Posts Tagged ‘Violence Against Women’

Partner violence during pregnancy and postpartum

November 17, 2008

The nurse should be acutely aware and observant to the possibility of violence toward women especially during pregnancy. Documentation is of little good though until the abused is ready to change her life. I have seen nurses become insensitive to the patient/victim because the victims present repeatedly in the ER, yet will not attempt to change their situation. It should be remembered that women who suffer freq abuse may not see a way out. Low self esteem, lacking the ability to support themselves or their children often hold them in the living arrangement they find themselves in. It becomes an unending circle of abuse, with only temporary reprieves of normal living.

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Violence and Abuse

October 1, 2008

I have just completed the chapter on Violence and Abuse from Stanhope: Community and Public Health Nursing, 6th Edition. I am reminded once again of the importance of evidence collection and verbal or behavioral cues. We as Nurses must be constantly alert to the whole environment when we are caring for our clients especially when it comes to children. I will once again admit, working in a fast paced clinic for several years and dealing with 60-80 patients per shift I would tend to over look some of the signs of emotional or physical abuse that were listed in this chapter. This chapter was another excellent reminder.

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Verbal cues for evidence collection

September 24, 2008

The process of collecting data for evidence in regards to abuse must be a daunting task. We as Nurses are well trained in assessing physical clues but what about verbal cues. As I progress through each chapter of “Forensic Nursing” by Lynch I am reminded to constantly be alert to what the client is trying to tell you. This past week I had a client in my clinic for routine immunization, I performed a TB test and 48 hrs later when she returned she was angry, became upset with me because I pronounced her name wrong. I have seen this particular client on several occasions and she is usually happy and positive and actually seems timid at times, I was quite shocked by her outburst. Without going into particulars I found out later that day after discussing the situation with one of the Drs. that this particular individual had reported domestic violence to our social worker earlier that morning. I knew her behavior was out of the ordinary so it prompted me to investigate further. We can either choose to get angry with the client ourselves or look further into the change in behavior. I am glad I chose the right way.

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Rape is serious

September 23, 2008

Our American society takes rape seriously. Third world countries do not. The female anatomy and examination can be crucial to trial proceedings and the definition of innocence or guilt in a rape trial. The nursing assessment and collection of evidence is often performed by an emergency department nurse. Omission of an important feature can win or lose a case. In my organization, only specially trained Emergency Department RNs are allowed to utilize what we call the “Rape Kit.” This assures proper collection and assessment is performed to protect the client.

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Is myspace.com, really that popular? April 25,2007

January 9, 2008

I printed out this article several months ago. Having just now cleaned off my desk the article has resurfaced. Myspace is quite popular with all ages. When utilized as initially intended, it is a great way to keep in touch with friends, family and associates. Myspace enables us to present ourselves to the public. The web site is user friendly and allows you to create dynamic presentations. I would however, like to foreworn all users to proceed with caution when personalizing their Myspace website. If the website is not set to private, anyone wishing to do so can view your Myspace. All your personal information that is placed on the site: name, address, age, pictures; are all accessible to anyone. Although Tom, the Myspace creator, has set an age limit for users, this is easily bypassed by lying about your age. I personally have a Myspace and enjoy looking at other Myspace sites. My son also has his own site. He is under age. I have access to his site and every so often will view it to make sure the content of the site is appropriate. I am writing this to help prevent violence against children, women, and men.

Original post April 25, 2007:
It seems now a days, the well-known Internet site http://www.myspace.com , is becoming more of a place for sexual predator, nudists, and drug dealers rather than a place for social networking. Recently in the news here in Jacksonville and Neptune Beach, Florida, there has been several crackdowns on sexual predators posing as under aged juveniles, attempting to engage in sexual activities with minors. There was an incident where an over aged man, got to engage in a gradual conversation with a under aged boy. The over aged man told him, he would have to meet his “older brother” first, for his approval. Well to find out, the over aged man, attempted to have sexual encounters with this male. Luckily the younger boy was able to beat him off and report it to authorities. Not everyone is as lucky though. Neptune Beach police officers on a regular basis set up undercover stings to catch sexual predators and offenders to catch them in a violation. Recently there has been a lot of news about the popular social networking going on in the website. Questions have been raised tremendously about safety risks for its many teen users. Also the possibility of identify theft. There have been several other different issues that have risen from Myspace.com. There are actually young girls running away to meet these guys that they have met on this Internet site. Some have come up missing and some have been beaten, raped or molested. Several companies are bringing forth a new policy about Internet usage due to the fact that they spend a majority of their time surfing Myspace.com rather than doing their job. A big institution in Duval county, Baker county, and Nassau county, here in Florida are among the new comers that have fired, or suspended several of their employees. Most of these employees were city or government officials. I personally do have a Myspace account to keep up with current friends and friends from high school, college, or family out of town. There is a lot of spam or junk mail that does come across each screen name. There are a lot of sexual offenders that take advantage of young users and know exactly what they are doing. Most parents do not understand the use of Myspace.com. Although there is an age block when initially signing up for the service. However if a teenager or child sets up the account, they can easily not check the appropriate age. Forensic specialist, local law enforcement, lawyers, attorneys and child support team workers are working together to stop the solicitation of the sexual offenders. They are working together to find a way to be able to identify these users, and start a regulation for the offenders to identify themselves before creating an account. Several children and teenagers have been caught in using this website to identify themselves, as people who they truly are not. Myspace is helping and also trying to help authorities to stop these offenders, predators and people imposing to be who they are not and to mislead the community. Parents honestly do not know exactly what this website is about and what exactly the misfortunes it can lead in to. Families of runaways are helping as much as they can, to find their children and to put a stop to this web site. However there are other ones out there, for example- Hi 5. This website is very similar to Myspace. Authorities are setting traps to catch some of these users, and so far they are working pretty well. Forensic specialists have the ability to search and read all documentation throughout the screen names to help find out what exactly did happen and how it happened. This is also helping to find the runaway kids that are still out there.

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Sexual Assault: Forensic Nursing in the ER, comment

November 15, 2007

RE: The post from August 9, 2005 and titled:
Sexual Assault: Forensic Nursing in the ER, in Forensic Nursing Chronicles

Fortunately in this case, the nurse (and /or physician) had the insight to do a rape kit and take the child seriously. All too frequently we hear about children who have been repeatedly sexually abused by a relative or a family friend, only to find out that their parent or caretaker didn’t take them seriously. These sexual acts, from molestation to penetration can have serious consequences to the child later in life.
I believe events such as the one in this case occur more frequently than most people think.
The program Dateline: To Catch a Predator, has multiple stories of men showing up at the home of a young teenage girl that they were in contact with on the Internet, only to find Dateline there instead. These men are from all walks of life. Previous sex offenders, people on Parole, religious leaders, just to name a few.
This is a widespread problem, not just an isolated case here and there. I’m glad there is a push in the medical community to be more aware of and recognize child abuse, but this is just a small part of it.

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Women from many different cultures

October 18, 2007
The forensics nurse is called upon to take care of many women from many different cultures. Rape and abuse happen every day. Women of all ages, from all cultures are victims. Providing culturally competent care in forensics nursing happens at many levels.
To begin with, the provider must understand her own feelings about different cultures, and acknowledge that one’s life experiences reflect the way in which one reacts to the world. Did the provider grow up in a tightly knit, excusive community? Was she exposed to many cultures prior to working in the health care setting? What messages did she hear as she was growing up?
The second step is to look at her own feelings working with cultures different from her own. Does she find it difficult and awkward, or does she approach each encounter as a learning experience? Stepping outside the box helps. The culture that condemns female circumcision needs to understand that other cultures may condemn the male infant circumcision. Also, try to visualize what it would be like to seek care and not be able to speak the language or understand the customs.
The third step is knowledge. The provider who learns about different cultures on many different levels is open to new information and ways of doing things. Ask questions. Are there certain personal or religious beliefs the client observes? Are there healers from different cultures who can do an inservice?
The fourth step is understanding basic human rights. Look into your client’s eyes, use touch and acknowledge that she is above all a woman of the human race. With the basic human right comes the right for privacy. Although it may seem easier to use the support person for an interpreter, this can be disempowering for the client. Have a good working knowledge of how to contact the interpreter and explain that the interpreter is specially trained. Some cultures require a female attendant. Know how to access this before the situation happens. If the partner seems reluctant to leave, have a plan worked out for a fellow nurse or medical secretary to find a reason to have him or her leave the room.
Lastly, ask the client if there is anything you could have done different. Reflect on the situation and learn from each case. Share information with your colleagues (maintaining confidentiality).

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Sexually Transmitted Diseases: Forensic Nursing in the ER, comment

October 15, 2007

RE: Sexually Transmitted Diseases: Forensic Nursing in the ER
Forensic Nursing Chronicles: August 2005

Having worked in a busy city ER, I have seen case after case of STD’s in young females. They come in for treatment, and are on their way. If rape is reported, (as in the case of LM), it can be challenging at best to get a teenager to report it. In the case of LM she changed her mind in the end and stated that it was consensual.
It is a shame that the man will be going around spreading several STD’s to each unsuspecting female. You would think he would be uncomfortable enough to seek treatment, with four STD’s.
Unfortunately LM will be reminded of the rape every time she has a herpes outbreak.

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Sexual Assault Nurse Examiners

September 17, 2007

From the statistics I read about, the majority of sexual assaults are perpetrated by males upon females, and unfortunately many go unreported. I have never understood the reasons how or why this violent part of humanity takes place or other forms of violence for that matter, but that’s how my mind works – I guess its part of my utopian brain. In any event, as a male nursing student I wonder how and if I would be able to help a female sexual assault patient since the likelihood of a male perpetrating her crime is very high. Would I be permitted to help, or would the female patient’s condition be compromised since I am a man? Are most SANEs female for this very reason? Just some questions from a guy nursing student that would like to help these patients if it’s possible.

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An Original, Standardized, Emergency Department Sexual Assault Medication Order Sheet

July 17, 2007

I read this article in the Journal of Emergency Nursing. An interdisciplinary group at the Massachusetts General Hospital emergency department created a standardized sexual assault medication order sheet. It follows sexually transmitted disease (STD) and HIV non-occupational exposure recommendations from the Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health (MDPH). It also includes alternative medications in the case of allergies to the first-line medications and features commentary for clinicians. The team believed that providing excellent standardized care to sexual assault patients was essential and improved the care while decreasing liability for nurses and physicians. Components of the medication order sheet included gonococcal infection, chlamydial infection, trichomoniasis, hepatitis B, pregnancy, tetanus, and HIV medication guidelines. It has been used for 1 year at the time of print of this article. It has received positive feedback that it is easy to use and eliminates confusion in choosing medications. In light of national data that demonstrate that sexual assault victims are not receiving adequate protections from infection and pregnancy it may be worthwhile for other institutions to adopt a similar approach to this national patient care problem.

Finkel: J Emerg Nurs, Volume 31(3).June2005.271-275









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