Intimate partner violence (IPV), commonly called domestic violence, is a public health problem. Because it is so widespread—more than 2 million women and men are assaulted by their current or former partner each year—several nursing and medical organizations advocate the routine IPV screening of all patients, followed by intervention when appropriate.
If you suspect abuse, attend to your patient’s immediate injury or complaint first. Then screen for IPV by asking simple and direct questions. In a secure place— away from a potential abuser—ask the patient if she feels safe in her relationship or if she’s ever been hit, slapped or kicked by her partner. (Keep in mind that men as well as women may be victims of IPV. Male patients with suspicious injuries should be screened as well.) Record the answers in the medical record, using direct quotes when possible. If the patient’s chart is used as evidence in court, these quotes will have greater credibility than if you paraphrase.
As always, be objective in your documentation. Thoroughly and accurately describe all the patient’s injuries. Include photographs of the injuries and a body map to indicate their location. Make sure that the written information in the medical record matches the photographs and body map.
Also, familiarize yourself with your state’s mandatory reporting requirements, including what must be reported, who is required to report and to whom, and under what conditions. It is your responsibility to report domestic violence even if a patient asks you not to report the incident. When you are required to make a report, tell the patient what you must do and why. Failure to report could result in sanctions on your license, though criminal charges are highly unlikely.
When your patient is ready to accept help, provide resources to help ensure safety and security. Offer to call the police if the patient is in immediate danger, or help create a plan to follow if the patient feels threatened. Also, give the patient the number of the National Domestic Violence Hotline (800-799-SAFE) and telephone numbers for the local police, shelters or advocacy agencies. Remember, offering your support may be all your patient needs to muster the courage to escape the violence.