This article was written by Teresa O'Connor of New Zealand Nurses Organisation for the monthly members' magazine, Kai Tiaki Nursing New Zealand. It featured in Volume 24, number 4 released in May 2018.
Enrolled nurse and UCOL Graduate Dalreen Larkin has huge empathy for the families she works with. Her role is to ensure all children with appointments at Whanganui District Health Board’s audiology outpatients turn up.
Traditionally, the clinic had a very high “did not attend” (DNA) rate for children, particularly Māori and Pacific children. In October last year, Larkin was seconded to a project to reduce the DNA rate. She has been very successful. Within three months, the DNA rate had dropped from between 30 and 40 per cent, to virtually nil. A good deal of that success is due to Larkin’s ability to understand and empathise with the parents she works with.
Empathy from experience
Her empathy has been born from her own experiences as a young Māori mother with lots of kids, little money and little self belief. “I met my husband when I was 15, had my first baby at 17 and had seven kids by the time I was 33.”
School held little interest but she had always treasured a desire to become a nurse. The responsibilities of motherhood didn’t crush that hope and when her youngest was six, she decided to take the plunge, encouraged by a friend who’d become sick of hearing her talk about becoming a nurse.
“My friend got the UCOL enrolment form. I needed that push; I needed someone to believe in me.”
Larkin started a health and science pre-nursing course. “It was scary and I wanted to quit in the first week. I hadn’t finished the fifth form. It was like a foreign language.” She failed, but that didn’t extinguish her hope and she completed the course the following year and embarked on her EN training at the Universal College of Learning’s Whanganui campus, qualifying in 2014.
She worked first as a casual at the DHB and then in medical outpatients, before her secondment.
Her current job involves ringing all the parents/caregivers on the department’s clinical list a week before the appointment and again a day before. She has a finely tuned sense of when somebody might intend not turning up. “There can be a slight pause when they answer the phone and I ask them if they’re going to come in, or it can be the sound of their voice.”
Impact of hearing loss
Undeterred, she will talk with them, often hear “a big story” before getting down to the “nitty gritty”. That can be a tale of a child whose behaviour at school means they are often kicked out of class because they are disruptive and their parents are at the end of their tether. During the phone call, she will discuss the impact of hearing loss on a child’s behaviour and language development and how that leads to deep frustration for the child.
“I have a bit of a laugh along the way. It really helps our Māori parents if they understand why their children have to come for an appointment.”
She talks with families when they come to outpatients. ”I want them to feel like they matter, that we care enough to talk to them, that we are real, not some unreachable clinical person.”
For many, getting to the hospital is not straightforward. They have no transport, and “a lot of our Māori families are big families, so finding someone who can give them a lift or who can babysit is hard.”
Larkin knows these challenges well. “When I see those families, I see me. I DNA’d so many times. Our son had hearing problems, but I thought ‘they’re just looking at his ears’ – I didn’t understand the importance of turning up. ‘They’ll send another appointment’ was my attitude. We had one car, our finances weren’t great and sometimes it meant my husband taking a day off work.
“But now I’m on the other side, I push home to our families how important it is to turn up. I tell them how much it costs if a child doesn’t turn up. I tell them they’ve got to turn up or they’re just wasting money. You should see the looks on their faces. I wish somebody had told me that,” Larkin said.
She is very persistent in tracking children who have not turned up, sometimes taking months to locate a child. She’ll use every avenue possible – “it’s a bit like stalking” she laughs. And once she’s ”got them”, she’ll work with the family and make referrals to other agencies, as needed. She is also passionate about “encouraging and uplifting” many of the mothers she sees. Again, she sees herself in them.
She also works on the newborn hearing screening team, which has a high DNA rate.
She loves her current role but her nursing journey hasn’t always been easy. At times she felt undermined, that some people wanted her to fail. But that only made her more determined, more confident in her own skills. Despite the challenges, including the loss of her beloved husband Mana in July 2016, she’s delighted she has fulfilled her life-long dream and is now helping those whose journey she understands so well.
The DHB is delighted too. Outpatients department clinical nurse manager Judie Smith said Larkin was the ideal person for the role.
“She has the ability to walk in others’ shoes and totally understands how it is for these families – there’s no judgement, no blame, she walks alongside them.”