Nursing Domestic Violence

Violence is a:
Includes physical, sexual, psychological abuse and stalking committed by one partner against the other in a relationship.

non-accidental acts, interpersonal or intrapersonal, that result in physical or psychological injury to one or more of the people involved.

Violence Includes:

physical, sexual, psychological abuse and stalking committed by one partner against the other in a relationship.

Intrapersonal Violence is

self-directed violence

% of women are abused

1 in every 3 women are abused in their life - EPIDEMIC

Women do not report abuse because:

� Fear of retaliation- fear of them or their children being murdered
� social isolation, but are knowledgeable about what will cause their
abuse
� financial dependence
� fear their own or children's safety
� low self esteem
� victims of domestic violence

Violence Triggers:

stressful life event, poverty, having/raising many young children in the home, social isolation

Places other than hospital where we can identity domestic violence -

ED's, OB/GYN--Particularly common
Primary care, Psychiatry, Pediatrics
out patient clients, home health care, immunization clinic, school nurse

Violence against women is more

prevalent than other kinds of violence in the neighborhood

Women tend to hide the abuse by:

women minimize what has happened to them, blame themselves, live in fear for their lives, etc

PHYSICAL NEGLECT IS THE

FAILURE TO PROVIDE ADEQUATE FOOD, PROPER CLOTHING, SHELTER, HYGIENE, OR NECESSARY MEDICAL CARE.

EMOTIONAL NEGLECT IS THE

OMISSION OF BASIC NURTURING, ACCEPTANCE, AND CARING ESSENTIAL FOR HEALTHY DEVELOPMENT

Elder abuse & neglect includes

Neglect
Emotional, sexual, physical abuse
Financial abuse

Typically see financial abuse by:

son or daughter (relative) may live with elderly parent and divert SS check and use it elsewise

Cycle of violence Phase 1:

tension building - leads to the batterer exploding

Cycle of violence Phase 2:

acute battering

Cycle of violence Phase 3:

honeymoon stage - batterer feels guilty and apologies to the victim

Potential violence Red Flags

� Intentional injures are generally more central (proximal)
� common injuries seen such as ruptured ear drum, hearing loss, neck bruising, petechiae from strangulation (will normally say they are being choked normally will not see any signs of 4 lbs for j

How does the batterer meet that power and control?

Giving victim allowance for the week
Isolated victim
Minimizing the situation
Using children for their own privilege

Physical clues to domestic violence

Multiple injuries
Injuries of different ages
Central distribution of injuries
Injuries suggesting a defensive posture: forearm bruises or fractures
Sexual assault

Domestic violence Patient Behavior

� Intense questioning about confidentiality
� blaming self: "clumsy," "stupid," "careless"
� change in behavior when partner is at patients side

Domestic violence Abuser's Behavior

� May stay close to pt
� may insist on following pt everywhere
� speaks for them

Sexual Assault Myths

� only promiscuous women are raped
� women enjoy being over powered
� the survivor will recover if they just get over it
� women routinely make false report
� committed by one race on another
� "No" means try harder
� homosexual men are more likely to be

Sexual Assault is

� sexual assault is any act of sexual contact or intimacy performed upon one person by another, and without mutual consent or with the inability of the victim to give consent due to age or mental of physical
- inability to give consent include alcohol or

rape is a crime of

violence, power and control. It is not a sexual crime or motivated by lust or desire
� sex is a byproduct of control

nearly 70% of rape victims

know their attacker

16-19 year olds are at greatest risk for

being sexually assaulted

surrender rape is

when the victim gives up to protect his/her life

Sexual intercourse means an act that includes

penetration of the female sex organ by the male organ

Male sex organ is

penis, scrotum

female sex organ

vagina, uterus, ovaries, fallopian tube, hymen, labia minora, clitoris, anything past the labia majora is considered rape

Hymen is a

collar or partial colar that surrounds the opening of the
vagina

REPORTING ABUSE IS

MANDATORY

Why wouldn't a women report violence?

Financial needs
Fear for own safety, or safety of children
Denial or disbelief
Emotional attachment or love for partner
Commitment to relationship
Hope the behavior would change
Shame and embarrassment
Staying for the sake of the kids
Depression & stress

Impact violence has on a person

Psychiatric disorders
Suicide
Depression
Cutting
Anxiety
PTSD

Genitals are a

mucous membranes and heal VERY quickly