluctant to leave home, and if she did allow us to take her to her appointments, she was reluctant to speak to us.
Bub arrives early and a long hospital stay
She delivered a baby girl at 34 weeks with intrauterine growth restriction. We couldn’t engage with her while in the hospital for almost two months. We liaised with the social workers at the hospital, doctors, and nurses, as we were worried about her and her baby girl.
Upon discharge, the baby required regular weight checks as she wasn’t gaining enough weight. We found it difficult to contact mum and couldn’t find her at her recorded address.
We persisted, and luckily, we were able to track her down.
We started to attend the home 2-3 times a week. We also brought her to appointments with the Danila Dilba midwife.
Building trust, improving compliance, and achieving positive outcomes
Over the next few weeks, bub started to slowly gain weight, and we started to see a shift in mum’s spirits. She and bub would be bathed, dressed and ready for our visits. Over the next few weeks, we were able to extend the time between weight checks as bub continued to grow.
With bub now on track weight-wise, we asked mum if she would like us to scale back our visits. After many months of feeling like we were pestering her – and knowing that bub was making good progress – we thought she would like some space to continue on her own.
To the contrary – she asked us to keep visiting every couple of days. She wanted us to come, check on the baby, and reassure her that baby was growing well. She attended all her appointments, including her postnatal check.
After all these months, mum also started to talk to us, slowly. She started openly sharing stories about baby’s development such as smiling, cooing, or doing tummy time with her partner. She was smiling and happy when sharing baby’s achievements. It was evident she was bonding with her baby girl.
She started to say, ‘thank you’.
We had also spent months trying to help the mother get support from Centrelink and finally she sorted it out.
Helping families thrive
The moral of this story is to highlight that building trust and rapport with a client can take longer than anticipated at times. It is the client’s journey, and we are here to walk alongside them. Having the luxury of time, which is often not possible in other health care interactions/settings, is an invaluable strength of the Australian Family Partnership Program.
This family is now engaged with their local health service, the baby is growing and developing, the mother is breast feeding, and she has bonded with her baby. She also has control over her contraceptive rights and financial freedom. These are “small changes” that have very positive long-term effects.
Evidence tells us that the first 1000 days are the most important and seeing this young family having a positive start despite many challenges is reassuring and heartwarming.
Articles
PANDA National Helpline
Find someone to talk to, Monday to Saturday.
1300 726 306
Call 000 for police and ambulance if you or someone else are in immediate danger
Talk with friends or family
Consider talking about how you are feeling with someone you trust. This might be a friend or family member. Once you starting talking you might be surprised at how many others have had similar experiences and the support they can provide you.
Talk with your doctor
Talking with your doctor can be an important step to getting the help you need. They should be able to give you non-judgemental support, assessment, diagnosis, and ongoing care and treatment. They can also refer you to specialists such as a counsellor, psychologist or psychiatrist.
Get help now
If you are having suicidal thoughts or are feeling disorientated it’s important to get help immediately. PANDA is not a crisis service, if you need immediate support call Lifeline 13 11 14 (24/7).