N304 Week 10 Interpersonal Violence College of Nursing (Student Copy)

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    NURS 304.3 – Week 10Interpersonal Violence & Nursing

    Practice

    Rod McKendrick

    Manager Victim Services

    Interpersonal Violence Specialist

    Saskatchewan Ministry of Justice

    [email protected]

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    Need to reak t!e Silence"

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    #a$il% Violenceackground Inor$ation

    What is abuse (what forms doesabuse take)?  '$otional or ps%c!ological a(use

      Social a(use )Social a(use in*ol*ingc!ildren+,!ose -!o are in control tend touse c!ildren or t!is t%pe o a(use

      'cono$ic/nancial a(use

      Ritual a(use

      P!%sical a(use -it!out t!e person consent

      Seual a(use

      Religious a(use eg in religious court

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    #a$il% Violenceackground Inor$ation

    What is family violence?  It is a co$ple pro(le$ no t-o situations

    are t!e sa$e 

    Ranges across t!e liespan  It in*ol*es an abuse of power and the

    violation of a position of trust  n% (e!a*iour (% one person against

    anot!er person in an inti$ate relations!ip-!ic! $a% endanger t!at person6s sur*i*alsecurit% or -ell7(eing

      8ust look (e%ond t!e a$il% and considert!e *alues and attitudes o t!e co$$unit%and t!e larger societ%. ,!e co$$unit% !as

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    #a$il% ViolencePre*alence o (use in 9anada

    : 8ost oten *icti$s o a$il% *iolence -ere in aspousal relations!ip -it! t!e accused -it! a(out!al o *icti$s )4;ed (%t!eir parent 13< (% an etended a$il%$e$(er 11< (% a si(ling and ;< (% a c!ild$ost oten a gro-n c!ild.

    : Victi$s o a$il% *iolence -ere predo$inantl%e$ale )?;

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    #a$il% ViolencePre*alence o (use in 9anada

    Saskatchewan $revention Institute

    Family Violence (Violence durin!pre!nancy)  Incidence o *iolence during pregnanc%

    ranges ro$ 4< to 1@

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    #a$il% ViolencePre*alence o (use in 9anada

    Family Violence ("hildren#$outh)  8ale a$il% $e$(ers -ere identi/ed as t!e

    accused in a si>a(le $aDorit% o a$il%7

    related seual );?

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    #a$il% ViolencePre*alence o (use in 9anada

    %overnment of anada &!""'(. )uick *acts on +lder

     ,-use in anada. Retrieved from

    Family Violence (%buse of the&lderly)

    8ost oten rustration anger or despair -as t!e

    apparent $oti*e or a$il%7perpetrated!o$icides against seniors. In contrast /nancialgain -as t!e $ost co$$onl% identi/ed reason(e!ind senior !o$icides co$$itted (% non7a$il% $e$(ers.

    14.; < o seniors in saskatc!e-an

      et-een 4< 7 10< o seniors )in 9anada+eperience so$e t%pe o a(use

      Victi$s -!o are elderl% are $ost likel% to

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    #a$il% ViolencePre*alence o (use in 9anada

    %overnment of anada &!""'(. )uick *acts on +lder

     ,-use in anada. Retrieved from

    #a$il% Violence )(use o t!e 'lderl%9ontinued+  2lder adults $a% eperience diFerent t%pes

    o a(use includingG P!%sical or seual a(use

    Ps%c!ological or e$otional a(use

    #inancial a(use

    Neglect unintentional neglect sel neglect ,!e% are doing t!is to take control o t!eir lie

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    #a$il% ViolenceAealt! 9are I$plications o (use

    Red ross &http/00www.redcross.ca0article.asp1id23"435tid2"'3

    dults -!o eperience a(use are  103< $ore likel% to (eco$e s$okers

      ;5< $ore likel% to (eco$e o(ese

      103< $ore likel% to (eco$e alco!olics  1;< $ore likel% to de*elop drug

    addictions

      43< $ore likel% to (eco$e suicidal

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    #a$il% Violence

    "onse'uences of %buse of Women  Aealt! conseHuences

      'cono$ic conseHuences

      I$pact o a(use on c!ildren

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    Aealt! 9onseHuences o (useo Wo$en

    P!%sical

    Seual and Reproducti*e

    Ps%c!ological and e!a*ioral

    #atal Aealt! 9onseHuences

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    'cono$ic 9onseHuences

    urden on societ%

    I$pact on e$plo%$ent

    Indirect costs sick ti$e c!ild care

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    I$pact on 9!ildren

    P!%sical 'Fects

    Ps%c!ological and e!a*ioral 'Fects) itaFects sleep

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    #a$il% Violence ,!e 9%cle o Violence

    6alker 7. (. :he -attered woman. ;ew

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    #a$il% Violence ,!e 9%cle o Violence

     ,!ree Stages o t!e 9%cle o Violence

    1.  ,ension (uilds and escalates

    . Violent Incident 7 lo- up

    3. (sence o Violence – Re$orseRo$anceP!ase

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    #a$il% Violence ,!e 9%cle o Violence

    Phase ension *uildin! Phase

      urationG da%s -eeks $ont!s %ears

      Initial inatuation o t!e relations!ip ades

     

    (user 7 starts e!i(iting aggressi*ea(usi*etendencies  Victim > attempts to stop aggression -y pleasing placating or

    staying out of the way thinking those actions can control the

    a-usive -ehavior 

    W!en t!ese actions do not control or stop t!ea(use t!e *icti$ -it!dra-s

       ,-user feels re?ected and tries harder to control the victims

    activities

     

     ,t this point an a-usive incident will inevita-ly happen

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    #a$il% Violence ,!e 9%cle o (use

     ,raits o t!e abuser in p!ase 1 )tension(uilding+   Jealous%

      ctions t!at isolate t!e *icti$) orcedcon/ne$ent+

      Rule c!anging

      Na$e calling

      o$inating

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    *amily Violence

    :he ycle of ,-use

     ,raits o t!e victim in p!ase 1 )tension(uilding+  Use o cal$ing tec!niHues

      8ini$i>ing a(users (e!a*iours  nger suppression

      #atigue

      9onusion

      Sel7dou(t

      Wit!dra-al

      #ear

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    *amily Violence

    :he ycle of ,-use

    Phase 2 Violent +ncident Phase

      P!%sical e$otional $ental spiritual or seuala(use

     

     ,!e *iolent incident relie*es t!e stresstensiono t!e a(user

    W!ile t!e perpetrator eels instant relie t!e*icti$ eperiences s!ockdenial

      Police are usuall% in*ol*ed at t!is stage *icti$$a% seek sae s!elter onl% 11713< *icti$sreport to t!e police

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    *amily Violence

    :he ycle of ,-use

     ,raits o t!e abuser in p!ase )*iolentincident+  nger

      ssault on t!e *icti$  Uncontrolled tension

      '!austion

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    *amily Violence

    :he ycle of ,-use

     ,raits o t!e victim in p!ase )*iolentincident+  #ear

      nger  8a% call t!e police

      8a% seek saet%

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    *amily Violence

    :he ycle of ,-use

    Phase , -emorse#-omance Phase

      (user (eco$es tender apologetic git gi*ingproclai$s lo*e one ti$e e*ent etc.

      (user $a% take actions and de$onstrate-illingnessdesire to c!ange )i.e. re!a( stopdrinking etc+

      Aig! nu$(er o -o$en return to t!e a(userduring t!is p!ase (elie*ing t!e a(user and

    t!eir actions to (e sincere

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    *amily Violence

    :he ycle of ,-use

     ,raits o t!e abuser in p!ase 3)Re$orseRo$ance+  pologies and pro$ises

      S!o-s insecurities  Ko*ing

      e$onstrates dependenc% on t!e *icti$

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    *amily Violence

    :he ycle of ,-use

     ,raits o t!e victim in p!ase 3)Re$orseRo$ance+  Luilt

      Aope  Koneliness

      Ko-7sel estee$

      ependenc%

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    9!allenges #acing Wo$enGW!% do t!e% sta%C

    #ear o inDur% )or deat!+ #inances #a$il%

    #ait! #at!er #atigue #antas% and #orgi*eness

    #a$iliar #oresig!t

    )P,As 005+

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    ;ov #' !" !""8

    http/00www.youtu-e.com0watch1v2?=AlB"a-y,C

     

    http://www.youtube.com/watch?v=jHZlO0abyAUhttp://www.youtube.com/watch?v=jHZlO0abyAU

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    ;ursing $ractice 5 *amily Violence

    What is the !oal of nursin! interventions inrelation to family violence? )9N 1;;+

      to e$po-er t!e client to take control

      to pro*ide support

      to $ai$i>e saet%

    S i R l t!

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    ScreeningG Role o t!eNurse sk t!e Huestion

    ckno-ledge t!e a(use

    Validate t!e -o$an6s eperience

    ccess i$$ediate saet%

    'plore options

    Reer to ser*ices at t!e -o$an6s reHuest

    ocu$ent t!e interaction

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    Screening or (use

    Uni*ersal ) general+

    Routine)speci/c to do$estic *iolence+

    Indicator ased )-ords t!at points

    to-ards *iolence+

    i t S i d

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    arriers to Screening andisclosure arriers to screening ro$ t!e pro*ider6s

    perspecti*e

    arriers to disclosure ro$ t!e client6s

    perspecti*e

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    sking t!e Muestion

    Responding -!en s!e sa%s B'SO

    Responding -!en s!e sa%s N2O and %oususpect B'SO

    Responding -!en s!e sa%s N2O

    )RN2 005+

    u ng r nc p es or

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    u ng r nc p es orScreening97'R %ttitude and approachability o t!e

    !ealt! care pro*ider *elief in t!e -o$en6s account o !er

    eperience "on.dentiality is essential or

    disclosure /ocumentation t!at is consistent and

    legi(le docu$ent -!at t!e *icti$eactl% sa%s

    &ducation a(out t!e serious eFects o*iolence & a(use

    -eco!nition t!at dealing -it! *iolence

    & a(use !as to (e at !er pace directed

    N i P ti & # il

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    Nursing Practice & #a$il%Violence /ocumentation

      ocu$ent Huotes o(ser*ed (e!a*iourp!%sical assess$ent and inter*entions )actsnot opinions+

      ccurac% is i$portant )speci/cs –-!o-!at-!ere-!en+

      ocu$ent as soon as possi(le – docu$entp!%sical and ps%c!ological s%$pto$s – (e

    o(Decti*e Huote t!e client+ -!en possi(le  Use tools suc! as (od% $aps to docu$ent

    locations and patterns o p!%sical inDuries

      Wit! a clients per$ission p!otograp! inDuries

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    N i P ti & # il

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    Nursing Practice & #a$il%Violence

    9!allenges o a rural setting related toa$il% *iolence includeG  Kack o access to pu(lic

    transportationp!one ser*ice  ecreased anon%$it% and con/dentialit%

      Kack o ser*ices ineFecti*e ser*ices

      Increased nu$(er o -eapons in t!e !o$e

    )i.e. !unting+  #e-er resources )i.e. e$plo%$ent c!ild

    care etc.+

    http/00www.mincava.umn.edu0documents0nursing0nursing.html

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    N i P ti & # il

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    Nursing Practice & #a$il%Violence

    "hild 3altreatment  Proessionals $ust report cases in -!ic!

    t!ere are reasona(le and pro(a(le

    grounds to (elie*eO or reasona(legrounds to suspect t!at a c!ild is or $a%(e suFering or $a% !a*e suFered a(useO)p. 4+

      9!ild protection o*errides o(ligation tocon/dentialit%

    N i P ti & # il

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    Nursing Practice & #a$il%Violence -eportin! child abuse#ne!lect

      n%one -!o !as a reason to (elie*e t!at ac!ild is (eing a(used or neglected !as a legaldut% to report it

       Bou are not epected to deter$ine i a c!ild is(eing a(used or neglected

      8e$(ers o t!e pu(lic are o(ligated (% t!e la-to report suspected a(use or neglect

      9onseHuences or ailing to report a suspiciono a(use or neglect )in Saskatc!e-an+ includeG /ne up to 5000

    Dail ter$ o up to 4 $ont!s

    2r (ot! s nurses – roessional licensin (od -ould also (e

    Nursing Practice & #a$il

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    Nursing Practice & #a$il%Violence

    Who do + report to?  Social Ser*ices 9!ild Protection 2Qce )30?7

    @=@73@00 Regina+

    %fter 4ours "risis 5ervices Prince l(ert 30?7@?471011 Saskatoon 30?7;337?00

    Regina 30?75?;7@4

      co$$unit% crisis centre or unit

      police oQcer  #irst Nations 9!ild and #a$il% Ser*ice

    genc%

    Nursing Practice & #a$il%

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    Nursing Practice & #a$il%Violence %dditional -esources for "hild

    3altreatment  ids Aelp P!one )17=007??=7?=?=+

    !ttpG---.kids!elpp!one.ca

      9!ild Welare Keague o 9anada !ttpG---.c-lc.ca

      National 9!ild 'ploitation 9oordination 9entre

    !ttpG---.rc$p7grc.gc.cancecc7cnceeinde7accueil7

    eng.!t$  9anadian 9!ild Welare Researc! Portal

    !ttpG---.cec-7cep(.ca

      #irst Nations 9!ild & #a$il% 9aring Societ% o 9anada

    !ttpG---.nccs.co$

    Nursing Practice & #a$il%

    http://www.kidshelpphone.ca/http://www.cwlc.ca/http://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.cecw-cepb.ca/http://www.fncfcs.com/http://www.fncfcs.com/http://www.cecw-cepb.ca/http://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.cwlc.ca/http://www.kidshelpphone.ca/

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    Nursing Practice & #a$il%Violence %dditional -esources for Family

    Violence  National 9learing!ouse on #a$il% Violence

    !ttpG---.p!ac7aspc.gc.canc7cn

      P,AS )Pro*incial ssociation o ,ransitionAouses and Ser*ices o Saskatc!e-an+

    !ttpGa(use!elplines.orgresourcesa(use7!elp7lines 

    !ttpGa(use!elplines.orga(out7a(useinor$ation7or7proessionals

    Nursing Practice & #a$il%

    http://www.phac-aspc.gc.ca/nc-cnhttp://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/resources/abuse-help-lines/http://www.phac-aspc.gc.ca/nc-cn

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    Nursing Practice & #a$il%Violence (use against 2lder dults

      Reassurance

      Unlike c!ild a(use reporting is not

    $andator%  (use !elp lines in S ,el p!one(ooks

      Re*ie- a*aila(le ser*ices

    Nursing Practice & #a$il%

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    Nursing Practice & #a$il%Violence K'LISK,I2N

    Lo*ern$ent o Saskatc!e-an  Luns!ot and Sta( Wounds 8andator% Reporting ct

    )eFecti*e Sept 1 00@+

      nd pro*ince in 9anada to enact t!is legislation

      2*errides con/dentialit% reHuire$ents

      !ttpG---.Hp.go*.sk.cadocu$ents'nglis!StatutesStatutesL;71.pd 

     

    Nursing Practice & #a$il%

    http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdf

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    Nursing Practice & #a$il%Violence ,!e Po-er and 9ontrol W!eel

      e*eloped (% t!e o$estic (useInter*ention Progra$ )ulut! 8innesota+

     

    ddresses *iolence in a co$$unit% contet  !ttpG---.t!edulut!$odel.org-!eelgaller

    %.p!p 

    http://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.php

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     ,!e Po-er & 9ontrol W!eel

    http/00www.theduluthmodel.org0training0wheels.html

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     ,!e 'Hualit% W!eel