The Nurse’s Role in Addressing Intimate Partner Violence

• October is Intimate Partner Violence Awareness Month, and nurses play a significant role in identifying signs of abuse. 
• The Centers for Disease Control and Prevention reported that roughly 41% of women and 26% of men experienced contact sexual violence, physical violence, or stalking by an intimate partner.  
• The most common barriers to an intimate partner violence screening include a lack of time, training, and comfort. 

Nurses play a significant role in identifying signs of abuse, and as mandated reporters, they’re expected to report suspected abuse to the proper parties.

With October being Intimate Partner Violence Awareness Month, it’s a good time to reeducate yourself on the potential signs of abuse. This will arm you with the information needed to help patients achieve better health outcomes and end the cycle of abuse.

Being observant is one of the most important aspects of being a nurse and your observations could save your patient’s life.

What is Intimate Partner Violence? 

Intimate partner violence includes physical and emotional abuse, stalking, and sexual violence.

Intimate partner violence affects millions of people in the United States each year. Data from Centers for Disease Control and Prevention’s National Intimate Partner and Sexual Violence Survey (NISVS) states:

• About 41% of women and 26% of men experienced contact sexual violence, physical violence, or stalking by an intimate partner during their lifetime and reported a related impact. 
• More than 61 million women and 53 million men have experienced psychological aggression by an intimate partner in their lifetime.

Due to the amount of people affected by intimate partner violence, it is imperative for nurses to identify and report possible abuse as quickly as possible

Signs of Intimate Partner Violence

Signs of intimate partner violence are not always obvious. Abusers and their victims can go to great lengths to hide abuse, making it harder to identify.  

Less Obvious Signs of Potential Abuse:

• Unexplained injuries. 
• Repeated visits for minor medical problems. 
• Repeated visits for anxiety or depression.

The patient may also present with physical reactions to trauma such as: 

• GI issues 
• Chest pain 
• Headaches

A partner who attempts to control the medical appointment, such as speaking for the patient, could also signal an abusive relationship. If possible, try to speak with the patient privately.

Starting the Conversation 

According to AMN Healthcare, there are several questions nurses can ask to determine the appropriate action. Before starting the conversation, ensure your patient feels comfortable and assure them you’re there to help not to cause trouble. Pay close attention to the words you use so you don’t unintentionally blame the victim.

Identifying Needs

To learn about the patient’s potential needs, start by asking how everything is at home.  

If the patient replies, ask a more critical question with caution, such as, “Are you worried about your safety?”

If the patient is not receptive to this question, try to frame a new question in a more indirect manner, such as, “You appear to be showing signs of anxiety. Is anything bothering you?”

Even if the patient is not receptive to questioning, determining if they’re experiencing domestic violence, and communicating the best response, will help you be an advocate

When providing care to domestic violence survivors, it may be difficult to know the “right” thing to say. Nurses can provide support in many ways, but the most important is listening. Specific phrases that are helpful include, “I believe you,” “It is not your fault,” and “You are not alone.” Avoiding judgment and offering supportive resources are also vital.

Understanding Your Role as a Mandated Reporter

Why is mandatory reporting important in nursing?

Nurses are commonly viewed as advocates and are among the most trusted healthcare professionals. Nurses often spend more time with their patients than the provider and may receive information vital to suspected abuse that the provider may unintentionally miss.

How should you document abuse as a nurse?

Follow your state regulations and guidelines for nursing documentation of abuse. Be sure you are stating the facts and leave opinions and judgements out of your documentation.

What are the most common barriers of intimate partner violence screening?

The most common barriers to an intimate partner violence screening, according to a recent study, include a lack of time, training, and comfort.

How can these barriers be overcome?

Maintaining a healthy patient ratio can help nurses overcome common barriers to intimate partner violence screenings. Providing ongoing training and education will enable nurses to feel more confident when completing an intimate partner violence screening. Combined, those efforts will increase the comfort level of the nurses who conduct the screenings. 

The Bottom Line

Intimate partner violence is a public health concern that affects millions of men and women. Nurses play a significant role in stopping the cycle of abuse. It is crucial to equip ourselves with as much training and ongoing education on intimate partner violence as possible to achieve positive outcomes for patients. 

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