Unfortunately, domestic violence or any kind of abuse uses a form of control over the behavior of another person with violence and or intimidation for personal gain. Some of the characteristics that would lead a provider to suspect violence are bruising, burns, cuts or scars, black eyes, missing teeth, etc. Patients usually don’t make eye contact, nervous to speak, very jumpy, abuser in the room and dominates the conversation, and does not allow the victim to be alone with the provider. Sadly, approximately 22.1 % of the surveyed women were physically assaulted by a current or former spouse, cohabitating partner, boyfriend or girlfriend, or date in their lifetime; 1.3 % of the surveyed women reported such violence during the previous year (Tjaden & Thoennes, 2000a).

My hospitals’ protocol is to inform the Charge RN, Social Worker, Patient Safety, and proper authorities if necessary of your suspicion. The next step is to implement hospital policy & procedure. There is a form that must be put into action and steps that have to be followed using the PEARR Tool, which stands for Provide Privacy, Educate, Ask, Respect & Respond. If a sexual assault occurred, we must get a SANE (Sexual Assault Nurse Examiner) or SART (Sexual Assault Response Team) and reassure the pt she is in a safe place.

Two weeks ago, I was completing a Non-Stress test (NST) on a patient. Because I have to place straps around her belly to get the baby on the monitor, I asked the patient to lift up her blouse and expose her belly. Immediately, I noticed bruising on her belly and on one arm. Horrified, I closed the curtain to give us privacy and started asking a ton of questions. I also completed a head-to-toe physical assessment which is not protocol for an NST but I just wanted to make sure there no other bruises, scars, or injuries on her body. After giving her the 3rd degree, thankfully, her bruising was caused by injecting the medication Lovenox. I also checked her medication list to verify that she was in-fact RX’d the medication. Unfortunately, for the patient, she contracted COVID-19 and developed blood clots in her lungs! In order to prevent complications during her pregnancy, she had to inject herself with a blood thinner. I was so relieved her bruising was from medication and Not anyone hurting her while she was pregnant.

References:

Tjaden, P. & Thoennes, N. (2000a). Full report of the prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey. Retrieved August 18, 2001, from http://www.ncjrs.org/txtfiles1/nij/183781.txt Tjaden, P. & Thoennes, N. (2000b). Prevalence and consequences of male-to-female and female-to-male intimate partner