Mentioning public health problems might bring to mind tobacco use, heart disease and prescription drug overdoses. Just as serious, intimate partner violence (IPV) is a public health problem that affects millions of Americans.
As the healthcare professionals who are most involved with patients, nurses are uniquely positioned to lead violence prevention and intervention efforts. Understandably, RNs may lack confidence when it comes to addressing this complex issue.
Achieving higher levels of education can prepare RNs to care for patients who are affected by IPV. The RN to BS in Nursing online program at Fitchburg State University, for example, puts an emphasis on caring for forensic populations.
What Is Domestic Violence?
To understand an RN's role in violence detection, prevention and intervention, it is helpful to get a sense of the scope of the problem. According to the Centers for Disease Control and Prevention (CDC), IPV was a recognized social problem in the 1960s and 1970s. In 1979, the Surgeon General's Report identified 15 priority areas for public health. Violence prevention was one of them. Forty years later, intimate partner violence is recognized by the CDC as a "serious, preventable public health problem."
The CDC defines IPV as "physical, sexual, or psychological harm by a current or former partner or spouse." The CDC stresses that IPV can occur among heterosexual or same-sex couples and does not require sexual intimacy. IPV is more common than many people think:
- The National Domestic Violence Hotline reports that in the U.S. alone, more than 12 million individuals a year are victims of rape, physical violence or stalking by an intimate partner. That is 24 people per minute.
- The majority of IPV victims are women, though men also experience domestic violence.
- The National Domestic Violence Hotline reported more than half a million calls and online chats in 2018.
How Can RNs Help?
RNs are known for being trustworthy. This positions them to advocate for patients experiencing IPV. As Futures Without Violence advises, "Being there for a patient unconditionally is the goal."
Patients experiencing IPV are often treated in emergency departments. However, they may not report IPV for many reasons, including:
- Fear for their safety
- Fear for the safety of family members
- Denial, shame and depression
- Hope that the perpetrator will change
- Lack of financial independence
- Distrust or a belief that nobody can help them
- Immigration status
Therefore, it is essential that RNs recognize the signs. Abrasions, bruising in the chest or abdomen, and broken teeth are common examples. But not all signs of IPV are this obvious.
The Emergency Nurses Association (ENA) points out that signs of strangulation can easily be missed. Yet, non-fatal strangulation in IPV is the "most predictive factor for subsequent severe violence." According to the ENA, victims of one episode are eight times more likely to become a homicide victim of that current or former partner.
A joint statement by the ENA and the International Association of Forensic Nurses (IAFN) cites research indicating low screening rates for IPV. Contributing factors may include provider discomfort with "screening questions, positive disclosures, and safety planning."
Compassion and respect for patients' dignity and worth go hand in hand with nursing. This helps RNs build rapport with patients. In turn, patients may feel safer discussing IPV with their nurse.
Pursuing education on IPV can prepare RNs to provide the appropriate prevention and intervention.
How Can a BSN Prepare RNs to Address Violence?
It is said that knowledge builds power. For RNs, enhancing knowledge and skills related to IPV can make the difference between helping a patient and being one more person who avoids the issue altogether.
The course NURS 4520: Caring for Forensic Populations in Fitchburg State's online RN to BS in Nursing program provides nurses with a foundation for preventing and reducing the consequences of domestic violence. Topics include:
- Individual, sociocultural, environmental and systemic factors related to violence and trauma
- Forensic health assessment
- Violence prevention and intervention strategies
Other courses that provide RNs with additional preparation to serve as advocates for vulnerable populations include NURS 3600: Health and Physical Assessment and NURS 4020: Social Justice and Advocacy.
In the foreword for a World Health Organization report on violence and health, Nelson Mandela wrote, "We owe our children — the most vulnerable citizens in any society — a life free from violence and fear. In order to ensure this, we must be tireless in our efforts not only to attain peace, justice and prosperity for countries, but also for communities and members of the same family."
RNs comprise the largest healthcare occupation, and they provide the majority of patient care. Because of the high incidence of IPV, RNs will likely care for patients who experience IPV. By becoming informed about IPV, RNs can take a leading role in substantially improving health outcomes for their patients.
Learn more about Fitchburg State University's online RN to BS in Nursing program.
The National Domestic Violence Hotline: Get the Facts & Figures
National Domestic Violence Hotline: A Year of Impact - 2018
FuturesWithoutViolence.org: A Call to Action: The Nursing Role in Routine Assessment for Intimate Partner Violence
Emergency Nurses Association: An Overview of Strangulation Injuries and Nursing Implications
Emergency Nurses Association: Intimate Partner Violence
World Health Organization: Violence and Injury Prevention
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