Unit 1: Lack of Training

Unit 1) Lack of Training: : 

Unit 1) Lack of Training: “I just don’t have enough training on this topic.” “I don’t feel prepared to adequately address abuse in my practice.”

Definition of Intimate Partner Violence (IPV): : 

Definition of Intimate Partner Violence (IPV): “physical, sexual, or psychological harm by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples and does not require sexual intimacy.”(CDC, 2008).

The nurse’s role: : 

The nurse’s role: Assessment and SCREENING!: Regular Screening should be done at ALL appointments, in ALL settings, with ALL patients. Percentage of reported abuse: -Self Reporting: 8% of the women reported abuse -Nurse assessment: 29% of the women reported (McFarlane and Parker, 1994). Compassion Support Resources Referrals Follow-up care

Recognizing signs of abuse during your patient assessment : 

Recognizing signs of abuse during your patient assessment -Bruising or bilateral injury in different stages of healing -Injury inconsistent with reported cause (esp. if to the head, neck, chest, breasts, abdomen, or genitals) -Inappropriate clothing for weather (covering up) -Delay in care seeking after an injury -Partner refuses to leave room and answers questions for the patient. -Physical injury during pregnancy. -Poor weight gain (during pregnancy) (FVPF: IPV Consensus; McFarlane & Parker, 1994). -Pt repeatedly late for appointments -Drug or Alcohol use -Submissive behavior, lack of assertiveness -Depression, crying, low self-esteem -Chronic pain without known cause - An unusually high number of visits to health care providers -High number of STI’s, pregnancies, miscarriages, and abortions -Repeat vaginal and urinary tract infections.

Myth Busting: : 

Myth Busting: Misconceptions Addressed: Maybe she deserves the beating, or does something to provoke him. Violent couples assault each other. If she hits him, she has to be ready to be hit in return. Abused women skip appointments, lie about their relationship, and don’t do what they say they are going to do. Why doesn’t she just leave? It is her own fault. What is the point of helping? She’ll just end up going back to him anyway.

Two major principals nurses must accept to assist in stopping the cycle of violence: : 

Two major principals nurses must accept to assist in stopping the cycle of violence: 1)Under no circumstances does any person deserve to undergo any form of abuse. 2)Abuse shouldn’t remain secret; it is a serious health concern that is within the scope nursing practice.

Misconception 1: It is her own fault, why does she provoke him? : 

Misconception 1: It is her own fault, why does she provoke him? It is a mistake to place blame on the victim. Doesn’t need to “learn how to keep him calm.” Anger is not the main problem Control is the problem. Help her!!! (Jones & Schechter, 1992).

Power & Control Tactics: : 

(ANDVSA) Power & Control Tactics: Isolation Emotional Abuse Economic Abuse Sexual Abuse Using Children Threats Intimidation Minimizing Denying Blaming Manipulation Using Male Privilege

Misconception 2: Abused women are unreliable and skip appointments. : 

Misconception 2: Abused women are unreliable and skip appointments. Control through isolation -he won’t let her go -he may cause obvious injuries so she is embarrassed -it may not be safe for her to leave children with him However, others do speak up, follow through and keep appointments. Back her up! HELP EMPOWER your patients. (Jones & Schechter, 1992).

Misconception 3: Why doesn’t she just leave? : 

Misconception 3: Why doesn’t she just leave? The following is an excerpt from the book Why Doesn't She Just Leave? By, Emilee Watturs and Heather Stark. "Why doesn't she just leave? That was what I used to thinkwhenever I heard a story about an abused woman. I had no sympathy for people I perceived as "willing victims." Pathetic, I used to think. She's just as much to blame for staying. Why, she's the co-conspirator. That's what I used to think... Now all I do is pray.” (http://whynotleave.com/default.aspx)

Barriers to Leaving: : 

Barriers to Leaving: Committed to the relationship Don’t believe in Divorce Belief in apologies or excuses Lack of self-confidence Lack of options Financially trapped Danger associated with leaving “If I leave he will take away everything from me.” -Anonymous “I left numerous times. . . but I have nowhere to go. -Anonymous “He threatened “you won’t make it to the day of the divorce.” –Anonymous (ANDVSA)

Leaving Is a Process: : 

Leaving Is a Process: Survivors of DV often successfully leave when it is their best chance for safety Survivors safely leave when they are ready They succeed in leaving only when it is safe to do so They successfully and safely leave only when they are supported appropriately We can support survivors by: Holding their abusers accountable for the abuse they perpetrate Providing a culturally competent systems response affirming survivors and their decision making ability (ANDVSA)

Misconception 4: What is the point of helping? She’ll just end up going back to him anyway. : 

Misconception 4: What is the point of helping? She’ll just end up going back to him anyway. May leave multiple times before the final break Leaving and returning should not be seen as failure Enable her to leave for good in the future! (Jones & Schechter, 1992).