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New RCN guidlines for stopping domestic violence and abuse



The RCN has published new support for nurses in identifying and helping victims of domestic abuse.

The RCN has published new support for nurses in identifying and helping victims of domestic abuse.

The support gives access to national resources focused on different groups including perpetrators and also key information in how to recognise those at risk based on NICE guidance.

The resources, which were compiled by a panel of experts including RCN members, note that domestic abuse is not exclusively male against female, andthat one in six men are likely to be affected.

The move comes one month after nursing charity Cavell Nurses’ Trust revealed that nurses themselves are three times more likely to suffer abuse at home than other people.

Nurses have been told to be aware of patients who show signs of depression, anxiety, self-harm, substance misuse, and sleep disorders as they could be affected by domestic abuse.

Patients having an intrusive “other person” come to consultations with them is another warning sign.

Other factors the RCN wants nurses to take note of include:

  • unexplained chronic gastrointestinal symptoms

  • unexplained gynaecological symptoms, including pelvic pain and sexual dysfunction

  • adverse reproductive outcomes, including multiple unintended pregnancies or terminations

  • delayed pregnancy care, miscarriage, premature labour and stillbirth or concealed pregnancy

  • genitourinary symptoms, including frequent bladder or kidney infections

  • vaginal bleeding or sexually transmitted infections

  • problems with the central nervous system – headaches, cognitive problems, hearing loss

The RCN was clear that there is no definitive list of signs for domestic abuse in patients and that all or none of these symptoms could appear.

However, it is important that if nurses are concerned for a patient’s welfare that they should start a conversation with them.

The questions should include “Has anyone ever hit, slapped, restrained or hurt you physically, or emotionally?” “Have you ever felt unsafe in your home situation?” and “Does anyone ever try to control your behaviour?”

The NICE guidelines advocate that these conversations need to have time and they need to be carried out in privacy and with an official interpreter if the individual does not speak English.

Carmel Bagness, RCN Professional Lead for Midwifery and Women’s Health, said: “Domestic abuse can have a devastating effect on individuals and families, however the signs are not always obvious and sometimes a subtle observation or sensitive question from a nurse or midwife can be a route to recognising someone who may be vulnerable and afraid.

“The new resource will be updated regularly to reflect changes in national guidance, and a pocket guide for healthcare professionals, to better support victims of domestic abuse, is planned for 2017.”

At RCN Congress this year, RCN members discussed the support available for nursing staff when identifying cases of domestic abuse, in a debate proposed by emergency nurse Amanda Burston.

Amanda, who worked with the RCN to create the new resources, said: “I want health care staff to be the leading force in standing up to domestic abuse, for the benefit of our own nurses, patients, and local communities.”