Domestic Violence: Telling Her To Leave Is Not Enough
You've done your job; you've noticed that the woman under your care seems to have an awful lot of accidents, and injuries are not consistent with her story, that her husband or boyfriend is controlling or verbally abusive, that she might be a victim of domestic violence. You've asked her if she feels safe, and you've given her the brochure, referred her to the shelter for the night and 'saved her life.' You've done good, right? Maybe, but have you done enough or have you just exacerbated her problems and put her in more danger? What IS enough, anyway?
I know a little bit about domestic violence; I was once in an abusive relationship. Back then, healthcare workers didn't ask you, when you came to the hospital with injuries from "a fall" or "running into a door" for the third time this year, whether you might be in danger from an abusive spouse. If they had, perhaps I would have caught on sooner; but on the other hand perhaps not. Maybe I would have left him sooner, but on the other hand, perhaps not. When I did leave, I had just begun to make a plan for leaving, but it wasn't a thorough plan. There were oh, so many gaps.
So the nurse or the physician or maybe the CNA noticed that you've been in the ER three times this year because you're so clumsy you keep running into doors or falling down the stairs, only the injuries are never completely consistent with your story. They notice that your husband or boyfriend is a bit controlling, is hovering, is answering questions posed to you. They get him out of the room on one pretext or another, and then they ask you if you're being abused. And perhaps because you're having an exceptionally weak moment, or you're particularly fed up right now or you're just being reckless, you admit that you are. So they give you a brochure and send you to a shelter for the night. They did good, right? They saved you?
Maybe they did save you. Maybe it was just the push you needed to get out of the situation and the guy is still apologetic or he isn't a hardened abuser or he's willing to relinquish control over you because he has another woman on the sidelines ready to be brought to the mainstream or the military just PCSed him to another assignment. But that isn't always the case.
So you've gone directly from the hospital or your GYN appointment or your trip to the Urgent Care clinic to have your broken bones set to the shelter or your aunt's house or the home of a good friend. You wake up the next morning with nothing to put on except what you took off yesterday, with no money and no car and nothing except what you had when you entered the clinic. Your car, your clothes, your credit cards, your THINGS are all in the home that you share with your abuser. In my case, I was on the side of the road with nothing except the clothes I was wearing and my dog. (At least I got my dog. My purse, not so much. But I got my dog.) Oh yes, I was 300 miles from my home with no money, no ID, no credit cards. I couldn't even get on the military base where we lived in military housing because I had no identification and I could not bring myself to call my abuser and ask him to vouch for me.
I had a good job as a nurse, I had my own car and my own credit cards. Until I met HIM, I had a good, independent life. I could support myself and any children I might have had. And I had a good friend who, unbeknownst to me, had been through it all herself. Once I brought myself to call her, collect, she helped me figure out the rest. I certainly wasn't in any shape to figure things out for myself.
Pointing out to someone that they're in an abusive relationship and sending them to a shelter isn't enough. I don't know what "enough" looks like, but that is far from it. There has to be a plan -- and the woman in the relationship has to have some input in the plan because she's going to have to live it. Any "help" that doesn't acknowledge the dangers a woman faces when she leaves her abuser and doesn't address what happens the morning after she wakes up in the shelter or her friend's house or the home of her aunt and uncle doesn't go far enough. It's a start, but it isn't enough and it may even put the woman in more danger.
I just wish I knew what would be enough.Last edit by Joe V on Nov 4, '16
About Ruby Vee, BSN, RN
Ruby Vee has '38' year(s) of experience and specializes in 'ICU/CCU'. From 'the Midwest'; Joined Jun '02; Posts: 11,872; Likes: 48,718.Jun 19, '14 by SoldierNurse22, BSN, RN, EMT-BAmen, Ruby.
The reasons in your post are exactly why many abused folks choose not to leave--because there isn't a safe "enough", far "enough", good "enough" option for them. I don't know what the answer is, either, but there must be better than what we have currently for these people who put up with more than "enough" on a day to day, minute to minute basis.Jun 19, '14 by LadyFree28, BSN, RNQuote from SoldierNurse22I wish I knew the answer too.Amen, Ruby.
The reasons in your post are exactly why many abused folks choose not to leave--because there isn't a safe "enough", far "enough", good "enough" option for them. I don't know what the answer is, either, but there must be better than what we have currently for these people who put up with more than "enough" on a day to day, minute to minute basis.
Not everyone survives leaving.
I'm one that survived.Last edit by TheCommuter on Jun 20, '14 : Reason: [/QUOTE] tagsJun 20, '14 by Delicate FlowerRuby, I am so sorry you went through this. I can't even imagine how it must have been.Jun 20, '14 by Esme12, ASN, BSN, RN Senior ModeratorI was married in another life to a police officer...I have no idea how I got there....I survived as well.Jun 20, '14 by nurseprnRNBeen there, done that, too. Sometimes you hear people wonder "Why doesn't she just leave him?" Well, I'll tell you why: For many people, the unknown is scarier than the known, even if the known is really bad and the unknown has potential to be better. Consider that when you have a patient who won't embark on a new plan of care, see that therapist, leave an abuser, move to a cleaner house, whatever it is. For some reason, they have no courage, no self-reliance, no confidence in their abilities to succeed.
And then you throw in economic thralldom, threats about hurting/taking your kids/your dog/your cat, and the imperceptibly slow, drip-drip-drip removal of all your support systems until all of a sudden you are unmoored, and it's even harder to think about "leaving."
In my case, I finally got the nerve to up and tell him to leave. We had been in couples therapy and, as so often happens, the woman changes and the man doesn't. He went back to hitting me. After the last one my therapist told me we were no longer going to work on saving this relationship (good plan). She gave me the contact info for a good atty.
A few days later I told him, and when he said no, he didn't want this, I said, "Look me in the eye and tell me that you love me and this will break your heart." And he couldn't, and I knew he wouldn't, and he knew I knew he couldn't, and that was that. He never laid a hand on me again.
And my kids grew up not seeing me in a bad marriage, and I met and married a wonderful lovely man 4 years later who wasn't scared of marrying a woman with young kids. We moved to the other side of the continent to be near family. Our 26th anniversary is coming up soon, and my grandchildren (all products of wonderful marriages) call HIM Granpa.Jun 20, '14 by cpolloc5One of my best friends is going through this. She is independent but he is her child's father. She has a restraining order and he has been in jail for hurting her but she lets him back in. It is hard to watch, devastating and I worry about her as well as her daughter. Domestic abuse is ugly and not spoken about enough, in my opinion. I have seen the look in her face as she asked me if I could adopt her daughter if something happens to her. It makes me sick to even consider the possibility of the next time. Please take care of yourself and accept help from others. You would do the same for your friends or family if you were in their position, so please let them do it for you, and let them give you strength and support. This is to anyone in this situation or any other situation which makes them feel scared, embarrassed, or isolated. There are people who love you and will be there for you.Jun 20, '14 by T-Bird78A friend of mine is a survivor herself. She is pushing legislators in our state for 2 CME hours for healthcare providers for domestic violence screening. She started small, by asking if she could display posters in the women's restrooms for local shelters and resources so they could at least get information discreetly. Check out Home for an idea of what it's grown to now. Providers should be better aware of the s/s and at least offer help when needed. When I was pregnant, my OB nurse asked if I felt safe at home or with my husband--while he was standing in the room. I said yes, and that's the truth, but if someone is afraid of their partner they are NOT going to admit it in front of them.Jun 20, '14 by 1feistymama, CNAT-Bird - my OB asked, with all 3 pregnancies, if I felt safe but she specifically sent my husband out of the room before asking me.
I as in an abusive relationship as a teenager. Fortunately, I was still living at home so didn't have to worry about finding a place to live but it starts out verbal and they are exceptionally talented at making you believe horrible things about yourself. I was a fairly confident teenager but in 3 months' time, he had me believing I was worthless and no one would ever love me other than him. I seriously considered going back to him but instead, I found a stubborn streak and figured being alone was better. There were other flings after him and about a year after him, I found my husband. We've been blissfully happy ever since - nearly 20 years now.
I don't think anyone truly understands what it's like to be on the receiving end of abuse unless they, too, have experienced it. They don't understand how degraded and unworthy you feel and how scary it is to attempt to leave the situation. You get brainwashed into believing that you will fail if you try to leave and then he'll be even angrier when you return to him and things will be worse than they already are. It's vicious, really. I agree, we need more than just shelters, we need life coaches that'll assist these ladies every step of the way.Jun 20, '14 by toomuchbaloneyOne of my daughters was in a physically and emotionally abusive relationship. The turd basket is the father of my oldest grandchild. He is lucky that he still draws breath as I had a plan all worked out to end his days until my spouse caught on. The potential for jail seemed a reasonable trade off at the time.Jun 20, '14 by Nola009In an emotionally abusive marriage at the moment. Want to leave, but feel paralyzed with fear. If I could get myself into this type of relationship, then wouldn't I just make more bad choices later? Not in physical danger, so I think it's sometimes better to deal with the "devil" you know...Jun 21, '14 by Ruby Vee, BSN, RNQuote from Nola009Leaving isn't easy. If you want to leave, start making a plan. No one deserves to be abused, emotionally or physically. As for the more bad choices later, of course you could make more bad choices. Or you could make some really good ones and end up in a happy, supportive marriage like I did and like Grn Tea did. But you'll never know until you leave . . . .In an emotionally abusive marriage at the moment. Want to leave, but feel paralyzed with fear. If I could get myself into this type of relationship, then wouldn't I just make more bad choices later? Not in physical danger, so I think it's sometimes better to deal with the "devil" you know...
When you're ready. Leaving is difficult.
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