Domestic Violence Screening Matters

By Karen Roush, MS, RN, FNP-C, clinical managing editor

I am a nurse. I am a doctoral candidate and a writer. I am a domestic violence survivor. I lived for years with fear and uncertainty—will this be a good day, a day of laughter and affection? Or a brutal day of fists and humiliation? Like many women experiencing domestic violence, I hid it from my family and friends. In fact, I even hid it from myself. I couldn’t see myself as a battered woman, wouldn’t accept that I was that kind of person. But domestic violence doesn’t happen to a certain kind of woman—it happens to anyone, rich or poor, college educated or high school dropout, urban and rural, of every ethnicity. We—you and I—all are the faces of domestic violence.

Just ask. October is National Domestic Violence Awareness Month. How many of your patients have you asked about domestic violence this month? Or any month? Twenty? Ten? None? Screening matters. One of every four women you see has experienced domestic violence. Research tells us that women will talk about it when asked by a provider that they feel cares and can be trusted. They will leave an abusive situation when they feel supported and resources are available to them. […]

2016-11-21T13:11:46-05:00October 12th, 2011|Nursing|6 Comments
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Taking Away Choice — The Wrong Answer to Domestic Violence

By Meg Stone, MPH. Stone is the executive director of IMPACT Boston, an organization that works to prevent violence and abuse by giving people the tools to protect their safety and advocate for healthy relationships and sexual respect in their communities. A long-time domestic violence advocate with a degree in public health, she has, in her own words, “a strong interest in raising awareness of the issues facing women who present to emergency departments with injuries related to abuse. My professional background includes training nurses and first responders in asking about domestic violence and documenting incidents of abuse on medical records.”

This post is longer than our usual, but we thought it was worth running in entirety. The names and identifying details of those mentioned have been changed.

In the mid-1990s it was rare in most places for nurses and social workers to call domestic violence organizations when women came to the emergency department with injuries related to abuse. I only remember one call from a hospital social worker in the upstate New York town where I worked as an advocate at the local battered women’s program.

Carolyn, the director of the battered women’s service, called me at home on my day off. Nobody else was available, she said, so could I please […]

2016-11-21T13:16:11-05:00August 10th, 2010|Nursing, patient engagement, Patients|1 Comment
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Are Domestic Violence and Pregnancy Preexisting Conditions?

By Peggy McDaniel, BSN, RN

Kaiser Health News recently ran a story about an attorney who was denied private insurance coverage based on a “preexisting condition”—that is, treatment she’d received following a domestic abuse incident. A majority of states have passed laws prohibiting insurers from denying coverage based on treatment for domestic violence, but  eight states as well as the District of Columbia have no such legislation. It is a challenge to track the occurrence of such denials. Insurers often use alternative ways to find out about a history of domestic abuse. They have been known to search for protective orders at local courthouses, which is public information, and search through medical records for documentation of treatment related to such incidents. 

A bitter irony is that nurses are expected to be aware of and directly question patients about suspected abuse, yet in doing so we could be setting up patients for future loss or denial of coverage. 

Pregnancy, likewise defined as a preexisting condition, can also be used to deny coverage. Health reform bills under consideration would disallow the practice of basing insurance rates on gender, a practice which has in effect discriminated against women, particularly those of child-bearing age. 

The practice of denying private health insurance coverage based on these and other preexisting conditions must stop. As a nurse and a consumer, I believe that everyone should be able to buy health care at a reasonable price. A rate such as $1,000 per month for a family is not affordable. In the end we all pay if people do not have some […]

2016-11-21T13:21:15-05:00November 6th, 2009|health care policy, nursing perspective|2 Comments
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Trauma in Pregnancy: An Expert’s Calm Look at What Nurses Need to Know

PregnantTrauma.

By Sylvia Foley, AJN senior editor

In this month’s CE feature on Trauma in Pregnancy, author Laura M. Criddle takes a calm look at a distressing subject. After outlining possible mechanisms of injury, Criddle reminds readers that “trauma care priorities don’t change when the patient is pregnant.” Initial interventions will still focus on the “ABCs”—airway, breathing, and circulation. She also points out that the fetus’s best chance for survival is “vigorous resuscitation of the mother,” since most fetuses will not survive maternal death.

However, the normal changes of pregnancy can affect both the nature of injury and the body’s responses; this has important implications for nursing care. Among Criddle’s key points:

  • Compression and displacement of various organs occur as pregnancy advances. This makes some injuries more likely, others harder to detect.
  • The normal changes of pregnancy can mask the signs of decompensation.
  • Pregnancy and its changes can also make complications after injury more likely.

Criddle provides several examples for each point. She also offers strategies for assessment and interventions for both mother and fetus.

Have you cared for pregnant trauma patients? What was the experience like? Please tell us in the comments.

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2016-11-21T13:21:20-05:00November 3rd, 2009|nursing perspective|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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