More than three quarters of domestic violence victims who report the incidents to police seek health care in emergency rooms, but most of them are never identified as being victims of abuse during their hospital visit. What can a nurse or a physician can do to prevent domestic after female patient discharge?
If the patient has reported the incident to the police and is escorted to the hospital, she should be identified as a victim of abuse (or a victim of domestic violence) at her intake. That should, logically, start the chain of communication with the local domestic violence prevention organization, including a safe house for her to be d/c to. If that didn't happen, then the attending nurse or physician should ask the patient if her injuries were the result of domestic violence. If she replies "yes", the RN or MD should notify the authorities, including the local domestic violence prevention organization.
Signs os domestic violence must be reported by hospital staff to the authorities to prevent new injuries. Offenders used to control themselves when increased the propability of imprisonment.
Dr. Aghakhani,
Here in the United States we train nurses and doctors to identify domestic violence (e.g., suspicious injuries, bruising consistent with domestic violence, inconsistent story, controlling partner, multiple ER visits, etc.). If they suspect domestic violence, they ask about it and refer her to the local shelter. Some shelters/hospitals have case workers who meet with victims at the hospital to explore options and create a safety plan. Beyond expressing concern and educating victims about their options, there isn’t much more that we can do. In Texas, medical staff are not required to report domestic violence to the police or to shelters. So, in sum, I think preventing domestic violence in women discharged from the ER lies in training staff to identify and ask about violence, educating women about domestic violence, connecting them to the local shelter and other resources, and, when possible, developing a safety plan. I hope this helps.
Lisa
It depends on whether or not there is a child involved here in UK and Ireland. Everyone is obliged to report domestic violence to the Police or Social Services if they believe a child is living in a household in which domestic violence is occurring. An investigation will then be carried out, and several outcomes are possible - and these are perhaps the kind of things you are interested in finding out more about Nader:
if a case is opened (that is, if there appears to be a risk of harm to the child, or a need for support to the family), support will be offered to the abuse survivor, such as an advocacy service and legal advice, she will be made aware of her rights and the support she can expect via a refuge etc if she wants to end the relationship
the police or social services will attempt to engage with the perpetrator and agree a safety plan with him, for example a plan for what he will do from now on when he feels angry, and abuse is likely
those are just a coupe of examples
In more general terms, I think it boils down to this: if the abuse survivor stays in the relationship, there is nothing much anyone can do to prevent the abuse recurring. Unless some mechanism of accountability for the perpetrator's behaviour is introduced the research suggests that it will most certainly continue. Possible mechanisms of accountability include: the abuse survivor standing up and saying this cannot continue, and taking more control (can be a very risky strategy,it is at this point the femicides are most likely); the judiciary may step in and introduce sanctions (unlikely in manycountries, and the value in sanctions is by no means underpinned by research findings; the perpetrator himself may seek therapeutic help, and hold himslef to account,perhaps motivated by the effect on his children (research doesn't really suggest that change is likely; And finally, some authorities have embraced a process called restorative justice, where extended family or community are brought into process - by opening the issue up like this , it helps introduce safety for the survivor
yes I have went on a biit here, I am on a lunch break....
The hospital service needs to have a collaborative relationship with community services and to refer on to these services as appropriate on or prior to discharge. You might like to read this evaluation of one such service and particularly the item "collaboration". In order for such referrals to work there needs to be community services such as women's refuges or women's services that can provide safe services to women and children. There also needs to be a good collaborative relationship between the police and the health services, and the child protection agencies and the health service. The ways the health services will work collaboratively with community services needs to be written into policy documents and supported by the management and clinical leadership of the health service:
http://www.aut.ac.nz/__data/assets/pdf_file/0003/63381/48_month_itru_report_web_file.pdf
In London, it has been identified that the majority of cases involving domestic violence will attend hospital, in one form or another as well as the GP, before they will seek help from the police. The majority of hospitals will have an IDVA based there to provide immediate support onsite. In the case of your question, there is little a nurse or doctor can do once they have discharged the patient, and particularly if the victim declines support. You cannot pressure an individual to acknowledge what they are experiencing, regardless of knowledge and expertise. Rather, wouldn't it be more expedient to do as much as you can prior to discharge? That is the whole of idea of hospital based IDVA's. There isn't a great track record of partnerships between hospitals and community based services, and though some doctors and nurses are trained to identify domestic abuse, it isn't always so clear cut, there isn't enough time, and attitudes often play a hinderance in masking what is truly in front of their eyes.
- Badges
- Science topic
- Similar topics
- Biological Science
- Bioecology
- Systems Ecology
- Landscape Ecology
- Connectivity