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Domestic Violence Education for Professionals
The Vancouver Hospital Domestic Violence Program has provided
inservice training on domestic abuse to many health care providers
-- nurses, social workers, physicians and other health care
personnel and students.
The training often includes the video "One Hit Leads to
Another", an excellent made-in-BC teaching tool that sets
the tone for the information to follow. An overview of facts
and stats about abuse is followed by an outline of why the
woman frequently does not choose to leave the relationship.
Health care providers have been criticized for asking "Why
don't you just leave?" Of course there are many and complex
reasons why she stays, which professionals need to consider.
An historical overview of men's oppression of women is provided,
from as far back as The Laws of Hammurabi, 2000 BC, up to
the Rule of Thumb and including the current struggle to implement
the proarrest policy initiated by the Attorney General in
1986 and reintroduced in 1992.
Signs and symptoms of abuse are outlined including injury
patterns as well as more occult presentations. Differences
between accidental and intentional injury are discussed; and
psychological sequelae of abuse and the ways these may manifest
in the Emergency Department or health professional's office
are explored.
The cornerstone of the presentation, which flows from the
understanding that abused persons may present with a multitude
of problems other than black eyes or "typical" injuries, is
"asking the question". We suggest that all persons are screened
for abuse. By asking the question about abuse the health worker
invites a disclosure and indicates that she or he is "tellable".
The shame that abused women feel makes it difficult for them
to reveal such a secret. Workers are given phrases to say
to reassure the woman that she is supported and understood.
Our program is woman-centered in that the professional follows
the lead the woman provides; if she wants to go to a shelter
or call the police it is the role of the worker to facilitate
that, but not advise it.
The need for a coordinated response from health care professionals,
law enforcement and justice is reinforced.
Kathleen Mackay MSW
Lianne Ritch RN
Domestic Violence Program
Vancouver Hospital and Health Sciences Centre
855 West 12th Avenue
Vancouver, BC
V5Z 1M9
Phone (604) 875-4111 ext. 2847
Fax (604) 875-4872
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