Intimate Partner Violence: When Closeness Turns Deadly: How to Identify and Help Protect At-Risk Patients

By McCarthy, Jessica; Williams, Janell et al. | American Nurse Today, March 2017 | Go to article overview

Intimate Partner Violence: When Closeness Turns Deadly: How to Identify and Help Protect At-Risk Patients


McCarthy, Jessica, Williams, Janell, Amiri, Azita, American Nurse Today


A PATIENT who experiences violence at the hands of a spouse or partner may think of it as a personal and private matter, but intimate partner violence (IPV) has serious health consequences. Severe mental and physical harm may result from an intimate relationship that has gotten out of control, and, ultimately, life itself may be at risk. (See Defining intimate partner violence.)

The personal nature of IPV is part of what makes it such a serious health risk. Emotional ties can hinder a patient from acknowledging or protecting himself or herself against violence inflicted by the partner. Most people want a partner or spouse with whom they can share their life. When a relationship turns violent, devotion can become deadly, giving a frightening and disturbing meaning to the expression "till death do us part."

What's more, signs of IPV are not always visible or easily detected. Identifying a patient at risk for this type of violence and protecting him or her from potential harm, are important nursing skills.

A highly prevalent danger

High rates of IPV make it a concern for society and a challenge to the nursing profession. According to the Centers for Disease Control and Prevention (CDC), IPV affects one in three women in the United States in the course of their lifetime. In addition, many people are surprised to learn that the CDC estimates one in four men experience this type of violence in their lifetime.

Consider also that researchers may underestimate how often IPV occurs. People seeking medical care commonly won't reveal this type of violence and may hide injuries that result from it.

Understanding this type of violence, and how to screen for it, will strengthen your ability to preserve your patients' health and well-being. You need to know how to establish trust with patients at risk, screen for this dangerous situation, and recognize ways you can intervene.

Effective screening

You can't rely on any single standard test or indicator when assessing for IPV. Recommendations for when to screen issued by national and international health and safety organizations vary. (See Screening recommendations for intimate partner violence.) Be familiar with policies your employer has in place related to assessment and care of victims of violence.

One common thread links victims of IPV: the victim knows the perpetrator, knows him or her well, and vice versa. Indeed, the perpetrator may accompany the victim to a hospital, physician's office, or urgent care center. He or she may try to prevent you from examining the victim privately. Many facilities place signs in waiting areas advocating patient privacy and stating that healthcare providers see patients alone in the exam room.

Effective screening depends on your ability to maintain a nonjudgmental attitude. As a nurse, you set the stage for establishing a trusting and open relationship with the patient.

Foster open communication

In addition to ensuring privacy, take steps to establish trust. Victims may be embarrassed or afraid and reluctant to discuss their situation, so project a supportive attitude. Make eye contact and never rush or talk down to the victim.

Be aware of and discard any preconceptions you may hold regarding IPV. This type of violence isn't restricted to any gender, race, age, ethnicity, or social class. It may occur in opposite-sex or same-sex relationships, and it affects people from all cultures and all walks of life.

Become comfortable with introducing the topic of IPV. Developing a standard approach to raising this sensitive subject to patients can help. For example, you might say, "Nurses look upon violence as a health issue. We now ask every patient about safety and health. Know that everything we discuss is confidential. Nothing you say will leave this room unless you clearly tell me it's okay to share the information."

Recognize male and female patients' different needs

Women are more likely than men to disclose IPV to a healthcare provider. …

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