TORONTO, March 8, 2007 – As we mark International Women’s Day, nurses in Ontario are working behind the scenes to protect women and girls from becoming victims of violence.
Statistics show that women who are abused are likely to visit a health-care facility 11 times before the abuse is recognized. That’s why Woman Abuse: Screening, Identification and Initial Response, an evidence-based, best practice guideline developed by the Registered Nurses’ Association of Ontario (RNAO) recommends that nurses working in all health-care settings routinely screen all females over the age of 12 for abuse. Directly asking all women and girls if they have experienced violence gives those in abusive relationships an opportunity to discuss their situation with a nurse in a safe and supportive environment.
Cornwall Community Hospital was one of the first hospitals in Ontario to introduce screening for woman abuse. The hospital recently passed a policy requiring every registered nurse to conduct the screening. At this time, all women and girls over the age of 12 are screened for abuse when they enter the Emergency Department. As more nurses at the hospital receive the training required to carry out the screening, it will become routine in every department in the hospital.
“We know that women who are victimized over a long period of time will not volunteer the information because they’ve been brainwashed into thinking that no one will believe them, that it isn’t abuse, or that if they tell, their partner will hurt her or her family,” explains Tazim Virani, Program Director, RNAO Nursing Best Practice Guidelines Program.
“The screening is very effective,” says Sarah Kaplan, a social worker who is the Coordinator of the Cornwall Community Hospital’s Assault and Sexual Abuse Program and a member of the panel that developed the guideline. “For example, we had a woman come in with a broken arm and when she was asked about abuse, she denied it. But, the story just didn’t match. So, the nurse got her alone in a room and just gently said ‘I’m concerned about how you got these injuries. They don’t seem consistent with your story. We see injuries like this with someone who has been hurt. Did someone hurt you?’ And then she said ‘Yes, my husband did this to me.’”
Virani says nurses are the most appropriate members of the health-care team to screen women for abuse. “Their role is extremely important. People see nurses as very open, they’re often frontline and they apply a holistic approach. The time they spend with the patient is critical because they need to determine whether it’s possible that the patient is being abused.”
When screening women and girls, nurses may discover that their condition is a result of the abuse. In one instance, Kaplan explains the nursing team discovered a woman had suffered a miscarriage. “We found out that the miscarriage occurred because she was kicked by her boyfriend,” says Kaplan.
Screening all women is a new philosophy and Kaplan admits it takes some nurses time to adjust to their new role. “We know that we are making history. This is a huge change. It involves changing attitudes and questioning your opinions about abuse,” says Kaplan. She adds that for nurses, the rewards of screening all women and girls greatly outweigh the challenges. “Nurses have the opportunity to save a life – and not just the life of the woman, there are usually children involved.”
RNAO’s ambitious Best Practice Guidelines Program, funded by the Ministry of Health and Long-Term Care was launched in 1999 to provide the best available evidence for patient care across a wide spectrum of health-care areas. The 30 guidelines developed to date are a substantive contribution towards building excellence in Ontario’s health-care system. They are available to nurses and other health-care professionals across Canada and abroad. To learn more about RNAO’s Nursing Best Practice Guidelines Program or to view these resources, please visit http://rnao.ca/bpg .
The Registered Nurses’ Association of Ontario is the professional association representing registered nurses in Ontario. Since 1925, RNAO has lobbied for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve.