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? Nurses Announcements Archive Article

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.

Specializes in pediatrics; PICU; NICU.

I think the scariest thing about domestic violence is how insidious it can be. My first husband was abusive in every way imaginable. It started with very slowly isolating me from my friends & family. Once he had me "all to himself", the physical & sexual abuse started. I was working full time (as a nurse) so he was always very careful not to hit me in places where others would see the bruises. There was always emotional abuse as well. It amazes me when I realize I still believe some of the crap he had me convinced of. After almost 3 years of this I had the locks changed while he was at work one day. I called an attorney who was able to get me an order of protection that day. When my husband called later that day to see how I was, I told him he couldn't come home again. He didn't really seem all that surprised & our divorce was finalized within 3 months. He was allowed to come with a police escort to get his belongings.

Unfortunately, I had lots of psychological damage for many years. The day our divorce was finalized, I walked out of the courthouse & had my first of many years of panic attacks. It got so bad that I developed agoraphobia. I was convinced if I left my house he would kill me. It took almost 3 years of therapy to overcome that. It's been almost 30 years and there are still times when I have nightmares about things he did to me & I get afraid that he's still "out there" (even though I have proof he died 3 years ago). Fortunately, I'm now married (almost 7 years) to a wonderful man who treats me like a queen.

I often wonder how I got out of the abusive marriage so easily. So many women don't survive leaving.

Nola, I would strongly encourage you to get some help. As I stated earlier, abuse often starts out as emotional & progresses to worse things. No kind of abuse is ever OK!

T-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.

Been there, done that! My biggest fear is for one of my daughters, to have to go through what I did.

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...

Fear is the result of emotional abuse. It's why emotional abusers do it-- to create fear and a sense of isolation in their victims. It's as bad as physical abuse.

Let me ask you this: Does he escalate in cycles? Does he escalate the abuse when you are out together and away from home (far enough away that you can't just walk away)? Name calling? Accusations of infidelity? Does he practice verbal "crazy making?" (Causes you to be confused and leaves you unable to defend yourself.) Are you at the point where you can "sense" his next outburst a day or more before it happens? Does he throw things, punch walls, or break things yet? Does he cause you to question your sense of safety with veiled threats?

(Just some things to watch for.)

The devil you know is NOT better than making a plan to exit. The very fact that you are fearful of the unknown, is exactly right where an abuser wants their victim to be: feeling weak, lonely, and helpless.

You lived just fine without him before you met him. What changed? More precisely who changed?

In my case, I got out before he hit me. He was to the point of hitting everything else around me, but not me....yet. He nearly put his fist through the wall once and his steering wheel was warped from him pounding on it any time he got mad. It takes a lot of pounding over a considerable length of time to warp a steering wheel made of steel (old school, full-size van). Clearly, his rage issues started far before me.

I remember thinking if he hit me, I'd know for sure it was abuse and it'd be easy to walk away but since it was verbal, it wasn't quite as clear. After being out of the situation, able to look back as an outsider, it is so glaringly obvious that it was only a matter of time until it escalated to that point. When you're IN the relationship, the blinders go up and you tell yourself it isn't as bad as people think. Wrong.....it is that bad.

You are worthy of a loving, caring relationship with a person who builds you up rather than tears you down. Right that down and read it over and over until you start to believe it.

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...
Nola009, just about anything is better than the devil you know. In what now feels like a lifetime ago, I had been with a devil like yours, for a long time, too long, I deserved better as do you. I truly understand that while you are in it, it is very difficult to find your way out. But, trust me, once you are out, you will wish you had left sooner once you feel again what it is like to be free. Back then, someone wise asked me to picture my life exactly as it was in another ten or twenty years and told me to go ahead and stay if I would be happy with everything exactly as it was every day for all those many more years to come, given that I was only passing through this life one time......so, although I was terrified of the unknown, and he was all I had known for so long, I gathered my courage as best I could and jumped off that cliff, and before long, landed into a much happier life. I hope the same for you, I wish you courage.

As a survivor of DV and a future nurse, I am curious as to how as a nurse I may one day be able to work with victims of DV?

Physical or mental...one way or another...future "wound" nurse.

Specializes in OB, Postpartum, Nursery.

I fought and won sole legal and physical custody of my children. I was my own lawyer. He had a free paid lawyer from his job. I was doing my prereq's and I still won, all while being stalked and afraid of what he could do to me or our children. The laws that are there to protect victims are not strong enough.

Specializes in ICU.
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...

I was in an emotionally/mentally abusive marriage for 15 years. It took every ounce of courage I had to get out. Do you want to know what finally did? The fact my son was starting to emulate him and was saying the same things to me his dad did. He isolated me from my family and friends. He controlled all of the money and I just had no idea how I would make it on my own. And yes sometimes I thought if I could just deal with him until my son turned 18 then I would get a divorce.

When the phone would ring during the day my stomach would drop, a million things would go through my mind. Was what I was doing at that moment going to be good enough for him? What if he says he is stopping at the house and it isn't clean enough for him? What can I do to pacify him so he won't yell at me today? But my day had finally come, I had to break the cycle for my son and I deserved to be happy. I deserved to do something I wanted in life, not try and please him.

The first couple of months were extremely difficult. I was scared all of the time. But you know what? People rallied around me. People that I hadn't talked to in years came to me with words of encouragement. My parents who knew what was happening and knew how miserable I was were there to help me. I got through it and I was taking 5 classes in school at the same time. The fact I could focus on school was a huge relief to me. It took my mind off of everything else. I wasn't allowed to go to school when I was married. I was expected to stay in my house all day every day and be his servant and maid.

You have to decide. No one can tell you what to do. My ex and I tried marriage counseling. Our counselor was so in disbelief by what my ex said she didn't want to counsel us anymore. She had never seen a man who was such a jerk before I think. She also thought I should get out of the marriage. It took me another 3 years to get out.

I know from the inside getting out seems like a lot of effort. You honestly don't know if you have the strength to do it because you use every ounce of strength that you have just to deal with it every day. But you will find your voice. I finally found mine and I have started dating again. I started in May and I have met someone wonderful who treats me like a princess and treats me well. I went out with some jerks and I noticed their "red flags" immediately.

I just wanted to share my story hoping it could give you a little bit of hope. Because I know you don't have much of that right now.

As someone who has just gotten out of an abusive relationship, I can't even tell you what enough is. Enough is the personal need in yourself to see that you deserve better. No one understands until they've been through it how alone you feel. How isolated you feel from everyone who cares about you. Even after you've left, and common sense tells you you've made the right choice, you wonder. You've let someone berate you so badly that you have no self worth and no self respect. You feel like you're crazy, that you're the one exaggerating simple things. It's the worst I have ever felt about myself. Period. It's a daily struggle, and no, telling a woman shes being abused isnt going to make her leave. The terror is almost beyond comprehension to outsiders. The only way to get someone out of that is to show they what they have to live for, because there were points where I would have gladly taken my own life rather than escape. It's embarrassing and painful. I don't think we as nurses understand fully what goes through the minds of these women...and my heart aches for them. At 27, I know what that feeling is like and I wish there was a way to help these women.

Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

Nola 009: My HMO offers support groups for women in or just getting out of abusive relationships. That helped me. Plus getting individual counseling with a psych doc helped me to see the abuse for what it really was. I sugar coated it in my mind. I also found out I was suffering from PTSD. I got on medication and saw things clearer after a bit.

I now can say I can see clearly now what things were, how bad they were.

I hope you get to a better place. ((Hugs))

Specializes in Stroke Seizure/LTC/SNF/LTAC.
T-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.

....we need more than just shelters, we need life coaches that'll assist these ladies every step of the way.

I whole-heartedly agree with ^^^^Life coaches^^^^. If the survivors don't recognize the cycle in the relationships, or recognize their own worth, then it it very likely to repeat itself. It only took 3 months for him to convince you that you were worthless without him, completed de-valued you as a human being, etc. :banghead:

I agree - the questions we ask "Do you feel safe at home?" are an excellent start, but I don't think they are "enough" either. I also agree that it isn't talked about often enough in school, at work, at church.

Maybe us survivors can come up with a thorough screening assessment AND develop an immediate, safe, and workable plan for the victims. that is applicable across the country. :yes: I want to be a Life Coach!

I came back to this post tonight just to read the other responses. Just want to say thanks to all of you for sharing your experiences, words of wisdom, and encouragement. Tears are in my eyes... it means a lot. Little by little, I have lost friends and even my own brothers will not speak to me. There was some falling out over something my husband said to one of my brothers or that one of my brothers said to my husband right before I started nursing school around 4 years ago and I haven't spoken to that brother since. He refused any (small) effort I made. My husband seems to feel just fine about it, claiming that my brothers aren't true men for reacting the way that they did. I believe that if they really cared, then they wouldn't give me the cold shoulder all this time. Eveny own mother dropped me like a hot potato, maybe because her favorite child did. Since she has found out I'm a nurse, I'm suddenly worth her time now and she has been wanting to 'hang out'. Never has discussed the silent treatments going on in the family, or her part in going along---she hasn't invited me to a holiday dinner, let alone her house in all these years!! And we all live within an hour's drive. That, above everything else has made me feel so low to the point where I'm planning on committing genetic suicide by not having any bio children and I'm just hoping to carry out the rest of my days in some helpful, positive way. I mean, I could probably use some counselling, but I just haven't found the right one. I do not trust easily. It's complicated for me. There's a mess of issues going on here. I want to be happier and healthier, but don't know where to start. And I really don't wanna be alone. But you people on AN have inspired me to do some soul-searching. Thanks.