VIOLENCE IN INTIMATE RELATIONSHIPS: WHAT CHALLENGES DO NURSES FACE?

Jacqueline Dienemann PhD, RN, NEA-C, FAAN - Professor, School of Nursing, University of North Carolina at Charlotte

jadienem@uncc.edu

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.