Domestic Abuse Assessment

I was so young when I got married the first time. At 19, I had no idea what I was getting into. Marrying a man 12 year my senior with a history of domestic assault; why would I ever think it wouldn't happen to me? Let me tell you how wrong I was and what I am going to do to help women like me. And how desperately I need your help now. Nurses Announcements Archive Article

I was all of 18 when I met my first husband. It was three days after 9/11 and my stepmother had just kicked me out of the house. I had no place to go. I went out with a girlfriend and met this charming, leather-clad man at the bar. I ended up drinking way too much and slept on his couch for three days while he convinced me how truly precious I was and how he just knew I was the one woman who could make him a better man.

He was very honest about how his first wife had had him jailed several times for domestic assault but he would never do something like that to me. She was evil, psychotic; she drove him to extremes of anger. I was a beautiful, sweet young girl and exactly what this 30-year-old man needed to be a true-life prince in shining armor. Of course, I should move in with him; my family was horrible, they did not love me as he could. No one would ever love me as he did. "Don't worry; I will take care of you now."

He was charming and darling for about a year. Until every member of my family had given up on seeing me again, hated me for "abandoning" them, and I had no friends left. Oh, he would yell at me, maybe cuff the back of my head; slap my face occasionally. However, I was young and did not know anything. I was always doing something wrong and he had to teach me. How else was I going to learn?

I married him. Why wouldn't I? I wanted a baby. I was not about to have another child out of wedlock (my first child died at birth when I was 15). I was going to do it right this time. I was going to do right by God so He would let me keep a baby. I wanted dozens of babies, in fact, but was willing to settle for four, maybe six.

He began beating me for no reason. He was mad I knew that John Hancock was the first president of the US, just not voted in as one. He beat me with a cell phone power cord for that. Taught me not to win at Trivial Pursuit. There were days when I could not go to work I was beaten so badly. Leave him, you say? Sure. With what money? He took my paychecks. If I tried hiding some in the tampon box, he would beat me. Where would I go? I had no family left. He had made me move hours away from my family and they all hated me for abandoning them, remember? Stay in a shelter? Sure. Let me go stay in the one safe house in the area; the one he would drive me by every time we went to town and point out to me as being the place "those women go to hide from their husbands when they get tired of being real women." Go to the hospital? I did. Listen up. NOT ONE NURSE OR DOCTOR EVER ASKED ME IF I WAS BEING ABUSED. NOT ONE. Call the police? Oh, please, don't make me laugh at the good ole' boy society you find in rural Iowa.

Eventually, I got pregnant. A little boy. Oh, I cannot explain the absolute joy... I wanted to be a mom more than anything else in the world. At 31 weeks, I was hospitalized for preterm contractions, placed on Mag Sulfate, bed rest for a few days. Got them stopped. I do not know what it is about being pregnant; but he hated me while I had that belly. He beat me almost every day. Guess how may nurses or doctors asked me while I was pregnant if I was being abused; what those marks were from? NOT ONE. At 37 weeks and three days, he hit me so hard my placenta partially abrupted. He was nice enough to take me to the ER right away.

They got the monitor on in time to see the FHR at 52 and dropping. Dropped to nothing. They knocked me out, took my baby by emergency C-section, and got vital signs back. They saved my son.

While I was out, they happened to ask my oh so wonderful husband what were our birth control plans? Did we want a tubal? That was our plans, he said. So they did it. After I woke up and they presented me with my first of at least nine children (I thought) the nurse mentioned how I (at 21, mind you) did not have to worry about hormonal birth control when breast-feeding since the tubal was done, how wonderful for me... Excuse me, what was that? I was brought paperwork from the legal department and signed them promising not to sue. The OB-GYN that had done my C-section and tubal swore to me he would do everything he could to reverse the tubal and make sure I was fertile again. Still no one asked the obvious, "What was going on here?"

I got home with our new baby. That day, my ex-husband hurt me, badly. He ruptured my uterus. The scarring from that... I would never carry another child. I had the most painful menstrual cycles. After a few years, I had a D&C and ablation. No more menses. Even less hope of having my dozen children. I never got that tubal reversed.

No one ever asked, "Do you feel safe at home?" "Has anyone ever punched, kicked, or pushed you?" "Does your partner monitor your time, or constantly accuse you of cheating?" "Are you being isolated from your family or friends?"

Eventually, after another 3 years of abuse, I grew some courage. I went back to school for nursing. I learned I was not stupid. I learned that people, even men, could talk to me and respect me without wanting to sleep with me. I learned that I deserved respect and civility and I was DONE being abused. I kicked that man out of my home. I still have to face him, every other weekend, because that is how the legal system works. He has rights to see his son. I have no rights to feel safe but that is not the focus.

Friends, here is what I want. I want you to ask every single women you see in your career those questions about domestic abuse. I beg you to make a difference. I want you to educate yourselves on the signs of domestic abuse and stand up for the women who have been beaten into submission and cannot stand up for themselves. I cannot explain to you the soul deep belief that I deserved to be treated that way. The nightmares I still have. The crushing guilt I experience for allowing this man to father my baby. My only baby. It was MY FAULT. I own that. However, how much sooner could I have gotten help if even one nurse had made a simple assessment?

Please, contact your local crisis intervention, police stations, etc. Find out the resources you can offer women. You will be shocked at how very little help there is. Statistics show less than 30% of women with traumatic injuries seen in the emergency room are assessed for domestic abuse. Studies are done that conclude it takes at least three times asking a domestic victim, alone with only a nurse asking, to admit to being abused. Domestic abuse victims are 46% more likely than non-abused women to seek medical care for illness, solely in the hope that someone, anyone, will notice them and help them. Please. Ask those few extra questions. Dedicate yourselves to be devoted to service for human welfare. Do you remember that part of the Nightingale Pledge? Hold that in your hearts.

Because of things that happened in my past I donate monthly to a domestic violence organization where I live.

I had the education and family support to get out of a bad situation.

I'm able to support myself.

But not everyone is, and not everyone has family to turn to.

Many of these organization also help rape survivors. There is nothing more infuriating or humiliating than to have to pay for your therapy as a rape survivor.

We have many charitable causes we support - these are mine.

My sweet husband donates money to the local women's shelter/rape crisis center every Mother's Day to honor me, even though I was not involved with them (I was on the other side of the country). I do love this man.

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.

As a victim of child abuse, both physical and emotional, I implore you to not only ask the questions, but make sure you listen, but just with your ears, but your heart as well.

I was admitted to a psychiatric hospital for suicidal thoughts the night after a significant attack. I was assessed on admission and asked about a new scar on the small if my back. I explained that it was a carpet burn. There were no further questions.

The next day I was transferred to a different hospital. Same body scan, scab marked on

body map, identified as carpet burn, no further questions.

I was discharged a few days later. I returned everyday for two weeks for partial hospitalization. Each day I had a body search, each day the scab was noted by different staff. Each day I said the same thing. I even said it was from my mom. Still no further assessment. And each day they sent me back to her.

Thankfully, I am okay now. It is almost ten years since I finally got out of the home, and it has been a long journey.

Remember, with children there is an extra issue to address because the legal guardian may be the perpetrator. The one who drives them to the ED immediately after an injury, the one who "lovingly" sits by their hospital bed 24/7, the one who refuses to let them go home without treatment (for fear of neglect investigation) and the one on whom we rely to keep them safe.