Nurses and Domestic Violence

[warmrain]

Hi,

I am a nursing student going through my second semester of school. For my theory class we are writing summary papers on nursing issues and are using nursing forums to gather more information. I have been lurking about this site for a week or so and I am hoping for some input from the nurses here. My paper won't contain any names just whatever subject information I can gather.

I am wondering about any nurse’s experiences with domestic violence victims and how they handled the situation. I read an article in a Nursing (2004) issue that gave information on what to do if domestic violence is suspected. They suggest doing a private interview with the patient, using open-ended questions, and reassuring them that what they tell you is confidential, that they are not alone and that help is available. They also advised to give the patient information regarding abuse and resources to go to for help. It then talks about doing follow up questions by phone, if abuse is denied, when you believe the abuser is not at home. Is what the article advises all that you can do as a nurse and is this advice helpful in a real life situation? Has anyone had any experience with victims of domestic violence and do you have any advice if this situation comes up?

I also read a brief article in The American Nurse (Jan/Feb 2003) about a tool to use in interviewing domestic violence victims. It is called the domestic violence survivor assessment (DVSA). The article details five stages women generally go through before they are free from domestic violence. The DVSA is then used to find where they are in their abusive relationship and help tailor interventions in a way that will be effective and lead to ending the cycle of abuse. Has anyone used the DVSA? Was it easy to use and was it a useful tool? Would you use it again? Are there any other tools that are helpful in working with victims of domestic violence?

Thanks for taking the time to read my inquiry and for any responses that you care to post!

[erjulie]

I'm an ER nurse, and the estimate is that 30% of the females we see are victims of domestic violence. We have a state mandated screening tool that we ask every patient if they are safe at home. I've rarely had a patient answer yes, and it certainly isn't 30%. So, the question may be "wrong", or people are un-willing to disclose this info. I have seen it all from dead (or soon to be dead) patients who were obviously victims, to beautifully dressed/maintained women who had that "haunted" look, a partner who wouldn't leave the room, and not an incriminating mark on them. My strategy is to walk the patient to the bathroom on the pretense of getting a urine specimen, and offering them the chance to verbalize. If they are not forthcoming, I ALWAYS tell them that we're always here, and that they would be safe while in the ER. The bathroom has a disply of brochures offering help. I've learned that the most we can do in many cases is offer an alternative.

One of the saddest experiences of my life was with an RN whom I admired greatly. An excellent RN, a great teacher, a flight nurse. She came to work one day smelling of ETOH with "bracelet" bruises on her wrists and finger bruises on her neck. All I could do is tell her that she was welcome at any time in my home, her husband would never find her there. She would not have been able to hear me ask her if she were a victim (of course she was),and I doubt that she'd ever have talked to me about the abuse. However, the look in her eyes when I told her that was most gratifying. She just understood that I would help if she could ever ask for help. Sometimes (many times, I'm afraid) that's all we can offer.

There is no time in the ED to do follow-up phone calls, and the thought that the abuser would answer the phone is frightening.

Good luck in school, I hope that your study gives you greater insight into this horrific silent epidemic and allows you to save at least one person.

[warmrain]

erJulie - thanks for your reply. I am sorry to hear about your RN friend. Did she eventually get help? Seeing all of that and being able to do only so much must be frustrating. I know they have to want to get help first but it still must be hard to deal with. I like how you walk them to the bathroom to get a private moment and what you tell them about being there and that they are safe in the ER. Too the brochures in the bathroom is a good idea. The ER in my home town doesn't have any in sight, even in the bathroom. Are there programs or campaigns in Illinois, your town or at your institution that help victims or aim at preventing abuse? I am just wondering how much attention this problem is getting in other states.

[erjulie]

Illinois has programs, as does the county we live in. Most areas have women's shelters, or a crisis line that can provide info for you to get the information. I would hope that every town, city, county and state of the Union has something in place.

I don't think my friend ever left her husband, she has since taken another job and I rarely hear about her. Good luck!

[warmrain]

Thanks for the help! Iam completing my paper now.