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The Nurse’s Role in Helping Victims of Intimate Partner Abuse

Student Number – 01010101


The Nurse’s Role in Helping Victims of Intimate Partner Abuse


The principal role of a nurse is to preserve the health of the population. In doing so nurses are required to wear many different hats. Kaakinen (2010) stated that nurses generally act as educators, counselors, coaches and guides, but contends that if nurses are to deliver effective and safe family care they must possess the ability to identify health issues, make accurate evaluations and customize suitable care plans. Whether it applies to one family member, or to the family as a unit, each step of the process requires the nurse to be thoughtful and deliberate (Kaakinen, 2010). The purpose of this paper is to discuss the subject of intimate partner abuse and its impact on the family, with the objective to highlight the critical role of the nurse in providing the affected family with the most suitable interventions.


Hamel (2014) stated that individuals who suffer physical abuse sustain a significant amount of physical injuries and display poor cognitive functioning as well as high occurrences of psychological disorders. Female victims generally suffer a greater impact than their male counterparts in IAP abuses, and reported an outstandingly higher degree of fear. Furthermore, women who are subjected to intimate partner abuse often times end up being depressed and anxious, and try to numb these feeling with prescription pills and tranquilizers. The injuries sustained by women are generally life-threatening ones that require a trip to the emergency room or doctor’s office, and because of their ordeal some of these women harbor suicidal thoughts and reported low self-esteem and poor social and occupational functioning (Hamel, 2014).


Dennis (2014) explained that children who witness domestic abuse often suffer behavioral, emotional and learning problems. Younger children, between the ages of 3 and 7 years, tend to wet their beds, be aggressive, anxious, hyperactive or withdrawn, while older children who are in their teen years generally abuse drugs or alcohol, run away from home, exhibit lack of confidence, or harm themselves (Dennis, 2014). In addressing the health needs of

families Kaakinen (2010) explained that since the family is considered as a unit, issues that occur in the family will have an impact on each individual member. The nurse has the option to assess the family individually or together and the questions asked could be about abnormal, unexpected events, to include how the family is coping with the somewhat inevitable instructive task (Kaakinen, 2010).


The interview should be conducted to establish the social, cognitive, spiritual, emotional and physical state of the family. Furthermore, nurses must determine the normal or unusual events that have happened to the family as a unit, or to individual family members. Nurses are also required to assess how family members are coping in their schools, communities, homes and with their immediate and extended families. If a nurse realizes that a family is at a risk to be harmed, he/she should collaborate with other healthcare professionals to: (1) bring families to the understanding that the risk is real, and (2) to help families make decisions concerning surveillance or management. The nurse’s role in every situation is to help families make choices that are most suitable for their specific cultures, beliefs and circumstances (Kaakinen, 2010).


Allard (2013) suggested that when a nurse is screening for IPA they should ask suspected victims direct questions about their personal experiences based on their professional suspicion, or by following a routine screening process. Questions could include asking patients if they have ever felt threatened by their partner. When nurses screen suspected victims of IPA, it is very crucial that it is done in a confidential and discreet manner, in an area where conversations cannot be overhead. Even if the patient insists, a nurse should never screen a suspected victim with their spouse, children or any other family member present. Family members or friends should never be asked to play the role of an interpreter, instead professional advocates or interpreters from an organization who specializes in this field should be used (Allard, 2013).

Hawley (2012) asserted that nurses should be quick to detect clues in a woman’s patterns of illnesses and physical injuries, and should be observant of the individual’s as well as her partner’s behavior. Suspicious behaviors include delaying to seek medical treatment for an apparent injury, or appearing anxious, depressed, evasive or embarrassed. Nurses must show empathy to make the victim comfortable enough to share information. They should start the interview by taking a seat next to the individual as this will suggest that they are committed to taking the time out to help them. The patient should also be assured that the information that they share will be kept in the strictest of confidence. Victims may be fearful to return to their home, or otherwise fear for the lives of their children. In general these women would have a history of frequent visits to the emergency room or doctor’s office for injuries. Another behavior that is typical of IPA victims is making excuses for the perpetrator by saying things like, he has an issue with drugs or alcohol, or he has a mental problem (Hawley, 2012).


Dudgeon and Evanson (2014) advised that if during screening the patient discloses that she/he has been abused, the manner in which the nurse responds may affect the individual’s willingness to seek further support. It is therefore important that the nurse assures the patient that she is believed, that the abuse is not her fault, and that she did not deserve what happened to her. The victim should also be made to understand that her experience is not unique and that the information that she shares is crucial to the nurse’s understanding of her health and safety. The nurse must then help the patient to create a safety plan, which may involve leaving her abuser permanently. A safety plan entails planning a route for escape: arranging ahead of time to have a secure place to stay and keeping important documents for her children and herself, as well as her car and house keys in a location where they are easily retrievable (Dudgeon & Evanson, 2014).


Victims of IPA must be provided with information about resources inside the facility and nurses are required to assist them with identifying any available community resources. They should also be provided with the telephone number of the hotline for domestic violence and any other crisis hotline numbers. Furthermore, nurses must advise victims to write these numbers on small pieces of paper and to conceal them in places where it would be hard for their abusers to find them. The same counseling and advice that is offered to individuals who choose to disclose their abuse must also be offered to those who choose not to (Dudgeon & Evanson, 2014).


Baird (2011) argued that protecting children should be included in the risk assessment procedure. Making a comprehensive assessment of the long-term and immediate needs of a victim and her children is a critical part of adequately handling an abuse disclosure. Every healthcare professional who works with children must be cognizant of the protocols and procedures of their organization with regards to protecting the welfare of children, and should know who in their organizations they need to contact to air these concerns. When assessing children, nurses need also to consider their safety as well as their developmental and emotional needs. Nurses must keep in mind that the needs and risks of individual families will vary: because of language barriers, isolation and immigration concerns, women from different backgrounds may require different safety plans. A nurse should never encourage a woman to leave her abuser before conducting a full risk assessment, or implementing a safety plan to protect the family. Even though enacting a safety plan can be complicated, it should nevertheless be tailored to fit the needs of the woman and her children (Baird, 2011).


Shavers (2013) explained that keeping the patient’s information confidential is an important part of keeping them safe and that this should be considered as a crucial part of the screening and assessment process. Safety policies may also include facilitating the patient’s

accessibility to the judicial system, referring them to resources such as a medical social worker in the community and providing them with a current list of updated community-based facilities such as emergency crisis centers and local shelters. The nurse should also be cognizant of the pertinent laws and policies for reporting to the different authorities. Furthermore, the nurse must ensure that the victim’s statement is accurately and clearly documented, as this may be later used as evidence in court. Educating victims about the patterns and cycles of abuse and when to seek help, is also a way of helping them keep safe (Shavers, 2013).


Collaboration among different healthcare teams and other agencies is an essential element of providing appropriate intervention and support for women and children who suffer domestic violence. This effort can foster a seamless delivery of care, but for this to happen healthcare workers must be familiar with the responsibilities and roles of other agencies. Creating links between agencies can help with identifying, opportunities, needs and initiatives, and a local forum is the perfect arena in which to make this happen (Baird, 2011).


Conclusion


The act of abusing an intimate partner is a criminal one that has very serious long-lasting consequences for not only the victims, but also their families and friends. Intimate partner abuse also has a direct effect on the healthcare industry, with victims requiring medical services that amount to billions of dollars. Nurses are in a very unique position to stop this kind of abuse or otherwise mitigate its impact. It is however, unfortunate that not all nurses are able or willing to investigate cases of suspected abuse. As nurses we are supposed to be advocates for our patients, and we can help these victims through active screening, counseling, education and by pointing them to the relevant resources. We can also form partnerships with other community initiatives to provide a voice for these victims so as to ultimately end domestic abuse.


References


Allard, C. (2013). Caring for people who experience domestic abuse. Emergency Nurse, 21(2), 12-16. Retrieved from: http://web.b.ebscohost.com.roxy.nipissingu.ca/ehost/pdfviewer/pdfviewer?vid=5&sid=

Baird, K. (2011). Working with women and children experiencing domestic violence. Primary Health Care, 21(1), 16-21. Retrieved from http://search.proquest.com/docview/851505465?accountid=12792

Dennis, T., PhD.M.Sc B.Sc Dip N.F.E.T.C. (2014). Time to tackle domestic violence: Identifying and supporting families. Community Practitioner, 87(9), 29-32. Retrieved from http://search.proquest.com/docview/1563110135?accountid=12792 9eaaa6-039f-4467-8997-19ee7739d0ff%40sessionmgr111&hid=101.

Dudgeon, A., MS, APRN, FNP-C, & Evanson, T. A., PhD, RN, APHN-BC (2014). Intimate partner violence in rural U.S. areas: What every nurse should know. American Journal of Nursing, 114(5), pp. 26-35.

Hamel, J. (2014). Gender-inclusive treatment of intimate partner abuse: Evidence-based approaches. New York, NY: Springer Publishing Company.

Hawley, D. A. (2012). Survivors of intimate partner violence: Implications for nursing care. Critical Care Nursing Clinics of North America 24(1), pp. 27-39.doi:10.1016/j.ccell.2011.12.003.

Kaakinen, J. R. (2010). Family health care nursing: Theory, practice and research (4th ed.). Philadelphia, PA: F. A Davis Co

McMahon, S. (2009). Basic concepts of the Bevis curriculum process: Building the framework and applying the system to nursing education and practice.(Adapted from Foley, D. 2003).Unpublished Manuscript. Faculty of Nursing, University of Windsor, Canada.

Shavers, C. A. (2013). Intimate partner violence: a guide for primary care providers. The Nurse Practitioner, 38(12), 39-46. doi:10.1097/01.NPR.0000437577.21766.37