Recognizing, Responding, and Supporting: A Nurse’s Approach to Domestic Violence

Photo from WILPF US Domestic Prisoners of War Issue Committee 

By Jazmine Roberson
Domestic Prisoners of War Issue Committee Member. Tampa, Florida 

This piece explores the critical role nurses play in addressing domestic violence within the healthcare system. Drawing on lessons from nursing school and clinical experiences, it highlights strategies for assessing abuse, supporting patient autonomy, creating safety plans, and connecting victims to vital resources—all while maintaining compassion, sensitivity, and professionalism

Throughout my nursing school experience, I have learned about domestic violence in the healthcare system. This knowledge stems from classes, personal observations, and hospital experiences. However, this is not an exhaustive exploration of policies or programs related to domestic violence; it is simply a summary of what I’ve learned so far.

In Florida, domestic abuse involving adults, unless it pertains to a child or a vulnerable adult, is not mandatory to report. If you suspect intimate partner violence (IPV), you can assist the individual by creating a safety plan and providing resources, but there is no legal obligation to report the abuse to law enforcement or state protective agencies, such as DCF or CPS. This may surprise some people, but it underscores the importance of respecting the autonomy and wishes of the patient.

One critical responsibility when conducting assessments is to report as much objective information as possible, based on what you observe and what the patient shares, to the attending physician. It is not the nurse’s role to offer personal judgments or assumptions about the situation. Remaining unbiased allows the physician to form their conclusions, which is essential for building a case to help the victim effectively. If you suspect abuse but lack concrete evidence, it is appropriate to communicate your concerns to the physician. However, always lead with factual information, such as physical assessment findings or the patient’s statements. Avoid sharing vague suspicions or personal opinions, as this can complicate the situation or lead to misunderstandings.

One key aspect I learned is that nurses must focus on the immediate needs of the patient. If a patient discloses abuse but expresses no intention of leaving their partner, your role is to address their current needs. This could include treating their injuries, providing resources for housing or food, or offering connections to community services. Reporting abuse without the patient’s consent could escalate the situation, especially if the patient lacks a robust support system to leave their partner safely.

Creating a safe environment to talk openly with patients about abuse is essential. For example, you can ask the patient to accompany you to a treatment room or lab for privacy, away from their partner. When discussing sensitive topics, it’s important to use open-ended questions rather than ones that can be answered with a simple "yes" or "no." Open-ended questions encourage the patient to share more details, which helps in understanding their situation better. For instance, instead of asking, “Are you safe at home?” you could ask, “Can you tell me about your living situation?” These approaches can reveal much more about their circumstances.

If children are involved, you need to tailor your questions to suit the child’s developmental level. When speaking with parents, a nonjudgmental tone is crucial. For example, rather than saying, “It seems like your discipline is harming your child,” you could ask, “How do you usually discipline your child when they misbehave?” This phrasing encourages openness and reduces defensiveness, which is key to gathering accurate information.

Substance abuse is often correlated with domestic violence, so demographic questions should include inquiries about alcohol or drug use. If the patient says they don’t drink but mentions their partner does, you can ask follow-up questions to assess the situation further. However, it’s vital to remain sensitive to the presence of the partner during these discussions, as raising suspicions could increase the patient’s risk.

Safety planning is another critical topic we covered. Hospitals often have rubrics or step-by-step guidelines to help nurses create safety plans with patients. These plans may include questions like:

•    Do you feel safe at home?
•    Do you have a support system?
•    What strategies have you used to cope in the past?

If your facility lacks resources for safety planning, online resources can be invaluable. Nurses should also familiarize themselves with local crisis services and hotlines to provide timely assistance.

Hospitals typically have care coordinators or social workers available to help patients access services related to domestic violence. While these professionals are excellent resources, it’s beneficial for nurses to be proactive by researching local services and crisis programs. In many cases, nurses may be the first—or only—people a victim has seen in months due to the isolation often imposed by abusers. Recognizing both physical and nonverbal signs of abuse is crucial in these situations. Asking thoughtful follow-up questions can provide opportunities for intervention.

Continued education is a requirement for nurses, including certifications and courses on topics like domestic violence, human trafficking, and substance abuse. These ongoing training programs, often mandated by the state, ensure that healthcare providers remain updated and capable of offering informed, compassionate care. While incidents can still slip through the cracks, advocacy for patients—whether it involves IPV, substance abuse resources, or faith-based support—is integral to holistic nursing care.

I am grateful for the knowledge I’ve gained in nursing school and through clinical experiences. These lessons have helped me understand how to better serve patients facing domestic violence. As I grow in my career, I hope to deepen my expertise and continue advocating for patients in vulnerable situations.