Title : The nurse and violence against woman in the emergency department: Critical issues in management
Abstract:
Background: Violence against women is the threat or harm resulting from physical, sexual, or psychological abuse (Patrick et al., 2022). Emergency room nurses have some responsibility for managing and caring for victims of violence. However, to achieve this goal, nurses must be competent and feel safe when they have to provide care (Rahmqvist et al., 2019).
Methods: The aim of this thesis is to investigate, report and describe the most critical aspects in the management by nursing staff of victims of violence accessing the Emergency Department (ED), in this case when it comes to intimate partner violence and domestic violence. This is a literature review, and the databases consulted were “Pubmed”, “Cochrane Library”, “Cinhal”, “Google Scholar”. The selection process of the articles resulting from the research carried out involved the analysis of each of them, first in the title and abstract, then in the contents, and led to the detection of nineteen (19) articles. The articles resulting from the review had to meet methodological quality criteria such as the internal and external validity of the research project, the validity and reliability of the data sources, the use of analytical methods appropriate to the type of study, the importance of the results in the practical and statistical context.
Results: The selected articles (19) were respectively qualitative-descriptive (9), literature review (4), cross-sectional observations (4), a scoping review and a quasi-experimental RCT. At first, from the studies it’s possible to identify and to categorize psychophysical consequences of victims’ of violence: psychological, such as PTSD (p < .001), depression (OR = 3.59), anxiety (OR = 2.19) and drug assumption (RR = 5.36, OR = 12.5); physical, as migraine (OR = 1.8), chest/abdominal/lumbar/pelvic pain, gynaecological infections and sexually transmitted diseases (OR = 2.8), unwanted pregnancies, abortions and use of emergency contraceptives (OR = 1.49). Critical nursing issues in the management women victims of violence in ED, emerged in the articles, can be categorize as follows: organizational and environmental, that includes time factor, internal barriers, use of screening tools and discharge; professional, such as evidence and clinical practice, experience and emotions of emergency personnel, knowledge of the phenomenon, use of TBI; victim related, means presence of their family members, social stigma, various and covered/underestimated signs and symptoms, fear of reporting the attacker. Also, accommodation of protected territorial structures is a main transversal issue.
Conclusion: Given the breath and complexity of the phenomenon covered, in light of the results, it’s important to invest and extend on/the professional training courses. Then, start to raise awareness of the issue among students in nursing during their courses and internships. Finally, and more difficult, to intervene on the organizational level, firstly of the ED, because violence against women must be understood as a team responsibility (Zijlstra et al. 2017), and not of the individual professional.
Keywords: emergency department, gender-based violence, battered women, nursing care, emergency
nursing, violence against women, victims of violence, intimate partner violence, nurse education.
Audience Take Away Notes:
- Operative answer in Emergency Department
- Classification of the main critical issues
- Proposals on how to manage the cases/processes regarding the critical issues.
- Basic and continuous training
- Increasing students’ sensibility on gender-based violence at university from a nursing standpoint/point of view
