Domestic Violence: The Elephant In The Room

October is Domestic Violence Awareness Month. It is a conversation that is difficult on either side and for every participant. But it's a conversation that could save a life. Maybe your patient's life. Maybe your best friend's or your sister's. Maybe yours. Nurses Announcements Archive Article

October is Domestic Violence Awareness month. It's a topic that has been addressed online and in print, but one that is excruciatingly difficult to bring up in a face-to-face conversation. I know this as a nurse, because it is awkward and uncomfortable to initiate the conversation with my patients, but I also know this as a survivor.

Recently, when I visited my oncologist, she brought up the topic in a perfunctory sort of way. "Do you feel safe at home?" she asked me, in exactly the same sort of manner she had asked me if my penicillin allergy is still current and if I'm taking my meds daily. She didn't make eye contact and it was clear she desperately wanted my answer to be in the affirmative because she wasn't comfortable discussing a negative. I don't blame her. It wouldn't have been comfortable for me either - on either side of that conversation. The thing is, I haven't always felt safe at home. My parents were violent and, like many survivors of childhood violence, I grew up to be a survivor of the more commonly thought-of domestic violence. Thirty years ago, I lived with a man who hurt me.

In the 1980s, no health care practitioner asked me if I was safe at home. And I wouldn't have known what to answer if one had. Domestic violence occurs at all socio-economic levels, in all strata of society. But it's one of those dirty little secrets that no one wants to admit to. I doubt you will ever encounter a man (at least not in our culture) who admits to beating his wife. (Or to being beaten by her, for that matter, because such things, while more rare, do happen.) And no one wants to be the woman who admits to being beaten. It's stigmatizing.

Thirty years ago, just before I married my abuser, I had a colleague whose live-in boyfriend commonly blackened her eyes when dinner wasn't ready on time. We all saw the black eyes. We all discussed her situation in hushed whispers so Donna wouldn't know we were talking about her. Then there was the day she showed up in our ER, left hand hanging by a thin shred of skin. Her partner had attacked her with an axe. It wasn't until then than Donna was willing to admit to being in an unsafe situation. She was scared to death he would kill her - and rightfully so. I remember discussing the situation with my friends and my soon-to-be husband. "No one would get away with that with ME," I proclaimed arrogantly. "If a man lifted his hand to me, I'd leave him." And I meant it. I thought I knew better. And I DID know better - until I didn't.

It started off slowly enough. He was transferred two thousand miles away from my friends and family. I made new friends, slowly, but that isn't the thing you discuss with a new friend. He became increasingly verbally abusive. He started throwing things. He started throwing things in my direction, which advanced to throwing things at me and then to throwing ME. There was a perfect impression of me in the drywall of our hallway, left when he slammed me against a wall. During one memorable fight, he threw me down a flight of stairs - the concrete stairs of our stoop. That could have killed me. It didn't, but it scared me. I went back into the house, packed a bag and flew to California to stay with my best friend for two weeks. I was too stupid or too ignorant to know how dangerous it was to go back into that house and pack a bag. I didn't understand that leaving is the most dangerous time for a woman. And I was too stupid not to go back when he agreed to get counseling.

Even in the counselor's office, it was excruciatingly embarrassing to admit that *I* was "an abused wife." Imagine how difficult it would be to tell your oncologist or your gynecologist or your PCP such a thing. I felt stigmatized, I felt "less than." It was now my dirty little secret, one that I didn't want anyone to know. And when it did come out, reactions were pretty much what I had envisioned. There was a lot of chest beating and proclamations that "I'd never let a man beat ME." Or "Why didn't you just leave him?"

I didn't leave him for myriad reasons, some valid and others not so much. I didn't want to admit defeat, that my marriage had failed. I had the first divorce in my extended family. I'm pretty sure I wasn't the first wife who endured physical violence. Our lives, finances and possessions were entwined. If you think that's a trivial reason, try to imagine yourself, right this moment getting up from your computer and leaving your home. Don't change your clothes, don't pack a bag. Just get up and walk out of your home with what you're wearing (flannel pajamas and comfy slippers? Ragged jeans and a T shirt) and what you can grab on your way out without slowing. Imagine that you might never be allowed to return to your home. What treasures are in that home that you'll never see again? Your grandmother's engagement ring that she gave you as she lay dying? The family Bible? Your photo albums, your purse, your dog? Your child maybe? Think about that for just a moment.

It's easy enough to SAY that things aren't worth your life. Your children, maybe but not Grandma's ring. But if you haven't lived it, you have no idea what it FEELS like. And until he actually tries to kill you, you may not get it that he might literally do so. Even if you know it in your head, it may not penetrate to that visceral level that demands action.

I left after my then-husband tried to strangle me to death. And because I met him through a blind date arranged by friends, I told those friends exactly why I left him. Then I had to endure dozens of rounds of "He's such a kind, gentle man. He would NEVER do such a thing. You must be making it up." "He's such a friendly, HUMBLE man. He'd never do that." We have all heard the rounds of praise heaped upon the head of a domestic abuser, the disbelief that "someone I know would do such a thing." Anyone who has read this board for more than a month knows that to be true. The knee-jerk expression of those beliefs is just one more type of abuse that the survivor of domestic violence has to face. I lost all of OUR friends, most of mine and even some family members because I finally found my backbone and wouldn't tolerate those kinds of comments, that kind of abuse.

It's not fair that a survivor of domestic violence has to lose her family, her friends, her reputation and her most treasured belongings. It's not fair that she has to listen to people who know HER postulate on how she must be making it up because they KNOW he "isn't that kind of man." None of it is fair.

October is Domestic Violence month. If you are in a relationship where you don't feel safe, make a plan. You don't have to leave right now if you're not ready. But have a copy of your insurance card, your social security card, your birth certificate, your passport somewhere safe where you can get to it but he can't. Keep extra keys. Have your own credit card and bank account, keep some cash. Park your car where it cannot be parked in. Keep your gas tank full. Know a safe place to go and at least three different routes to get there. Know who you would call to pick up your kids at school or daycare if you can't get to them. Have a plan. Please have a plan. Domestic violence doesn't just happen to other people. It can happen to you. It can happen in the wee hours of a holiday morning, on a Monday evening when he's had a bad day at work or his football team is losing or just before you're supposed to show up at your sister's wedding. Don't become a statistic.

For other articles in this series about domestic violence please read:

Domestic Violence: What Leaving Feels Like

Domestic Violence: Rebuilding


References

Bruised All Over - Nurses play role recognizing and stopping domestic violence.

Specializes in Hospital medicine; NP precepting; staff education.

I am amazed and inspired by the resilience shown by survivors of domestic violence. I pray that others who read this will move to act on their behalf before any other tragedies occur.

Wow. That was rough. I'm glad your ok. Fortunately I haven't been in that situation but my mom has told me before about her first husband (my half sister's dad). He was abusive and her jaw pops sometimes when shes eating. I saw my half sister get abused during her 1st marriage. Its a shame this kind of thing happens often:sour:

Specializes in retired LTC.

TY to those of you who have so movingly shared your stories. And I'm sure there are readers here who do not yet have the strength to respond as you have.

A prayer for you all.

Specializes in ORTHO, PCU, ED.

Wow Ruby...makes me count my blessings. You came out on the other side and can tell it to help others find a way out. That takes a strong person. Thank you for sharing.

Specializes in 15 years in ICU, 22 years in PACU.

As more people, with their ever handy cell phones, document what goes on in their lives include their abusers actions, I so hope it will get harder for abusers to get away with denying it happened.

It ain't right. It never was right and I hope to goodness the criminals that do this stuff will get to see it plastered all over their rap sheet.

First step to change is admit there is a problem.

And here we are talking about it on Allnurses. I've already copied this article for my personal records.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thanks you for writing this post, Ruby.

As a DV survivor, I feel very reflective during this month-unfortunately this month has many memories of incidents of my late ex where I was traumatized from October until January, when I was shot 7 times and survived. He committed suicide with a 9 mm Beretta lodged into his mouth.

I did everything right in terms of leaving-I got a restraining order approved by photographing and calling for help after I received a concussion after an argument after work near my clients house (Home Health) ; I ran across a 8 lane highway to get away, thanks to a few bystanders. I went to my local ER and admitted that my late ex had attacked me and even threatened me with his gun when I refused to go to his counseling appointment with him-he had thoughts of suicide and was exhibiting signs and symptoms of paranoid schizophrenia, and was getting dangerous by the minute.

I was very aware of the danger that was to follow, however, my sense of control was in the balance and I desired to get that control back was my driving force to leave. I went into that ED, one I had worked in and people knew me and knew my ex, and declared what he did to me. I recall the support that I got that day as one side of my face swelled from the impact of hitting my head on the concrete as he attempted to drag me into his car to go to therapy; I am grateful for the young couple that finally helped me while others ignored, laughed, and put their windows up as I asked for help because he broke my phone-he would do it again, right before he shot me and killed himself on the block of my client's house-and to the bystanders that helped me after I was shot, they were willing to risk being involved in something that gets swept underneath so much by society, I am forever grateful for that I have the courage to admit on present screenings and physical histories that I am a DV survivor.

I was weary that day he cornered me on my clients block-I even knew that day he was going to attack me. I had my restraining order, IDs for my jobs and personal ID, social security, and everything identifiable to contact anyone who needed to get in touch with my family-my thought process was to go down with a fight. I remembered the golden shell casing popping out to secure the bullet into place as he grabbed my throat and had the gun to my face as a bystander tried to stop him and called police. I remember that a motorist stopped and intervened before she shot me and was a police officer that helped get me to safety after he shot me. I had struggled during the attack-he shot me in my arm, abdomen twice, hip buttock and grazed my other arm and barely missed my face-a small scar today that I could've cleared with Mederma, however, I left a small mark to remind me that I know the signs, and will never be placed in that situation ever again in my life. EVER.

Oh my God. Your story makes me cry. You are so much braver than me. I have no words.

Mavrick: Admitting it, yea.

There's still such a stigma against the victim (I like the word SURVIVOR, too, scratch "victim") that she was not strong enough to stop it.

It's like asking a rape SURVIVOR why she was wearing that outfit, or why she was in that part of town. There's so much shame with DV.

I'm not implying you are saying this, Mav, just going off your one sentence, which spurred a thought.^

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thank you, Ruby Vee, Lady Free, and Galendria for sharing this part of yourselves, and for all those that come after and put down their words.

Ruby, that was so powerful, and I am humbled by your strength and willingness to "go first" in this dialogue.

My mom is a breast cancer survivor, but it's DV that I'm putting in my signature for October.

I, too am a breast cancer survivor. But breast cancer, as difficult as it was, was not the worst thing that ever happened to me.

Specializes in Palliative, Onc, Med-Surg, Home Hospice.

Thank you for sharing.

My sister left her abuser after nearly 12 years of marriage. We (her family) never knew the extent of the abuse until she moved to SC to live near our mum. She then finally opened up. She explained to us that she didn't leave him sooner because he played the "your grandma wouldn't have left your grandpa when he was sick" card. (He had a bad back). He did a good job on playing the guilt card. She finally said "enough" and walked out, leaving all her possessions. We were lucky in that when my sister went to go get her stuff (after 6 years and a divorce) she was able to get it. But, she told me that it would have been worth it to let him keep our grandmas stuff in that house. She started to live again.

I have asked patients if they are abused, and the standard reply is "no". I have had a wife of a patient pull me aside and tell me she was abused by her husband. She used her husbands hospitalization to escape. She was in her 70's. Sometimes we forget that even the elderly can be victims of DV. SC has a very high rate of death r/t DV. Asking is a good start but it isn't enough, is it?

Specializes in Hospital medicine; NP precepting; staff education.

In the ER we do these screenings all of the time and I get so annoyed when pt's treat it as a joke with the pretend glances at their SO to imply that uh-oh, I better watch what I say. There are times when I wonder if they really are playing around or not because they stop chuckling when I level them with a stare that says I am not asking for kicks and giggles.

In the ER we do these screenings all of the time and I get so annoyed when pt's treat it as a joke with the pretend glances at their SO to imply that uh-oh, I better watch what I say. There are times when I wonder if they really are playing around or not because they stop chuckling when I level them with a stare that says I am not asking for kicks and giggles.

I think people don't say anything because they are scared that person would hurt them again and maybe worse if they said anything. Its a terrible cycle. Living in fear. Damned if u do damned if you don't kinda thing. :down:

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Thank you for sharing your personal story, Ruby.

Although I have not experienced intimate partner violence in my adult life, I did spend my early and middle childhood years in a chaotic household with a volatile father who beat my mother, used illicit drugs out in the open, drank to excess, and destroyed furniture and other property.

The memories still haunt me on a daily basis. At times I wished my mother would have divorced my father because a loving single-parent home would have seemed more nurturing than the personal hell I witnessed.