Screening for abuse, comment


As I read through the various postings, many readers have voiced the same concern – the need for doctors and in particular nurses, to be further educated in the screening and assessing of suspected victims of abuse. I agree with the theory that the medical profession has an obligation to reach out to this patient population -whether they are willing or not to admit they are in an abusive relationship. I have a lot of mixed emotions on this topic – I think what is needed is a bit more than assessing our patients. I think it has to start with us, the nurses – taking a look at ourselves and our own relationships. In the past week I had to take my daughter to a wake and two funerals. One of her best friends had to bury both her parents, separately. The mother died a violent death – the victim of domestic violence, the father then took his own life. The mother was not only a truly loving and special person, she was a smart, educated professional. A nurse. I think as nurses, doctors – "healers" – we sometimes overlook the very things that we are trained to look for. Most of us enter this profession to "help" others, to make a difference, to not allow our patients to give up, but rather to be strong and overcome. I think it is in most of our nature to root for the underdog, take on the stray – we can help and change those who can’t help themselves. This young woman saw the signs, began to live in fear for the safety of not only herself, but for her children as well. She tried to help her husband deal with his emotions and his behaviors. She tried to help and be supportive. Tragically, the very day she took legal steps to protect her family, was the day she died. I think as healthcare professionals we not only hold an obligation to help those we provide care for, but we must also recognize the obligation to help ourselves. To reach out to our peers and our co-workers. I think that sometimes we are just blinded by the need to make things better.

Original Post
September 28, 2009
Title: Screening for abuse, comment
I think that all nurses and doctors should receive additional training in screening for abuse depending on their specialty area. Patients will present differently depending on whom they are being interviewed by. Many times in the situation of children they are with their abuser when they present and it is difficult to separate the two. The abuser does not want you to have words alone with their child. I worked many years as a school nurse and suspected many cases of abuse that were reported to the appropriate authorities only to find that the child was disbelieved and then years later found to be telling the truth. Adults are very savvy at making a child look like a liar but seldom do these children have the capabilities to make up the horrendous story I heard. Unfortunately the investigators seem to want to believe the abuser. These children were also ones with poor grades (not sleeping at night due to the abuse), behavioral issues (they just wanted someone to listen) and many times documented storytellers (the only way to get attention) so it was very easy for the abuser to discredit them. If we are all trained to look for something other than physical marks we may start to diminish abuse against our children. Part of the assessment should not include where the parents reside in society. Several times the investigators simply found out what the parents did for a living and that in itself ended the investigation.

Original Post:
September 8, 2009
Title: Screening for abuse
Thank you for this important message. It is absolutely imperative that ALL providers know the signs and symptoms of physical, emotional and sexual abuse. Furthermore, it is absolutely necessary that ALL providers screen every patient at EVERY patient encounter for abuse. Providers should incorporate screening for abuse into their health assessment. It is very easy to do. Providers can accomplish this important task by 1. Printing the screening question on the pre-assessment paperwork, 2. Asking the patient during the assessment, "Do you feel safe at home?" 3. Knowing the s/sx and incorporating screening into every pt encounter. So very important.

Original Post
September 2, 2009
Title: Abuse
Child and elder abuse continue to be very under reported making it imperative that doctors and nurses have education on signs of abuse. Nursing home abuse is also very under reported since nursing home pts. are lacking in visitors and seen as demented. Nurses also need to know who to contact should abuse be suspected.

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