“One Day He Breaks Your Arm, and Then . . .”: How Nurses Can Help Rural Survivors of Intimate Partner Violence

Photo by Damien Gadal, via Flickr. Photo by Damien Gadal, via Flickr.

 By Sylvia Foley, AJN senior editor

“Imagine for a moment that your husband or boyfriend is regularly assaulting you, and often tells you that ‘nobody cares.’ Now imagine that you live in an isolated rural community. The nearest health care services are 75 miles away—and you can’t get there because he removes the car battery to keep you from driving . . . One day he breaks your arm, and then he drives you to that distant hospital. Will the nurses recognize what is happening? Will there be a chance for you to tell them?”

In this month’s CE feature, “Intimate Partner Violence in Rural U.S. Areas: What Every Nurse Should Know,” Amanda Dudgeon and Tracy Evanson explain why it’s important for nurses in all practice settings to understand the particular issues that rural survivors face and how to address them. (Most, though not all, victims of intimate partner violence are women; this article focuses primarily on female survivors.) Here’s a brief overview.

Intimate partner violence is a major health care issue, affecting nearly 6% of U.S. women annually. Multiple mental and physical health problems are associated with intimate partner violence, and billions of health care dollars are spent in trying to address the consequences. Although prevalence rates of intimate partner violence are roughly the same in rural and nonrural areas, rural survivors face distinct barriers in obtaining help and services. Because rural […]

2016-11-21T13:04:49-05:00May 7th, 2014|nursing perspective|4 Comments

AJN’s May Issue: Intimate Partner Violence, What Clinical Nursing Instructors Do, Containing Cholera, Noise in the ICU, More

AJN0514.Cover.OnlineAJN’s May issue is now available on our Web site. And in honor of Nurses Week, we are offering free access to the entire issue for the whole week (May 6-12). Here’s a selection of what not to miss.

Intimate partner violence. A major health care issue, intimate partner violence (IPV) affects almost 6% of U.S. women annually. And while prevalence rates of IPV are similar in rural and nonrural areas, rural survivors face distinct barriers in accessing care. “Intimate Partner Violence in Rural Areas: What Every Nurse Should Know” describes the unique aspects of IPV in rural populations and provides nurses with tools and information crucial to effective intervention. This CE feature offers 2.5 CE credits to those who take the test that follows the article. And don’t miss a podcast interview with one of the authors (this and other podcasts are accessible via the Behind the Article page on our Web site or, if you’re in our iPad app, by tapping the icon on the first page of the article).

Containing cholera. While still recovering from a magnitude-7 earthquake, Haiti confronted a second disaster: a rapidly growing cholera epidemic. The authors of “Responding to the Cholera Epidemic in Haiti,” part of a nongovernmental relief organization team sent to Haiti, describe how they managed more than 23,000 cases of cholera […]

2016-11-21T13:04:55-05:00April 25th, 2014|Nursing|0 Comments

International Women’s Day: Remembering Lives Shadowed by Violence

DSC_0028 Photo by Karen Roush

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

She lived in a trailer with her boyfriend and her three children, all under the age of five. He beat her up regularly.

Every few weeks she came in to see me at the health center where I worked as an NP in urgent care. Sometimes she would come in with bruises, but most of the time it was for the less obvious sequelae of violence—unexplained chest pain, palpitations, anxiety attacks, back pain, relentless headaches. There was a policy in urgent care that you couldn’t ask for a particular provider. So she would call to speak to me directly and when the operator put her through she’d know I was on and would come in.

I’m not sure why she came to trust me over the other providers. Maybe she could sense that I understood and didn’t judge her, though I had never told her about my own history of domestic violence. But it was probably because I listened. There was not much else I could do. She had gone to a counselor when I encouraged her to, but that didn’t last long—it was hard for her to find transportation for the 30-minute trip into town. […]

2016-11-21T13:08:10-05:00March 8th, 2013|nursing perspective|3 Comments

Domestic Violence Screening: Why the Rush to Dismiss It?

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

All rights reserved. Photos by author.

A recent study reported in JAMA, “The Effect of Screening for Partner Violence on Women’s Quality of Life” (abstract only), is being touted in overly simplistic headlines across the Web (the word “debunks” has been getting a lot of use) as further evidence that domestic violence screening doesn’t improve outcomes for women.

Don’t believe it.

The problem doesn’t lie with the researchers or with JAMA; they accurately reported just what they found. The problem lies with how it is being interpreted by others as further proof of the overall ineffectiveness of screening for intimate partner violence (IPV).

What the study actually found was that there was no difference in health outcomes between women who received computerized screening and a resource list and women who just received the resource list or women who received neither.

This is how it worked:

Women in primary care settings who agreed to participate and who were randomized to the screening group were seated in front of a computer and responded to the three questions in the partner violence screening (for example, “have you ever been hit, kicked, punched or otherwise hurt by someone within the past year?”) […]

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