Published Mar 1, 2003
How many of you address abuse and neglect with your OB patients on the admission assessment? Do you ask only a few questions or do you have a detailed questionnaire?
Just wondering...I would love to hear what everyone else is doing.
My good friend is pregnant and said that she was asked this question. I was pretty shocked, actually. I'm NOT trying to be a smartass here, but I was a little confused that anything *could* be done about abuse/neglect during such a life-changing situation. Like, "Gee, Mrs. Patient, is there any way we can help you resolve your domestic violence problem while you're currently going through this life changing event?"
Okay, that was pretty smartassish. Clearly I am not an OB nurse :) So tell me - how many times do you get an affirmative answer to these questions? What do you do about it when you do?
WE screen EVERYONE with EVERY visit, even if they are frequent fliers. Have a very specific questionaire they can fill out in silence ( I rarely interview them verbally if ANYone else is in the room, or ask them to leave). Also, we must document any suspicious bruising, burns or other injuries noted on the patient at the time of their admission. Its a big JCAHO special -interest item and if anyone is NOT doing this, they will be very soon if they are JCAHO-accredited.
If they admit to abuse, we are required to report it in WI when they are pregnant. If she weren't, then no. It's done to protect the baby.
Thank-you for your replies. SmilingBlueEyes is correct. This has to be a part of our assessment. We are just adding this aspect of nursing assessment to our admission process. I am interested in receiving copies of questionnaires from other OB departments.
I dont know and I am not in OB. However when my sister who was abused was pregnant she was told by MD and counsilor that abusive behavior tends to increase with pregnancy. I would think that this would make it a valid thing to screen for. JMHO
at your cervix
Originally posted by SmilingBluEyes Have a very specific questionaire they can fill out in silence
Have a very specific questionaire they can fill out in silence
SmilingBluEyes, I would love to see the questions that you ask!!! I think this is a great idea!!!!!!
I will get a copy at work and post them here for you guys next week, ok?
That would be great Deb.
We ask something along the lines of: Do you feel threatened, controlled, afraid or abused in your relationship with anyone? It's written on the admit form. If they're alone we ask, otherwise we hand them the paper to read. There's a prepared statement to read to them first; something along the lines of "We are required to ask everyone this question." Never had anyone actually admit to D.V. via that form though. The ones that come in for a labor check after a D.V. incident are referred to police.
We visited a women's shelter last Friday and this was addressed. They said that 25% of pregnant women that suffer abuse do so during this time.
They are hoping by healthcare asking the questions that they will know (if abused) that someone cared enough to ask and may return. They don't expect them to admit it through casual conversation.
Due to our high volume, a written questionaire might be difficult ...
(I still want to see it, though, ...also, do you have it in Spanish?)
We do have a big poster in the bathroom, bilingual, with 'tear off tabs' that offers counseling and support for abused women...so when they are in their alone in the bathroom, they can take a number...
Personally, I TAKE (not send) each woman into the bathroom, give her a gown, explain a clean catch urine sample AND, at this PRIVATE time, ask her if she is safe in her home! I include physical, emotional and sexual assault in my line of questioning. If they look shocked or offended at the questions, I just let them know that statistically pregnant women are at GREATER risk of being abused than nonpregnant women and that I am just trying to be sure they are safe!
Now, if anyone can tell me how to protect the obviously abused patient, who denies it vehemently!!!!!
sbic56, BSN, RN
I think this is one of those areas that bothers nurses in a big way because we are such fixers. Problem is, there is nothing we can do until they are willing to accept help. It has to be their decison to leave a bad situation. Letting them know, repeatedly, that they do not have to endure such treatment is the best we can do. There are so many issues at hand here. Self esteem issues, mainly. They need to know they can make it without the abuser; that they are worthy individuals. Of course, when the welfare of the child is involved, we have to protect that unborn child, thus opening up a whole new set of problems...sure wish the answers were easy!!
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