24 Hours: Trish Dovestone

Raising awareness: Trish Dovestone says the biggest challenge in her job is keeping up the profile of family violence.
Raising awareness: Trish Dovestone says the biggest challenge in her job is keeping up the profile of family violence.

Trish Dovestone is a nurse co-ordinator for the family violence intervention programme (FVIP) run by the South Canterbury District Health Board.

She works 20 hours a week, sharing the role with Lelia Currie. She has been in the job for just more than two years, and comes from a background in the aged-care sector.

I work Monday, Tuesday, Wednesday, and do my 20 hours over those three days. I usually start at 8.30am, although I had an early start today and went to the gym in the morning, shot home again and made sure my two teenage boys were organised for the day, and dropped the older one off at high school on my way to work. That's my usual start to the day.

I think it's the same for everyone these days, clearing emails and voice messages. I'll get messages from staff wanting support and advice about family violence issues that they are dealing with with clients or patients. Or we'll get emails from other FVIP co-ordinators in other areas, maybe some information from our national manager, or just general updates of what's happening within the DHB.

Staff might phone to say they've met with a client and a family violence issue has been discussed, and they'll talk about what they've done. Often they just need some support that they have done the right thing, or want some advice on what else they can do for this person. It could be an in-patient or an outpatient, someone who may have disclosed they are in a violent relationship. Lelia (Currie) and I cover the week between us. I am lucky to work with Lelia who has been in the role for several years and is very wise.

Because White Ribbon day is this week, I've been out and about this morning and have done the display board in the hospital foyer, and put up posters around various areas. I've sent out the agenda for our FVIP steering group, which meets quarterly, and has internal (DHB) and external (community) members.

There are 19 members on this group including the paediatrician and the nurse manager of ED, and external members including Women's Refuge, the elder protection co-ordinator, CYF and police. Collaboration is just so important in the family violence area. We feed back to this group what we have been doing over the last quarter, and they guide and provide oversight and direction for the programme.

The role here came about when the Ministry of Health in 2002 developed family violence intervention guidelines in response to what was happening in New Zealand; the number of children dying because of family violence. So family violence intervention programmes were set up and are now in all the DHBs. It's about raising awareness of family violence and training staff on what it is, helping them to identify, support, and intervene safely and appropriately.

Family violence can be partner abuse, child abuse and neglect, and elder abuse and neglect. In the past few years, we've mostly focused on child abuse and neglect and partner abuse, but over the past six months, we've been looking at implementing programmes on elder abuse and neglect.

South Canterbury's ageing population means we've got one of the highest rates of over-65s – 18 per cent compared with the national average of 12 per cent.

With elder abuse, we're hoping to make staff more aware, and look at the big picture of what's going on for that older client or patient. It could be physical or emotional abuse; the highest reported is emotional abuse, but there can also be financial abuse, sexual abuse and neglect. It can be active neglect by family, or it can be passive neglect through a lack of skills or knowledge about caring for an elderly relative.

We are looking at raising awareness through training sessions early next year, and I'm working with Geeta Muralidharan (South Canterbury elder protection co-ordinator) on this. We went to Dunedin last week to meet with the FVIP co-ordinator there who has been doing some work with elder abuse and neglect, so we could see how they are approaching it.

We'll target at first the areas that are specifically dealing with elderly, although there aren't many departments in the hospital that don't deal with elderly.

We've got a Ministry of Health AUT (Auckland University of Technology) audit coming up in December, and there's quite a lot of pre-audit work to be sent away to them before they come down to visit us.

I'll often go for a walk around areas in the hospital, updating resources and just to show my face. That gives staff a chance to ask questions, and also prompts them to be thinking about family violence.

We take on projects throughout the year. Mine is the elder abuse and neglect policy, so I've been developing that. And I'm working on the whanau ora evaluation tool, so I've been working with members of the local Maori community. This evaluation assists us to ensure our programme is culturally safe for our Maori families and also for families of other cultures. Over the two years I've been here, I've noticed people are more comfortable about talking about family violence – staff are aware that it's a priority for this DHB. Family violence is very much part of the health business – the health implications for people living with family violence are huge.

Women experiencing partner abuse present so many more times to health professionals than women in non-abusive relationships – and not necessarily always with physical injuries.

I think anything we can do, to empower a woman to make the right decisions for her at that time, is important; it's giving them information. And it's the same with children, anything we can do to keep a child safe. And sometimes it's just that the parent or parents might need some support or help with their parenting skills.

The television campaigns – are you ok – raise awareness of the issue, reinforce those messages and support what we are doing here.

The biggest challenge is keeping up the profile of family violence – there's probably always something else that's going to be implemented that staff have to deal with as well. It's about keeping it going, sustaining it.

The training that we do, staff come away feeling they have learned a lot of new information about family violence. And we always talk at orientation for new staff – we have a 30-minute slot to do an overview of the FVIP and why we have one in this DHB, and that's usually very well received.

The training, it's a collaborative approach with Women's Refuge, police and CYF, it's an eight-hour core training day, and then we follow up a few weeks later. In the training, we provide statistics, look at what is family violence, partner abuse in one session, and child abuse in another, the myths and misconceptions, the dynamics, the cycle of violence.

One in three women in New Zealand will have had a form of partner abuse at some time over her life period.

Overall, with training and orientation sessions, we've dealt with close to 500 staff in the DHB.

I've just done an interpersonal and family violence paper through the University of Auckland. While I've learnt a lot here over the two years, it certainly consolidated and reinforced this. It's the "whys" that are interesting – why does family violence happen, and why is it happening like this in New Zealand? It's learning more about the dynamics. And New Zealand is actually leading the research on family violence in the world.

If I'm at a social event and people ask what I do, they say, that must be awful. But it's rewarding in that you are raising the awareness on what have been taboo subjects, and hopefully somewhere in the work we are doing there's some positive outcomes for families.

We have six-monthly national meetings with the other co-ordinators from the DHBs, and then we have regional meetings twice a year as well, with the South Island co-ordinators.

I'll be heading out the door about 4pm, and then it's just the usual working mother's thing; running around with the out-of-school activities and sports. I am just starting Mauri Ora study through the Open Wananga – Maori culture and history so have to find some time for that. I touch base with Ken and the boys over dinner, usually try to go for a walk, and if I'm lucky, I get to read a book before bed and it's time to start all over again.