Ask Me If I'm Safe At Home

Ask your patient if she is safe at home -- even if her husband is handsome and charming, well-dressed and well spoken. Ask even if you know her husband, he's the life of the party or you've worked with him for years. Ask because maybe you've only met Dr. Jekyll; she may be living with Mr. Hyde Nurses General Nursing Article

My husband and I shared the same PCP. After my first visit to the practice, no one ever asked me again whether I was safe at home. I wasn’t. But no one asked because everyone had met my husband, the handsome, charming life of the party. The guy that everyone liked. They all “knew” I was safe at home because he was “such a nice guy.” They knew him, you see. A nice guy like him couldn’t possibly be an abuser.

They only met Dr. Jekyll. I lived with Mr. Hyde.

I’ve written numerous articles on the website about domestic violence, about the ex-husband who strangled me into unconsciousness and left me on the highway with the clothes on my back and my dog. I’ve written about the elephant in the room, what leaving feels like, about starting over again and about the bravest thing I’ve ever done. I lived it; I’m resilient.

Thirteen years after I left my abuser, I married again. THIS time I married a friend, someone I had known and worked with for nine years, dated for more than five years. THIS time I was sure I was going to be safe at home because he really loved me. THIS time I knew I had the right person. I had known him for years; I knew all there was to know about him. And we were happy, for a time. For years. And then I got sick and I needed him. Suddenly, he was not the center of attention at all times, because I had to focus on my health; on getting better. And my happy marriage and perfect husband were never the same again.

I beat breast cancer, and a serious back injury. I had two joint replacements -- he dropped me off at the hospital for the surgery and had to be BEGGED to come and get me when I was discharged. He had a bad cold, you see. It was such an effort to come to the hospital to get me. I had a post op infection and a fever that registered as “HHH” on our cheap electronic thermometer. AT one point, he actually told me, “I know it must seem strange to you, me whining about my bad cold when you have a potentially lethal post op infection . . . But it’s a really. bad. cold.” After 48 hours of me peeing every 15 minutes, he finally deigned to take me to the doctor. After he took a nice, long nap.

My best friend asked me if I was safe at home, and I assured her that I was. I had lived with abuse; I had survived it. I knew what it was like and this wasn’t it.

My husband, the man I thought loved me more than anyone on earth except his daughter, only talked to me to nitpick. Or criticize. Or scream at me that I was fat and useless. I was pretty useless -- I’d just had a joint replaced, I had a fever and a CAUTI and was exhausted from trying to get down the stairs to the bathroom every fifteen minutes with my cane and my brand new artificial joint. Eventually, I recovered, but rather than stopping, the screaming and the criticism just escalated. Soon he was having tantrums three or four times a day. I was tiptoeing around him, trying to avoid setting him off and trying to please a man who could not BE pleased. He was always right, he was never wrong and if I dared to disagree with him -- or even failed to agree with him quickly enough -- there was punishment. One day he opened the kitchen cupboards and smashed all of my coffee mugs. There were shards of my coffee mug collection on the floor, in the sink and in the dog’s coat. Another time, he swept everything off the dining room table -- almost everything -- and sent it flying into the next room. Just my stuff, it seems. One time I came home from work to find that he had painted the closet doors, and “somehow” got white paint on every one of my jackets. It was an accident, it just happened. He didn’t mean to. But HIS jackets somehow escaped the carnage. That winter I was always cold because I didn’t have a winter coat. HE was warm enough -- and was I harping on THAT again? He SAID he was sorry that my coats “got paint on them.” It was an accident. Why couldn’t I just get over it?

My old friend asked me if I was safe at home, and I assured her that I was. I had lived with domestic violence, I knew what REAL abuse was like, and this wasn’t it. There was no perfect Ruby-shaped dent in the drywall, no purple fingerprints on my neck. I was safe.

There was a letter from the mortgage company telling us that we were going to have to find another lender as one of the conditions of our loan was keeping homeowner’s insurance. My husband admitted that he had let the homeowner’s insurance lapse because, and this is really special, he was angry at me. Somehow this became my problem and I had to scramble to get the house insured. He had so many single cars or at-fault accidents that the car insurance was cancelled. I got that reinstated as well, at an exorbitant cost. Then we took a 900-mile car trip to see his daughter graduate from college, and I drove because I was frightened of riding with him. I stopped to go to the bathroom and foolishly left the keys in the car -- he was sleeping. When I came back, he was behind the wheel and raging at me because I stopped to go to the bathroom too often. For the next three hours, he wove in and out of traffic, changing lanes and exceeding the speed limit by 30 mph or more, tailgating, cutting people off, screaming at me the whole time for being fat, ugly and useless. In a deluge, with standing water on the roads and people sliding off the road right and left trying to avoid him. I was terrified, clinging to the armrest and promising God that if I lived through this, I would leave him. When we got to our destination, he dropped me off at the hotel and took off in the car to “see friends.” If there had been an available hotel room or rental car, I would have left him that night. There wasn’t, and I didn’t.

And then, in a domestic violence thread on AN, one of our members recommended Patrica Evans’ book about the verbally abusive relationship. And I realized that my happy marriage and perfect husband had deteriorated into a verbally abusive relationship. “It’s not that bad,” I told myself. “I’m strong. I can deal with this. It’s not as if he’s VIOLENT. I lived with that, but he isn’t like that. But maybe it’s time he got back on his Prozac.”

In an extreme act of courage -- or perhaps idiocy is more the word -- I brought up the Prozac discussion with my husband, whose depression had always manifested as anger. Get the depression under control, and he’s easier to live with. That was the night he had such a tantrum that I left “walk the dog” and was afraid to go back. Instead, I sat on a park bench in the rain and called the National Domestic Violence Hotline. They asked me if I was safe at home. I thought I probably was -- after all, all he did was scream. And throw things. And smash things. And punch things. And drive recklessly and terrify me. “Abuse is about power and control,” they said. “Verbal abuse can escalate to physical abuse. They can kill you.” But we were on vacation on our boat, in a town too small to have a hotel or an Enterprise. I got back on the boat with him, and we cast off to go to the next town.

My husband went to his PCP and asked for anti-depressants. He was referred to a psychiatrist. For Prozac? Or Zoloft? I wasn’t sure he needed that. Turns out I was wrong. He came home from the psychiatrist's office, a study in rage. “That guy doesn’t know a thing,” he raged. “I am NOT a narcissist.” He was kicking the punching bag (a safe enough thing for him to kick, I thought) and I went to “walk the dog.” Only I was too afraid to go back, so I sat on the bench cleverly placed at the school bus stop, and cried. A neighbor lady sat down next to me. I had nodded at her at the mailbox but had never talked to her, unlike my husband who frequently stopped to talk to her and her husband when they were outside.

“He’s a narcissist,” she said. “Run.” Who was this woman to tell me my husband is a narcissist? She’s the clinical psychiatrist who lived a house over from us, and who could easily hear his rages through her open windows. She started the domestic violence program in our state -- and in another state. She’s an expert. She knows.

“Are you REALLY safe at home?” She asked. “Really?”

“No,” I had to admit. I wasn’t really safe at home.

Just the other day, my new PCP asked me if I am safe at home, and I assured her that I was. I am, you see. I left my husband, the love of my life, with what I could carry and my dog. I rented a car and drove a thousand miles AWAY. I’m safe here. I’m living with a generous friend who lost her husband to cancer. I have my own bed now, and a bed for my dog. I bought a car last year, and this year the divorce is final. I don’t have much, but what I do have is MINE. I don’t have my house, or my lovely dishes or my leather sofa or any of the things that I once thought were so important. But I have me again, me without the soul-crushing load of abuse. I’m getting my sense of humor back. One day it will be my superpower again, but for now, my superpower is resilience. Really. I am finally safe at home.

Ask your patient if she is safe at home. Even if her husband is handsome and charming; even if you KNOW him -- he works at your hospital, he's a good guy. Because perhaps you've only met Dr. Jekyll and she lives with Mr. Hyde.

Specializes in Cardiac Care.

I'm in tears, and I'm speechless.

I think you are one of the strongest women ever. Thank you for writing this.

Thank you for sharing your story. I have been emotionally abused and had to tolerate it for a time as my Mother was dying but it finally ended. Started over, but then was hurt and disappointed and ostracized by those who I thought I could trust. I am about to start a new chapter of my life which will in time lead to relocation. Then I will leave all the memories behind me. You have boosted my self-confidence as I combat the fear of the journey that I am about to take. I am alone now with no family left but what I have learned is that loneliness is not a reason to be a doormat for more abuse. Thank you so much and I wish you much Happiness; you certainly Deserve it.

I can still remember the only time that I've asked that question and was told no. I had no idea what I was supposed to do with that information. Don't assume your staff or coworkers know what they need to do with it.

In my case I was in Italy with my doctor in the Navy, so I asked him. He didn't know what to do either.

(turns out she lived by herself in a crime ridden area)

Ruby, I remember reading about your first marriage before but I didn't realize what a nightmare you'd been through more recently. Thank God you finally got out! We as if ppl feel safe at home in our endo center but most patients make jokes about their dog or the gun they have at home. I need to make sure they understand how important asking this question can be.

Thanks for much for sharing your story ?

Specializes in ICU; Telephone Triage Nurse.

I had also married a narcissist, and he gradually controlled every aspect of my life. As a new grad if I came home late from work due to the myriad of things that can happen in bedside nursing (a code, a late admit, or just being behind in charting) I was obviously with someone else. I eventually discovered he had been recording my phone calls for nearly 2 years - he proudly told me, "I've been inside your head for years".

He threatened he would sue me for custody of our son and for child support if I dare left him (he also threatened he would "get me into trouble" with the SBON, that I would never work as a nurse again). My self esteem was rock bottom and I lived in constant fear. I felt trapped but had no where to go.

Finally getting away with my baby was the hardest thing I've ever done - I continued to look over my shoulder for years afterward, and wake in fear from small noises in the night.

Ruby Vee, from one survivor (and crusty old bat) to another you have my sincerest respect. Hugs from afar my friend from a kindered spirit.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Poignant. You are a survivor and a warrior. I have my own story of abuse from a prior husband. He nearly killed me. But I am not stealing your thunder here. I just want to congratulate you on surviving and writing such a well-thought article.

Specializes in Pediatrics, Family medicine.

Wow! I am left speechless. First off, congratulations for being so brave! Secondly, this was so well written, it was like a book and I could envision it all. I am so happy that you are safe and have your sanity back. You are brave, strong, beautiful, smart, and courageous. Great job!

Thank you Ruby for so eloquently describing what it is like to live with a Mr Hyde.

Your description is eerily similar to my experience. Every single line had me nodding and remembering. My Mr Hyde declined to visit me the day after the birth (emergency Caesarian) of my daughter because "he was tired and needed a lay in! (All day)" missing visiting time and then apparently had more important things to do during evening visiting time. We also had many accidents where somehow only my stuff got damaged. The tantrums, the tiptoeing round his moods, the driving, the money....And of course it was always somehow my fault.

It took me 12 years to leave.

As far as everyone was concerned he was charming, funny, loved his family. Then one day he forgot himself for a few seconds and Mr Hyde came out in front of my family. My parents lent me 2 months rent money and a month later I was out, 2 kids in tow.

That was all I needed, someone else to see it and assure me that it wasn't my fault and a little bit of practical assistance. My life is my own now, and it's beautiful.

Thankyou again for writing this and painting such a clear picture.

Specializes in TCU, Dementia care, nurse manager.

Thanks for sharing your story. It make me, and others, better nurses and better people.

@Ruby Vee Thank you for being courageous enough to share your story so transparently, I felt the mental and emotional turmoil so powerfully. Brought me to tears - so grateful your resilience is serving you on this new path.

I remember being in the hospital, twice I had allowed the father of the child to attend with me at the appointments, we had separated after a second incident of violence this one during my second pregnancy in front of my child. Someone on an online community made me realize with their own raw story and honest recounting just how deep I was in the abuse cycle and what I would be facing if I left without the protection of a TRO to address custody. I was still so “in love” and wanting to keep our family unified in some way that I would never have thought to do this and yet I have no doubt that was a precious gift that changed the course of my life. Thank you for sharing your story, that person will never know but she may have saved my life, and she certainly protected me and my children from devolving into his power to manipulate and control us. You may have done the same with your story of resilience, strength, and courage.

Your story struck me to respond because in the hospital twice during admission I was asked if there was any history of abuse or violence ... I allowed him to be present for these appointments so how could I answer honestly? I was safe, I was separated, I was legally protected and stable in my home environment, but if I needed any support, I could not have sought it then and I will always wonder if any one could be helped by more open ended questions in private. In my new life, I was asked these same types of question in front of my husband, thankfully I am truly safe now but still disheartening that not much has changed - across 13 years and 3 hospitals and a multitude of doctor’s appointments no one has ever truly “asked” me if I was or felt safe at home in a manner I could answer if I chose.

Specializes in Geriatrics, Dialysis.

Thanks to your generosity and honesty Ruby many people might feel the support they were looking for to see themselves in a similar situation and get help, get out before it's too late. So thank you for that!

I've commented before on the mandatory "do you feel safe?" at appointments and got a little push back for questioning the rote use of that. I still question it's usefulness when it's just asked as a rote question with no apparent interest in the answer. The previous respondent alluded to this as well, the question was asked of her with the partner in the room and no way to answer truthfully so what good is asking a question that can't be answered? Or the respondent that wondered how she would react, what should she do if somebody answered her question with no, they don't feel safe at home? I'm not saying asking isn't important, but what is important is asking in a way that makes the patient feel like they are being listened to and can answer truthfully. I do feel safe at home, but if I didn't I don't know that I'd feel comfortable answering honestly when the person asking is pretty obviously asking just because they have to. So for those of you that have to ask "do you feel safe at home?" every appointment please make a point to do so when you are alone with the patient and please, please act like the answer matters and have a plan how to respond if the answer is no.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
1 hour ago, kbrn2002 said:

Thanks to your generosity and honesty Ruby many people might feel the support they were looking for to see themselves in a similar situation and get help, get out before it's too late. So thank you for that!

I've commented before on the mandatory "do you feel safe?" at appointments and got a little push back for questioning the rote use of that. I still question it's usefulness when it's just asked as a rote question with no apparent interest in the answer. The previous respondent alluded to this as well, the question was asked of her with the partner in the room and no way to answer truthfully so what good is asking a question that can't be answered? Or the respondent that wondered how she would react, what should she do if somebody answered her question with no, they don't feel safe at home? I'm not saying asking isn't important, but what is important is asking in a way that makes the patient feel like they are being listened to and can answer truthfully. I do feel safe at home, but if I didn't I don't know that I'd feel comfortable answering honestly when the person asking is pretty obviously asking just because they have to. So for those of you that have to ask "do you feel safe at home?" every appointment please make a point to do so when you are alone with the patient and please, please act like the answer matters and have a plan how to respond if the answer is no.

The answer does matter -- so you're right, ask as if it matters and know how to respond if the answer is no. It isn't that difficult for a medical practice to have a list of domestic violence shelters in the area or the phone number for the National Domestic Violence Hotline.

For the record, though, even the asking might make someone stop and think about her situation, even if she doesn't answer that she isn't safe, or even if she doesn't have the opportunity to give a truthful answer because the abuser is sitting right next to her. Every little bit helps.