Nursing and domestic violence are connected as nurses play a critical role in helping to identify and prevent domestic violence, which has become a public health problem. Learn how Northeastern University’s ABSN program can help educate future nurses to fill this need.
Nurses are at the forefront of healthcare, hearing patients’ needs and helping to determine treatment. Nursing and domestic violence are connected, as nurses are trained to recognize sensitive issues relating to mental health and domestic violence, also called intimate partner violence.
When people hear the word “abuse,” they often think of physical harm, but it can also include emotional, psychological, sexual, and financial mistreatment.
Understanding the Scope of Domestic Violence as a Public Health Issue
Domestic violence is not just a personal problem; it is a public one. The National Intimate Partner and Sexual Violence Survey (NISVS) report, released in 2022, estimates that over 47% of women in the U.S. experience intimate partner violence in their lifetime. It might surprise you to know that more than 40% of American men have experienced the same. About 12 million people report domestic violence crimes each year.
Domestic violence has become a public health problem, and nurses can help identify when a patient needs help, what actions need to be taken, and how they can offer support. The American Association of Colleges of Nursing (AACN) notes that nurses frequently care for victims, perpetrators, and witnesses of violence, and the organization recognizes the “magnitude” of health problems related to it.
The Nurse’s Role in Domestic Violence Prevention and Intervention
A nurse’s role in domestic violence prevention is critical, as they often help identify and intervene in domestic violence cases. The trouble is the widely reported shortage of nurses. Northeastern University’s Accelerated Bachelor of Science in Nursing (ABSN) program is helping to fill that gap.
If you have a non-nursing bachelor’s degree or a minimum of 62 college credits, you can earn your nursing degree through Northeastern in as few as 16 months. Northeastern’s ABSN program serves students through its campuses near Boston, Massachusetts; Providence, Rhode Island; and in Charlotte, North Carolina.
Barriers to Reporting Abuse
Despite the willingness of nurses and other healthcare professionals to help, victims of abuse are often reluctant to come forward.
While domestic violence victims number in the millions, they often don’t disclose what is happening. The U.S. Bureau of Justice Statistics reports that more than half (52%) of domestic violence victims don’t report the crime to authorities.
Some reasons victims do not disclose include:
- Fear for their own safety or the safety of their children or family
- Denial
- Emotional attachment or love for partner
- Hope the behavior will change
- Shame or embarrassment
- Depression
- Lack of faith in other people’s ability to help
The first step toward helping a patient heal is identifying the abuse.
Community health nurses play an important role as they work with at-risk populations.
Developing a Nursing Care Plan for Domestic Abuse
Because patients often don’t talk about the abuse they’re receiving, it can be difficult to know what is going on and address their needs. Developing a plan to screen for and respond to domestic abuse cases is important for handling them appropriately and effectively.
The Nurse Journal recommends the following to screen for domestic violence:
- Conduct routine screenings. Nurses must look beyond a person’s gender, socioeconomic status, race, and other stereotypes and utilize a trauma-informed, compassionate approach.
- Establish trust with the patient. Rather than peppering a patient with questions to force them to disclose abuse, demonstrate empathy. Be supportive by being patient and calm, asking permission before touching the patient, giving the patient information, and other tactics.
- Know the phases of abuse. Abusers often follow a cycle of violence, beginning with calm, followed by tension, an explosion, and so on.
- Understand the relationship between illness and abuse. Common illnesses related to abuse include back pain, depression, diabetes, and more.
According to the Crisis Prevention Institute, outward physical signs of abuse can include:
- Bruising in the chest and abdomen
- Multiple injuries
- Minor lacerations
- Ruptured eardrums
- Delay in seeking medical attention
- Repeated injuries
Other issues can include drug abuse, anxiety, abdominal pain, sleeping and eating disorders, gynecological problems, suicide attempts and more.
You might have noticed your healthcare provider at your recent medical visit asking questions like “Is everything ok at home?” or “Are you safe?” These questions are designed to help gauge whether you are experiencing abuse or other issues.
Many healthcare facilities have incorporated patient safety-related questions during medical or hospital visits. Stanford Health Center, for example, draws from a series of direct and indirect questions to help determine if a patient is safe at home. They can include:
- Has anyone close to you ever threatened or hurt you?
- How are things going at home?
- How do you feel about the relationships in your life?
- What happens when you and your partner disagree?
- Are your friends and family aware of what’s going on?
How patients answer such questions could start them on a path toward healing and a better situation.
Nurses are “mandated reporters,” meaning that if a patient discloses abuse, they must report it to authorities. Each state has its own rules about how and when this should happen.
Collaborative Efforts in Addressing Domestic Violence
In addition to screening for abuse, nurses and other healthcare providers need to consider the best collaborative approach to handling situations in which a patient might be experiencing domestic violence.
Nurses and other medical providers need to remember that domestic violence can happen to anyone, regardless of background. They should employ empathy and active listening skills and watch for more subtle signs like delays in seeking treatment or repeat visits for things like anxiety or headaches.
According to the National Network to End Domestic Violence, a trauma-informed approach includes individualized care. It recognizes the physical and mental effects of trauma yet looks beyond what happened. It considers how trauma affects the brain, as an abused person is continually in survival mode. Patients can also have Post-Traumatic Stress Disorder.
The organization lists five principles of trauma-informed care:
- Awareness: Nurses and other healthcare providers are aware of the effects of trauma on survivors.
- Safety: Victims need to be safe physically and emotionally.
- Trustworthiness: The provider should work to build trust with the patient.
- Empowerment: Patients need to be involved in decisions about their care.
- Inclusiveness: Accept and encourage people from all backgrounds and physical abilities.
In addition to taking a trauma-informed approach, nurses can connect patients with resources like the National Domestic Violence Hotline, local shelters and other services.
Education and Training for Nurses on Domestic Violence
Education is key to a healthcare provider’s ability to identify abuse and better help those in need of treatment and assistance.
The AACN recommends a list of competencies that should be included in nursing education to help better prepare future nurses to provide care to victims of violence.
Some suggestions include:
- Faculty should acknowledge their assumptions about domestic violence and stay current on related health problems.
- Content relating to domestic violence should be included in nursing education, whether integrated into the curriculum or as a standalone course.
- Students’ clinical experiences should include practicing screening, assessing, and caring for victims of violence.
According to a study published in NursingOpen, “Nurses tend to play a statistically significant role in recognizing individuals who are DVA victims, boosting the developments of safety plans, as well as expediting access to support.” It concludes that university courses on domestic violence will help equip future nurses.
The International Association of Forensic Nurses offers an online Intimate Partner Violence Nurse Examiner certificate program as continuing education for registered nurses.
If you are interested in serving this vulnerable population, you must first become a registered nurse by earning a nursing degree and passing the NCLEX licensure exam. Ask the schools you are considering what kind of domestic violence training you would receive.
Start Your Nursing Journey at Northeastern
Northeastern University offers two paths as part of its ABSN program, second degree and transfer, allowing students to complete their degree in as few as 16 months. The program is a rigorous blend of online and onsite curriculum over four semesters. Three main components include:
- Online courses covering the fundamentals and theories of nursing.
- Nursing labs where students apply nursing principles in a hands-on, controlled environment.
- Clinical rotations that provide students with real-world experience in diverse practice settings at area healthcare facilities.
An admissions counselor can work with you to determine your eligibility for the ABSN program and any prerequisites you might need to take.
Contact us today to begin your nursing journey and move closer to making a difference in the lives of those who need it most.