Nursing Blog The Nurse's Role in Detecting Domestic Violence
The Nurse's Role in Detecting Domestic Violence
Signs of Domestic Violence Many different assessments exist to determine if a person is a victim of domestic violence. One such assessment is the HITS assessment. You ask them if their partner hurts or threatens them. They answer on a scale of 1 to 5 with one indicating rarely and five indicating frequently. A score greater than 10 strongly indicates domestic violence. However, it may be easier to assess them for outward physical signs of domestic violence. Some signs you may look for are: anxiety, avoiding your questions, hyper-vigilance, unwillingness to speak when the partner is around, and a partner that is overly controlling. Some signs in the person's history may include: a suicide attempt, injury inconsistent with story, overdose, trauma, physical symptoms of stress, reluctance to seek care, repeat visits, or vague complaints.
Ethical Concerns When a nurse suspects that someone is a victim of domestic violence, he or she has an ethical and legal responsibility to help them through that problem. A nurse's first ethical duty is to do no harm. By allowing someone to continue to live in a circumstance that promotes violence, he or she is allowing them to continue to come to harm. Nurses have a duty to help their patient live in a healthy environment. An environment that includes domestic violence is not an environment that promotes health and well-being. An environment in which domestic violence is common is a detriment to the patient's health, and it is the nurse's duty to assist them to find a way out of this situation, if they can. This includes mandatory reporting making referrals to counsellors, social workers, shelters, or any other social services that can help the patient get out of the situation that is causing her harm. As a nurse, you are a trusted professional, and she may not open up to anybody but you. If you don't help her, no one else may.
References San Francisco General Hospital; Domestic Violence Program; 2000
The Online Journal of Issues in Nursing; Ethics: Domestic Violence, Nurses, and Ethics: What are the Links?; Mary Cipriano Silva, PhD, RN, FAAN and Ruth Ludwick, PhD, RN, C; May 2002 |
A woman sits on the examination table in the middle of the emergency room. The curtain is drawn around her, but she seems to shrink from the sight. She has a large bruise forming over her eye, and you know that by morning, she'll have a shiner that everybody will see. She claims she fell down the stairs. You don't believe her. This is the third time this month she's been in here with a fall. When you confront her about her falls, she doesn't look at you, and she doesn't want to talk about it. You are certain she is a victim of domestic violence, but what can you do about it? As a nurse, you have the duty both ethically and legally to help her.