Domestic Violence Interventions for Medical Personnel
Create a Climate:
- Establish a safe and secure environment. Ensure confidentiality, informed consent and patient autonomy. Provide privacy; never ask about abuse in front of family or household members.
- Display posters, brochures, and publications on domestic violence in examining rooms as well as in waiting room.
- Develop knowledge of local domestic violence programs.
- “Because abuse and violence have become so common, I routinely ask all my patients about this problem.” Institute routine screening on all patients *JCAHO Standards.
- Interview in private.
- Be alert for subtle signs as well as red flags.
- Inquire in a sensitive, respectful, non-judgmental manner.
- Take complete history – Presenting problem or chief complaint. Review previous and current charts. Patient’s appearance and demeanor. Relevant medical, sexual, social, and medication history.
- Don’t judge patient (or yourself) by patient’s response to you. A victim of abuse will take steps to leave when they have the strength and support to do so.
- Health provider role is to provide medical care, acknowledge and validate the home situation as being abusive, offer options and referrals to local domestic violence program.
Intervene by Building Trust and Providing Support
- Listen actively, non-judgmentally, with respect.
- Assure concern for health and welfare. Assess for potential danger and develop a safety plan.
- If patient is not ready to acknowledge fears, abuse, or ask for help; you could say:
- I am afraid for your safety.
- I am afraid for the safety of your children.
- It will only get worse. Violence increases in seriousness over time without some type of intervention.
- I am here for you when you are ready to leave. We also have a local domestic violence program, which can help you plan to leave safely.
- You deserve better than this. No one deserves to be treated this way.
Document Injury and Symptoms
Records should include:
- Patient’s history and statements.
- Description and location of injuries (use body map).
- Physical examinations (symptoms and clinical findings).
- Diagnostic procedures, including lab and x-ray.
- Photographs of injuries with consent form and time, date and name of photographer.
- Community consultations and resource referrals.
Referral to Local Resources
- Contact your local domestic violence agency for information, brochures, posters and services provided. They often can provide an in-service training for your staff. All people in your offices should know and be able to refer domestic violence victims to local resources in case you are unavailable
- Check out other resources such as National Domestic Violence Hotline 1-800-799-SAFE(7233)
- Family Violence Prevention Fund at www.fvpf.org