How Nurses Can Spot the Hidden Signs of Domestic Violence and Offer Lifesaving Help

Experts stress importance of sensitive approach, comprehensive screenings

22-NUR-3406259-DomesticViolenceResources-3-CQD_650x450

Clinical providers routinely use screening tools to inquire about patients’ personal relationships and confirm they’re safe at home. However, in addition to these screening questions, it’s important for providers to be aware of other potential signs of abuse.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Barriers to treatment

Although screening questions, which often begin with nursing staff, can be a way to broach sensitive topics, it’s also important to have a clinical workforce that’s trained to recognize the warning signs of abuse and know how to respond, explains Michele Reali-Sorrell, DNP, RN, a Cleveland Clinic forensic nurse manager. Because few patients will readily admit to being victimized, she encourages clinicians to remain vigilant when managing suspicious injuries and complaints.

“Victims often feel unsafe or even ashamed to admit they’re being abused; some patients may have even normalized the dynamics of their violent relationship and no longer recognize the abuse for what it is,” says Reali-Sorrell. “That’s why it’s so important for providers to understand the complexity of these situations and be prepared to address any red flags.”

Spotting subtle clues

Jennifer Rivchun, APRN, MSN, FNP-C, patient safety program manager for Cleveland Clinic South Pointe Hospital, urges caregivers to remember that domestic violence crosses all boundaries of gender, age, race and socioeconomic status.

Unexplained contusions, lacerations, bite marks and burns are among the most obvious signs of potential abuse, but Rivchun cautions providers to also watch for subtler complaints, including delays in seeking care and repeat visits for chronic or seemingly minor medical issues.

“Repeat visits for emotional issues like anxiety or depression can be signs of an untenable domestic situation, as can chronic GI issues, chest pain, or headaches — problems that can often be physical reactions to trauma,” says Rivchun.

Advertisement

A dominating partner who attempts to control the clinical visit or consistently speaks for the patient is another potential red flag, explains Reali-Sorrell. “In some cases, a cognitive problem like dementia can prevent patients from speaking for themselves. But in the absence of such issues, a patient’s silence may indicate controlling or manipulative behavior by a partner,” she says. “In these situations, it’s crucial to find an opportunity to talk with the patient privately.”

Employing empathy

Although it can be difficult for those who have not experienced domestic violence to understand why victims decline help or stay with their abusers, it’s crucial to avoid blaming the victim, says Ashley Withrow, LISW-S, a victim advocate at Cleveland Clinic.

“There are a million reasons why people remain with their abusers, including justifiable fear, practical concerns about food and housing, and worries about the wellbeing of children or pets,” she says. “The goal is to work with the patient to develop a safety plan, regardless of whether those steps include leaving the abuser.”

Withrow urges to caregivers to approach these cases with empathy, understanding that a victim’s attempts to leave or pull away from an abuser often lead to an escalation in violence.

Efforts to persuade a victim to “just leave” the relationship are unwise, she says, unless there is a strong safety plan in place. “It is important to understand that any patient seeking help for domestic abuse is taking a significant risk. Providers must be prepared to really listen to their patients and connect them with resources that can help protect them. Information about local shelters or a referral to a victim advocate or social worker on site can be lifelines for at-risk patients,” says Withrow.

Advertisement

Rivchun urges nurses to intervene when warning signs arise. “You never know when you might save somebody’s life by taking that next step,” she says.

Withrow adds, “When you think about the sheer volume of individuals in our society who experience domestic violence at some point in their lifetimes – violence isn’t a matter of if, but of when.”

Related Articles

Headshots of Woodward and Blankemeier
March 13, 2024/Nursing/Clinical Nursing
Home Care: Moving Beyond the Hospital (Podcast)

Nurses play pivotal role in patients’ ability to recover in the comfort of their own homes

Head shot of nurse Dena Salamon
February 29, 2024/Nursing/Clinical Nursing
Speaking Up in the Perioperative Setting (Podcast)

Advocating for patient safety is imperative in fast-paced surgical settings

23-NUR-3955494-NN-CLABSI-reductEfforts-RTmeAuditProcess-CQD-kc_650x450
December 26, 2023/Nursing/Clinical Nursing
Nurse-Led Effort Pays Off by Reducing CLABSIs

Redesigned protocols enhance infection-prevention measures

23-NUR-3991019-NN-Rsrch-BasicDiabetesKnowledge-OutptntNurses-CQD_650x450
December 13, 2023/Nursing/Clinical Nursing
Study Highlights Gap Between Real and Perceived Diabetes Knowledge in Outpatient Nurses

Longevity in healthcare, personal experiences may provide caregivers with false sense of confidence

23-NUR-4101309-GrowingTheForensicProgram-CQD_650x450-1
November 22, 2023/Nursing/Clinical Nursing
Behind Closed Doors: Forensic Nurses Approach Victims With Empathy and Precision

Specialized team prioritizes trauma-informed care and evidence collection

23-NUR-3955502-NN-Plan-of-careVisitsBenefitsTeamApproach-CQD_650x450
November 20, 2023/Nursing/Clinical Nursing
Improving Teamwork, Morale and Outcomes with Plan-of-Care Visits

Collaborative approach leans on expertise of nurses

23-NUR-3955467-NN-TeamBirthModel-CQD_650x450
October 30, 2023/Nursing/Clinical Nursing
Nurses Champion New Patient-Centric Model of Labor and Delivery Care

TeamBirth aims to improve outcomes by facilitating collaboration between patients and caregivers

Ad