Course Book : #102 - Domestic Violence Update

Domestic Violence

2 Contact Hours

Meets Florida Requirements

Author: Monica Oram, RN, BSN


This course is intended for the reader to be able to achieve the following
Objectives:
1.Define Domestic Violence
2.Understand the cycle of violence
3.List situations that increase the chances of homicide in Domestic Violence
4.Describe proper response of the caregiver to suspected Domestic Violence.
5.Learn the steps to take to help victims of Domestic Violence.
6.Florida Law as it relates to Domestic Violence.


What is Domestic Violence?
Domestic Violence is a pattern of behavior. One intimate partner or spouse exerts this behavior over another as a way to control a person. Domestic Violence may include actual or threatened physical, sexual, psychological or economical abuse of an intimate partner and/or children.

Domestic Violence includes both physical and sexual assault and battery. Assault means threatening or trying to harm a person. Aggravated assault means assault with the use of a weapon, such as a gun, knife, blunt object, rope or any other object that can be used to harm someone. Battery means actually harming someone, either physically or sexually. Aggravated battery means battery with the use of a weapon. Stalking means pursuing or following someone in order to frighten or intimidate them in some way. All of these violent acts are common in Domestic Violence.

Domestic Violence is a crime that can happen to anyone. It affects spouses, former spouses, relatives, parents, children, boyfriends, girlfriends or anyone who is living together. It is not always easy to know if a person is a victim of domestic violence, especially if you don't know what to look for. Victims of domestic violence are usually women and children. Many times they are injured so badly they need medical attention. Other times, you cannot tell by looking at them that they are a victim of violence.

ALL HEALTHCARE PROFESSIONALS ARE REQUIRED BY LAW TO RECOGNIZE THE SIGNS OF DOMESTIC VIOLENCE AND ABUSE AND TO REPORT IT. You will need to know the signs and how to report them.
Common Injuries

The most common injuries include burns, (especially cigarette burns)  bruises, and internal bleeding, head injuries ( especially hematomas), injury to the abdominal area, and broken or fractured bones. Injured people may not want to explain how they got their injuries, or their explanation may not seem to be likely. Sometimes the people involved will tell different stories about what happened, or their explanation for the injury does not match a medical diagnosis. These are all warning signs that an injured person could be a victim of domestic violence.

Why Does Domestic Violence Happen?        
 
   There  are many reasons why domestic violence takes place. There are many reasons why violence and abuse can become a problem for a family. The family may have always used physical punishment as a way of disciplining. They may simply accept violence as a normal way of dealing with problems. The abuser may have never learned positive coping skills and may use violence to deal with frustration and stress. Drugs and alcohol can also add to violent behavior, because they can cloud judgment and thinking ability. The family may have a very fixed role, such as mom stays at home, dad goes to work, the children don't speak unless spoken to.
   Children learn from their parents. When the parents vent their aggressive feelings through verbal abuse or physical abuse, this becomes a learned behavior. Children grow to accept this as the norm. Sometimes they learn that violence is the only way to cope with frustration and stress. Sometimes they learn to be afraid of confrontation, and go to any length to avoid a fight. When these children grow up and begin to form relationships, raise families, and cope in the real world, the cycle begins again. Some of them will become abusers, others will become adult victims of violence





Understanding An Abuser

    Abusers are often emotionally dependent and have low self esteem. They fear abandonment, they could be very frightened that their families will leave them all alone, so they do everything they can to keep them from leaving. They may isolate the victim, keeping her from talking to others about what is happening. They may threaten to commit suicide if the victim leaves, or even threaten to kill the victim and/or the children if they leave. Sometimes they will even threaten to kill the families beloved pet if they choose to leave. Sometimes they make the victim think she is stupid, crazy, or losing her memory. Once she begins to think these things, it is very hard for her to believe in herself anymore, or take steps to leave the abuser.
   Abusers are cruel, dominating, and physically and verbally violent. They will often try to blame the victim for what is happening, and excuse their own violent behavior, saying that they just "lost control". Many abusers suffer from alcoholism and drug abuse, which can increase violent tendencies. Abusers often suffer from depression and suicidal thoughts.
   However, abusers can sometimes be very loving and caring. They may love their families very much and feel terrible after they hurt them. But, feeling bad about violent behavior does not excuse the behavior. There is no excuse for domestic violence. In fact it is a crime, and against the law to abuse anyone!
   Since domestic violence is a learned behavior, it has to be unlearned. There are effective treatment programs in many communities that will help an abuser overcome violence by substituting positive coping skills for violence.

How bad is the problem?

Abuse is the most under reported crime in America. Many times because the victim feels ashamed and too scared to report it.
According to the National Coalition Against Domestic Violence, more than half of all women are victims of abuse sometime in their life.
Abuse results in more injuries than rape, auto accidents, muggings, and shootings combined.
40% of women murdered are murdered by their husband, ex-husband or boyfriend.      
FBI statistics show that 1 in 4 girls and 1 in 6 boys will be sexually assaulted before they are 16. At least 75% of them know the abuser.
One in 3 women, and 1 in 5 men will be sexually assaulted sometime in their lifetime.
According to the Center for the prevention of sexual assault, 65% of rapes, and as many as 80% of attempted rape is not reported to police.


Battering is an escalating process. It often starts out with name calling, followed by threats, and damaging personal possessions or hurting pets. It may escalate into physical encounters including hitting, pushing, slapping, biting, kicking, and so on. Battering then can become life threatening by choking, breaking bones, pushing down stairs, head injuries, or use of a weapon.

Cycle Of Violence
Tension Building:
Tension builds in a relationship
Abuser is irritable, frustrated, and has poor ability to cope with stress
Victim tries to keep the batterer calm by complying with every request
Abuser is afraid the victim will leave

Abuse Occurs:
Abuser is "trying to teach a lesson to the victim"
Loss of control and anger
Victim has no place to go
Victim is controlled by abuser
Victim has low self esteem, just as the abuser does.
When over, the victim says something like " I deserved it"

Calming Cycle:
Referred to as the honeymoon phase
Abuser says he "is sorry" and "it will not happen again"
Abuser becomes nice and affectionate
Abuser is afraid victim will leave





Why Women Stay
Victims of domestic violence typically have no place to go because of the social isolation implicated upon them by their abuser. Many times they suffer from lack of financial resources due to having no money. The abuser often will not allow the victim to have any cash on hand, and if they have jobs outside of the home, the abuser will typically take control of all money by demanding that the paychecks be turned over to the abuser. Many victims have no financial means to support themselves, since many do not have jobs outside the home. Many of them have dependant children and worry about how they will provide for their children's needs if they were to leave. Many have no place to go. Sometimes they have no transportation to get away. And still others will fear that they will be found and killed by their abuser if they attempt to leave.
    Sometimes due to religious beliefs a woman will choose to stay. Believing that divorce is wrong, and it is the duty to try and preserve the marriage at all costs. Many individuals believe that the police see domestic violence as a domestic dispute, and not a crime.
What the victim needs to do before she leaves
The following important steps need to be followed before a victim leaves:
1.Call the local shelter or domestic violence hotline.
2.Gather the following items and hide them at a friend's or neighbors house:
Medications and prescriptions
Insurance information
Clothing for self and children
Birth certificates
Marriage certificate
Social Security cards
Financial information
ATM cards or credit cards
School and medical records
Legal documents
Account numbers
A set of duplicate keys
3. Save money
4. Disable any weapons in the home (unload guns, get rid of ammo, hide them, ect.)
5. Make an escape plan
6. Leave

Victims who are separated from the abuser should take the following precautions:
1.Change locks
2.Install security system if possible
3.Educate children about safety issues.
4.Get counseling from a local shelter
5.Consider obtaining a restraining order.

Legal implications
Statistics show that between 4 and 6 million women are abused annually.
Many states have laws that mandate the reporting of suspected or known abuse.
In Florida, domestic Violence is defined as :
" any assault, aggravated assault, battery, aggravated battery, sexual assault, stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family member by another who is in or was residing in the same single dwelling unit"

In Florida Statues, Section 455.222 it states, " Physicians, osteopaths, nurses, dentists, dental hygienists, midwives, psychologists, and psychotherapists obtain as part of their bi annual training, a course in Domestic violence "

In 2001, Governor Jeb Bush signed into law a "Family Protection Act" that states that there is a mandatory 5 day jail term for any crime of domestic violence in which the perpetrator deliberately hurts a victim. The law makes a second offense a felony. The offenders are treated and sentenced as criminals.


How to screen for Domestic Violence

As a healthcare professional you should be aware of how to screen a victim for violence. Some questions to ask are as follows:
How were you hurt?
Has this happened before?
Do you know who hurt you?
Was there a weapon involved?
Do you have children?
Are they hurt?
Have they been hurt by the abuser?
Did you report it to the police?
Does the abuser have a restraining order?
Did he threaten to kill you?
Do you have a safe place to go?
Do you have financial ability to leave the abuser?
Can I give you the number to the abuse shelter in our area?

Then, it is important to document the findings in your notes. Be certain you use only objective charting, and quote what the victim tells you as fact. Do not add any of your assumptions, or judgments into your notes.  


Conclusion

Domestic Violence will likely continue to be a major problem around the world. If abuse is to be prevented, we as healthcare professionals in all settings must educate ourselves and assess all patients for signs of abuse during each visit and for those identified as being at risk, offer prompt interventions and referral information. Only through such measures can we promote the health and well being of our society.    

National Domestic Violence Hotline Number: 1-800-799-7233
National Abuse Registry 1-800-96ABUSE
National Child Abuse Hotline Number 1-800-962-2873 (1-800-96ABUSE)
 


References:
Center for Prevention of Sexual and Domestic Violence
www.cpsdv.org

National Coalition against Domestic Violence
www.ncadv.org

Domestic Violence

2 Contact Hours

Meets Florida Requirements

Author: Monica Oram, RN, BSN


This course is intended for the reader to be able to achieve the following
Objectives:
1.Define Domestic Violence
2.Understand the cycle of violence
3.List situations that increase the chances of homicide in Domestic Violence
4.Describe proper response of the caregiver to suspected Domestic Violence.
5.Learn the steps to take to help victims of Domestic Violence.
6.Florida Law as it relates to Domestic Violence.


What is Domestic Violence?
Domestic Violence is a pattern of behavior. One intimate partner or spouse exerts this behavior over another as a way to control a person. Domestic Violence may include actual or threatened physical, sexual, psychological or economical abuse of an intimate partner and/or children.

Domestic Violence includes both physical and sexual assault and battery. Assault means threatening or trying to harm a person. Aggravated assault means assault with the use of a weapon, such as a gun, knife, blunt object, rope or any other object that can be used to harm someone. Battery means actually harming someone, either physically or sexually. Aggravated battery means battery with the use of a weapon. Stalking means pursuing or following someone in order to frighten or intimidate them in some way. All of these violent acts are common in Domestic Violence.

Domestic Violence is a crime that can happen to anyone. It affects spouses, former spouses, relatives, parents, children, boyfriends, girlfriends or anyone who is living together. It is not always easy to know if a person is a victim of domestic violence, especially if you don't know what to look for. Victims of domestic violence are usually women and children. Many times they are injured so badly they need medical attention. Other times, you cannot tell by looking at them that they are a victim of violence.

ALL HEALTHCARE PROFESSIONALS ARE REQUIRED BY LAW TO RECOGNIZE THE SIGNS OF DOMESTIC VIOLENCE AND ABUSE AND TO REPORT IT. You will need to know the signs and how to report them.
Common Injuries

The most common injuries include burns, (especially cigarette burns)  bruises, and internal bleeding, head injuries ( especially hematomas), injury to the abdominal area, and broken or fractured bones. Injured people may not want to explain how they got their injuries, or their explanation may not seem to be likely. Sometimes the people involved will tell different stories about what happened, or their explanation for the injury does not match a medical diagnosis. These are all warning signs that an injured person could be a victim of domestic violence.

Why Does Domestic Violence Happen?        
 
   There  are many reasons why domestic violence takes place. There are many reasons why violence and abuse can become a problem for a family. The family may have always used physical punishment as a way of disciplining. They may simply accept violence as a normal way of dealing with problems. The abuser may have never learned positive coping skills and may use violence to deal with frustration and stress. Drugs and alcohol can also add to violent behavior, because they can cloud judgment and thinking ability. The family may have a very fixed role, such as mom stays at home, dad goes to work, the children don't speak unless spoken to.
   Children learn from their parents. When the parents vent their aggressive feelings through verbal abuse or physical abuse, this becomes a learned behavior. Children grow to accept this as the norm. Sometimes they learn that violence is the only way to cope with frustration and stress. Sometimes they learn to be afraid of confrontation, and go to any length to avoid a fight. When these children grow up and begin to form relationships, raise families, and cope in the real world, the cycle begins again. Some of them will become abusers, others will become adult victims of violence





Understanding An Abuser

    Abusers are often emotionally dependent and have low self esteem. They fear abandonment, they could be very frightened that their families will leave them all alone, so they do everything they can to keep them from leaving. They may isolate the victim, keeping her from talking to others about what is happening. They may threaten to commit suicide if the victim leaves, or even threaten to kill the victim and/or the children if they leave. Sometimes they will even threaten to kill the families beloved pet if they choose to leave. Sometimes they make the victim think she is stupid, crazy, or losing her memory. Once she begins to think these things, it is very hard for her to believe in herself anymore, or take steps to leave the abuser.
   Abusers are cruel, dominating, and physically and verbally violent. They will often try to blame the victim for what is happening, and excuse their own violent behavior, saying that they just "lost control". Many abusers suffer from alcoholism and drug abuse, which can increase violent tendencies. Abusers often suffer from depression and suicidal thoughts.
   However, abusers can sometimes be very loving and caring. They may love their families very much and feel terrible after they hurt them. But, feeling bad about violent behavior does not excuse the behavior. There is no excuse for domestic violence. In fact it is a crime, and against the law to abuse anyone!
   Since domestic violence is a learned behavior, it has to be unlearned. There are effective treatment programs in many communities that will help an abuser overcome violence by substituting positive coping skills for violence.

How bad is the problem?

Abuse is the most under reported crime in America. Many times because the victim feels ashamed and too scared to report it.
According to the National Coalition Against Domestic Violence, more than half of all women are victims of abuse sometime in their life.
Abuse results in more injuries than rape, auto accidents, muggings, and shootings combined.
40% of women murdered are murdered by their husband, ex-husband or boyfriend.      
FBI statistics show that 1 in 4 girls and 1 in 6 boys will be sexually assaulted before they are 16. At least 75% of them know the abuser.
One in 3 women, and 1 in 5 men will be sexually assaulted sometime in their lifetime.
According to the Center for the prevention of sexual assault, 65% of rapes, and as many as 80% of attempted rape is not reported to police.


Battering is an escalating process. It often starts out with name calling, followed by threats, and damaging personal possessions or hurting pets. It may escalate into physical encounters including hitting, pushing, slapping, biting, kicking, and so on. Battering then can become life threatening by choking, breaking bones, pushing down stairs, head injuries, or use of a weapon.

Cycle Of Violence
Tension Building:
Tension builds in a relationship
Abuser is irritable, frustrated, and has poor ability to cope with stress
Victim tries to keep the batterer calm by complying with every request
Abuser is afraid the victim will leave

Abuse Occurs:
Abuser is "trying to teach a lesson to the victim"
Loss of control and anger
Victim has no place to go
Victim is controlled by abuser
Victim has low self esteem, just as the abuser does.
When over, the victim says something like " I deserved it"

Calming Cycle:
Referred to as the honeymoon phase
Abuser says he "is sorry" and "it will not happen again"
Abuser becomes nice and affectionate
Abuser is afraid victim will leave





Why Women Stay
Victims of domestic violence typically have no place to go because of the social isolation implicated upon them by their abuser. Many times they suffer from lack of financial resources due to having no money. The abuser often will not allow the victim to have any cash on hand, and if they have jobs outside of the home, the abuser will typically take control of all money by demanding that the paychecks be turned over to the abuser. Many victims have no financial means to support themselves, since many do not have jobs outside the home. Many of them have dependant children and worry about how they will provide for their children's needs if they were to leave. Many have no place to go. Sometimes they have no transportation to get away. And still others will fear that they will be found and killed by their abuser if they attempt to leave.
    Sometimes due to religious beliefs a woman will choose to stay. Believing that divorce is wrong, and it is the duty to try and preserve the marriage at all costs. Many individuals believe that the police see domestic violence as a domestic dispute, and not a crime.
What the victim needs to do before she leaves
The following important steps need to be followed before a victim leaves:
1.Call the local shelter or domestic violence hotline.
2.Gather the following items and hide them at a friend's or neighbors house:
Medications and prescriptions
Insurance information
Clothing for self and children
Birth certificates
Marriage certificate
Social Security cards
Financial information
ATM cards or credit cards
School and medical records
Legal documents
Account numbers
A set of duplicate keys
3. Save money
4. Disable any weapons in the home (unload guns, get rid of ammo, hide them, ect.)
5. Make an escape plan
6. Leave

Victims who are separated from the abuser should take the following precautions:
1.Change locks
2.Install security system if possible
3.Educate children about safety issues.
4.Get counseling from a local shelter
5.Consider obtaining a restraining order.

Legal implications
Statistics show that between 4 and 6 million women are abused annually.
Many states have laws that mandate the reporting of suspected or known abuse.
In Florida, domestic Violence is defined as :
" any assault, aggravated assault, battery, aggravated battery, sexual assault, stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family member by another who is in or was residing in the same single dwelling unit"

In Florida Statues, Section 455.222 it states, " Physicians, osteopaths, nurses, dentists, dental hygienists, midwives, psychologists, and psychotherapists obtain as part of their bi annual training, a course in Domestic violence "

In 2001, Governor Jeb Bush signed into law a "Family Protection Act" that states that there is a mandatory 5 day jail term for any crime of domestic violence in which the perpetrator deliberately hurts a victim. The law makes a second offense a felony. The offenders are treated and sentenced as criminals.


How to screen for Domestic Violence

As a healthcare professional you should be aware of how to screen a victim for violence. Some questions to ask are as follows:
How were you hurt?
Has this happened before?
Do you know who hurt you?
Was there a weapon involved?
Do you have children?
Are they hurt?
Have they been hurt by the abuser?
Did you report it to the police?
Does the abuser have a restraining order?
Did he threaten to kill you?
Do you have a safe place to go?
Do you have financial ability to leave the abuser?
Can I give you the number to the abuse shelter in our area?

Then, it is important to document the findings in your notes. Be certain you use only objective charting, and quote what the victim tells you as fact. Do not add any of your assumptions, or judgments into your notes.  


Conclusion

Domestic Violence will likely continue to be a major problem around the world. If abuse is to be prevented, we as healthcare professionals in all settings must educate ourselves and assess all patients for signs of abuse during each visit and for those identified as being at risk, offer prompt interventions and referral information. Only through such measures can we promote the health and well being of our society.    

National Domestic Violence Hotline Number: 1-800-799-7233
National Abuse Registry 1-800-96ABUSE
National Child Abuse Hotline Number 1-800-962-2873 (1-800-96ABUSE)
 


References:
Center for Prevention of Sexual and Domestic Violence
www.cpsdv.org

National Coalition against Domestic Violence
www.ncadv.org

Domestic Violence

2 Contact Hours

Meets Florida Requirements

Author: Monica Oram, RN, BSN


This course is intended for the reader to be able to achieve the following
Objectives:
1.Define Domestic Violence
2.Understand the cycle of violence
3.List situations that increase the chances of homicide in Domestic Violence
4.Describe proper response of the caregiver to suspected Domestic Violence.
5.Learn the steps to take to help victims of Domestic Violence.
6.Florida Law as it relates to Domestic Violence.


What is Domestic Violence?
Domestic Violence is a pattern of behavior. One intimate partner or spouse exerts this behavior over another as a way to control a person. Domestic Violence may include actual or threatened physical, sexual, psychological or economical abuse of an intimate partner and/or children.

Domestic Violence includes both physical and sexual assault and battery. Assault means threatening or trying to harm a person. Aggravated assault means assault with the use of a weapon, such as a gun, knife, blunt object, rope or any other object that can be used to harm someone. Battery means actually harming someone, either physically or sexually. Aggravated battery means battery with the use of a weapon. Stalking means pursuing or following someone in order to frighten or intimidate them in some way. All of these violent acts are common in Domestic Violence.

Domestic Violence is a crime that can happen to anyone. It affects spouses, former spouses, relatives, parents, children, boyfriends, girlfriends or anyone who is living together. It is not always easy to know if a person is a victim of domestic violence, especially if you don't know what to look for. Victims of domestic violence are usually women and children. Many times they are injured so badly they need medical attention. Other times, you cannot tell by looking at them that they are a victim of violence.

ALL HEALTHCARE PROFESSIONALS ARE REQUIRED BY LAW TO RECOGNIZE THE SIGNS OF DOMESTIC VIOLENCE AND ABUSE AND TO REPORT IT. You will need to know the signs and how to report them.
Common Injuries

The most common injuries include burns, (especially cigarette burns)  bruises, and internal bleeding, head injuries ( especially hematomas), injury to the abdominal area, and broken or fractured bones. Injured people may not want to explain how they got their injuries, or their explanation may not seem to be likely. Sometimes the people involved will tell different stories about what happened, or their explanation for the injury does not match a medical diagnosis. These are all warning signs that an injured person could be a victim of domestic violence.

Why Does Domestic Violence Happen?        
 
   There  are many reasons why domestic violence takes place. There are many reasons why violence and abuse can become a problem for a family. The family may have always used physical punishment as a way of disciplining. They may simply accept violence as a normal way of dealing with problems. The abuser may have never learned positive coping skills and may use violence to deal with frustration and stress. Drugs and alcohol can also add to violent behavior, because they can cloud judgment and thinking ability. The family may have a very fixed role, such as mom stays at home, dad goes to work, the children don't speak unless spoken to.
   Children learn from their parents. When the parents vent their aggressive feelings through verbal abuse or physical abuse, this becomes a learned behavior. Children grow to accept this as the norm. Sometimes they learn that violence is the only way to cope with frustration and stress. Sometimes they learn to be afraid of confrontation, and go to any length to avoid a fight. When these children grow up and begin to form relationships, raise families, and cope in the real world, the cycle begins again. Some of them will become abusers, others will become adult victims of violence





Understanding An Abuser

    Abusers are often emotionally dependent and have low self esteem. They fear abandonment, they could be very frightened that their families will leave them all alone, so they do everything they can to keep them from leaving. They may isolate the victim, keeping her from talking to others about what is happening. They may threaten to commit suicide if the victim leaves, or even threaten to kill the victim and/or the children if they leave. Sometimes they will even threaten to kill the families beloved pet if they choose to leave. Sometimes they make the victim think she is stupid, crazy, or losing her memory. Once she begins to think these things, it is very hard for her to believe in herself anymore, or take steps to leave the abuser.
   Abusers are cruel, dominating, and physically and verbally violent. They will often try to blame the victim for what is happening, and excuse their own violent behavior, saying that they just "lost control". Many abusers suffer from alcoholism and drug abuse, which can increase violent tendencies. Abusers often suffer from depression and suicidal thoughts.
   However, abusers can sometimes be very loving and caring. They may love their families very much and feel terrible after they hurt them. But, feeling bad about violent behavior does not excuse the behavior. There is no excuse for domestic violence. In fact it is a crime, and against the law to abuse anyone!
   Since domestic violence is a learned behavior, it has to be unlearned. There are effective treatment programs in many communities that will help an abuser overcome violence by substituting positive coping skills for violence.

How bad is the problem?

Abuse is the most under reported crime in America. Many times because the victim feels ashamed and too scared to report it.
According to the National Coalition Against Domestic Violence, more than half of all women are victims of abuse sometime in their life.
Abuse results in more injuries than rape, auto accidents, muggings, and shootings combined.
40% of women murdered are murdered by their husband, ex-husband or boyfriend.      
FBI statistics show that 1 in 4 girls and 1 in 6 boys will be sexually assaulted before they are 16. At least 75% of them know the abuser.
One in 3 women, and 1 in 5 men will be sexually assaulted sometime in their lifetime.
According to the Center for the prevention of sexual assault, 65% of rapes, and as many as 80% of attempted rape is not reported to police.


Battering is an escalating process. It often starts out with name calling, followed by threats, and damaging personal possessions or hurting pets. It may escalate into physical encounters including hitting, pushing, slapping, biting, kicking, and so on. Battering then can become life threatening by choking, breaking bones, pushing down stairs, head injuries, or use of a weapon.

Cycle Of Violence
Tension Building:
Tension builds in a relationship
Abuser is irritable, frustrated, and has poor ability to cope with stress
Victim tries to keep the batterer calm by complying with every request
Abuser is afraid the victim will leave

Abuse Occurs:
Abuser is "trying to teach a lesson to the victim"
Loss of control and anger
Victim has no place to go
Victim is controlled by abuser
Victim has low self esteem, just as the abuser does.
When over, the victim says something like " I deserved it"

Calming Cycle:
Referred to as the honeymoon phase
Abuser says he "is sorry" and "it will not happen again"
Abuser becomes nice and affectionate
Abuser is afraid victim will leave





Why Women Stay
Victims of domestic violence typically have no place to go because of the social isolation implicated upon them by their abuser. Many times they suffer from lack of financial resources due to having no money. The abuser often will not allow the victim to have any cash on hand, and if they have jobs outside of the home, the abuser will typically take control of all money by demanding that the paychecks be turned over to the abuser. Many victims have no financial means to support themselves, since many do not have jobs outside the home. Many of them have dependant children and worry about how they will provide for their children's needs if they were to leave. Many have no place to go. Sometimes they have no transportation to get away. And still others will fear that they will be found and killed by their abuser if they attempt to leave.
    Sometimes due to religious beliefs a woman will choose to stay. Believing that divorce is wrong, and it is the duty to try and preserve the marriage at all costs. Many individuals believe that the police see domestic violence as a domestic dispute, and not a crime.
What the victim needs to do before she leaves
The following important steps need to be followed before a victim leaves:
1.Call the local shelter or domestic violence hotline.
2.Gather the following items and hide them at a friend's or neighbors house:
Medications and prescriptions
Insurance information
Clothing for self and children
Birth certificates
Marriage certificate
Social Security cards
Financial information
ATM cards or credit cards
School and medical records
Legal documents
Account numbers
A set of duplicate keys
3. Save money
4. Disable any weapons in the home (unload guns, get rid of ammo, hide them, ect.)
5. Make an escape plan
6. Leave

Victims who are separated from the abuser should take the following precautions:
1.Change locks
2.Install security system if possible
3.Educate children about safety issues.
4.Get counseling from a local shelter
5.Consider obtaining a restraining order.

Legal implications
Statistics show that between 4 and 6 million women are abused annually.
Many states have laws that mandate the reporting of suspected or known abuse.
In Florida, domestic Violence is defined as :
" any assault, aggravated assault, battery, aggravated battery, sexual assault, stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family member by another who is in or was residing in the same single dwelling unit"

In Florida Statues, Section 455.222 it states, " Physicians, osteopaths, nurses, dentists, dental hygienists, midwives, psychologists, and psychotherapists obtain as part of their bi annual training, a course in Domestic violence "

In 2001, Governor Jeb Bush signed into law a "Family Protection Act" that states that there is a mandatory 5 day jail term for any crime of domestic violence in which the perpetrator deliberately hurts a victim. The law makes a second offense a felony. The offenders are treated and sentenced as criminals.


How to screen for Domestic Violence

As a healthcare professional you should be aware of how to screen a victim for violence. Some questions to ask are as follows:
How were you hurt?
Has this happened before?
Do you know who hurt you?
Was there a weapon involved?
Do you have children?
Are they hurt?
Have they been hurt by the abuser?
Did you report it to the police?
Does the abuser have a restraining order?
Did he threaten to kill you?
Do you have a safe place to go?
Do you have financial ability to leave the abuser?
Can I give you the number to the abuse shelter in our area?

Then, it is important to document the findings in your notes. Be certain you use only objective charting, and quote what the victim tells you as fact. Do not add any of your assumptions, or judgments into your notes.  


Conclusion

Domestic Violence will likely continue to be a major problem around the world. If abuse is to be prevented, we as healthcare professionals in all settings must educate ourselves and assess all patients for signs of abuse during each visit and for those identified as being at risk, offer prompt interventions and referral information. Only through such measures can we promote the health and well being of our society.    

National Domestic Violence Hotline Number: 1-800-799-7233
National Abuse Registry 1-800-96ABUSE
National Child Abuse Hotline Number 1-800-962-2873 (1-800-96ABUSE)
 


References:
Center for Prevention of Sexual and Domestic Violence
www.cpsdv.org

National Coalition against Domestic Violence
www.ncadv.org