Family violence rf order 12

Family violence rf order 12

• 1.
  Renee Franquiz MSN,RN
• 2.
  Family Violence: Prevalence Prevalence  Half of all Americans have experienced violence in their families  Types of Violence/Abuse  Domestic – Intimate Partner  Child Abuse  Sexual Assault
• 3.
  Intimate Partner Violence  One in every four women will experience domestic violence  1.3 million women are victims of physical assault each year.  85% of domestic violence victims are women.  Females have been most often victimized by someone they knew.  Females 20-24 years of age are at the greatest risk  Most cases of domestic violence are never reported to the police  Source: National Coalition Against Domestic Violence
• 4.
  Effects of FamilyViolence  Effect on Children Development adversely affected Energy needed to accomplish developmental tasks successfully goes to coping with family violence  Effect on Adolescents Poorer coping and social skills Higher incidence of Dissociative ID d/o Poorer impulse control
• 5.
  Intimate Partner Violence  Establishes power and control Intimidates – Looks, gestures, brandish weapons Threaten – To Hurt, leave, report to authorities Isolates – Prevents from having outside involvements Economic enslavement – Control finances, gives an allowance, prevents from working Minimizes – Makes light of the abuse, denying Pawning the Children – use them as a weapon, threaten to take them Emotional abuse – putting down, name calling, humiliation
• 6.
  Profile of theVictim  Represent all demographics  Demonstrate low self-esteem, helplessness, hopelessness, powerlessness, guilt, shame  Attempts to protect perpetrator  Takes Responsibility  Denies severity of the situation
• 7.
  Profile of thePerpetrator  Low self esteem/Easily threatened  Jealous/Possessive – See partner as a possession  Degrading and Humiliating  Uses threats and intimidation  Poor Coping Mechanisms  High incidence of substance abuse  Experienced violence as a child Escalates and greatest risk of violence is when partner attempts to leave relationship
• 8.
  Cycle of Violence  Phase I Tension Building (weeks to years) Minor Anger, Verbal Abuse, Minor Physicality Victim is tense and accepts blame; Attempts nurturing Prolonged tension makes the victim withdraw, abuser becomes more threatened and angry  Phase II Acute Battering (Hours) Physical Violence, battery and injury  Phase III Honeymoon (hours to years) Remorse, contrite, loving, kind, apologetic Abuser feels in control now of self Victim visualizes this as the image of the relationship
• 9.
  Child Abuse  Approx 5 children die every day as a result of child abuse  80% of children that die from abuse are under the age of 4  90% of juvenile sexual abuse victims know their perpetrator  Child abuse occurs across all demographics  About 30% of abused and neglected children will later abuse their own children  Source: US Dept Health and Human Services
• 10.
  Child Physical Abuse Physical Injury regardless of intent  Suspect When: Unexplained injuries Healing Injuries Child resists going with parents Child cowers Caretaker “harsh” Injury does not match story Caretaker w/Hx of Abuse
• 11.
  Child Emotional Abuse Behavior that results in impairment of social, emotional, intellectual function  Victim Characteristics Overly compliant Inappropriately adult Developmental delays Lack of Attachment  Suspect When Parent Belittles, rejects, ignores, isolates
• 12.
  Child Neglect  Failure to provide that which is needed for health, welfare, growth and development  Victim Characteristics  High absenteeism from school  Unkempt – Poor hygiene, lack of appropriate clothing  Steals – for food or “essentials”  Lack of medical care – immunizations  Suspect When Caretaker  Indifferent, apathetic  Bizarre Behavior
• 13.
  Self-Assessment of theNurse  Work with a partner and discuss your honest feelings about: ○ Intimate Partner Violence ○ Child Neglect ○ Child Abuse ○ Child Sexual Abuse ○ Sexual Assault -Rape
• 14.
  Nursing Process -Assesment  History  Physical  Privacy  Use experts – Child  Direct Abuse Teams, SANE  Therapeutic Comm Nurses  Inspect for physical  Separate Providers injuries - trauma,  “Tell me what bruises, welts, happened” fractures, bites, burns  Explore for qualities  Match to the story of a perpetrator and victim ○ Inform client/family if a referral is being made
• 15.
  Nursing Process NursingDx  Rape-Trauma Syndrome  Powerlessness  Delayed Growth and Development  Risk for other directed violence  Anxiety  Fear  Disabled family coping  Caregiver role strain
• 16.
  Outcome Criteria Physicallyand Psychologically safe from harm Reduction of Stress-Related Symptoms (Anxiety, Panic, Fear, Sleep Disturbance) Demonstration of Trust Initiation of Grief Response Develops a safety plan
• 17.
  Nursing Process - Intervention  ABCs – Treat any physical injuries, attend to stress response, photograph  Ensure a safe environment  Listen, empathize, comfort, reassure  Call or direct to authorities  Critical Incident Debriefing – psychological care  After care  CPS for child abuse  Safety Plan Domestic Violence  Support Groups Sexual Assault  See page 740 in Townsend for good overview
• 18.
  Developing a SafetyPlan  A plan for a fast escape when violence occurs  Identified sign of escalation of violence and designate this as a time to leave  Include in plan a destination and a way to get there  Have the hotline referral telephone number of a shelter or a safe house