VIOLENCE IN INTIMATE
RELATIONSHIPS: WHAT CHALLENGES DO NURSES FACE?
Jacqueline Dienemann
PhD, RN, NEA-C, FAAN - Professor,
NOTE: DVSA and DV Response Pathway will be distributed
Challenge: Lag between
New Roles, Laws and Culture. Women’s lives are changing over time as their
cultures are widening their roles in society, offering more educational and
employment opportunities, and more legal rights in marriage, work, and the
community. Yet, despite all the changes,
new services for survivors and laws against intimate partner violence, in no
country are women and men treated in the same manner. IPV continues as a major
problem.
Nursing education can help to shape nurse behavior with
women patients who have experienced domestic violence. IPV is widely included
in the Nursing curriculum, but is rarely updated with new evidence, changes in
laws, and advances in services or included in clinical experiences. Faculty
need to keep content and experiential learning current. Keep in mind 95% of
nurses are women and therefore also vulnerable to abuse. School and employers vary in the services to
assist survivors that are students or employees.
Challenge: Health Care
System’s focus is physical symptoms, diagnosis, and
predictable trajectory of treatment and recovery. IPV is a chronic health problem and therefore
does not fit this model resulting in frustration by both survivors and care
providers. Nurses need to be aware of the
need to reform health care to become more holistic and responsive to chronic
health problems such as IPV. All chronic health problems have both a medical
and social aspect that impacts the client’s health. Nurses may be key providers
of care for those with chronic health problems and need to be involved in
changing the system.
Challenge: Nurse’s role
and IPV is more than screening and referral. A nurse’s
immediate response when a woman discloses may be critical to how she perceives
all of health care about this health problem.
Nurses need to know women are more likely to disclose in settings where
they know the providers such as a primary care or prenatal office or clinic or
a community health visitor, etc. Need to know how to respond to the context of
an individual woman and work with her over time even if DV is not the primary focus
of why she is coming for health care.
Challenge: Evidence
based nursing employs best practices that include the
most current research and other evidence and consideration of patient
characteristics and resources available.
Nurses need to be involved in defining policies that use best
practices. This requires education in
research, library skills, and viewing the nursing role as beyond the bedside to
participation in shaping the system of care.
There is a responsibility of the health system to have a structure for
self governance of nursing practice and evidence based practice and a
responsibility of nurses to learn and use the skills to provide the best
nursing care.