N304 Week 10 Interpersonal Violence College of Nursing (Student Copy)

8/16/2019 N304 Week 10 Interpersonal Violence College of Nursing (Student Copy)

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NURS 304.3 – Week 10Interpersonal Violence & Nursing

Practice

Rod McKendrick

Manager Victim Services

Interpersonal Violence Specialist

Saskatchewan Ministry of Justice

[email protected]


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Need to reak t!e Silence"


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#a$il% Violenceackground Inor$ation

What is abuse (what forms doesabuse take)? '$otional or ps%c!ological a(use

Social a(use )Social a(use in*ol*ingc!ildren+,!ose -!o are in control tend touse c!ildren or t!is t%pe o a(use

'cono$ic/nancial a(use

Ritual a(use

P!%sical a(use -it!out t!e person consent

Seual a(use

Religious a(use eg in religious court


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#a$il% Violenceackground Inor$ation

What is family violence? It is a co$ple pro(le$ no t-o situations

are t!e sa$e

Ranges across t!e liespan It in*ol*es an abuse of power and the

violation of a position of trust n% (e!a*iour (% one person against

anot!er person in an inti$ate relations!ip-!ic! $a% endanger t!at person6s sur*i*alsecurit% or -ell7(eing

8ust look (e%ond t!e a$il% and considert!e *alues and attitudes o t!e co$$unit%and t!e larger societ%. ,!e co$$unit% !as


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#a$il% ViolencePre*alence o (use in 9anada

: 8ost oten *icti$s o a$il% *iolence -ere in aspousal relations!ip -it! t!e accused -it! a(out!al o *icti$s )4;ed (%t!eir parent 13< (% an etended a$il%$e$(er 11< (% a si(ling and ;< (% a c!ild$ost oten a gro-n c!ild.

: Victi$s o a$il% *iolence -ere predo$inantl%e$ale )?;


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Saskatchewan $revention Institute

Family Violence (Violence durin!pre!nancy) Incidence o *iolence during pregnanc%

ranges ro$ 4< to 1@


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Family Violence ("hildren#$outh) 8ale a$il% $e$(ers -ere identi/ed as t!e

accused in a si>a(le $aDorit% o a$il%7

related seual );?


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%overnment of anada &!""'(. )uick *acts on +lder

,-use in anada. Retrieved from

Family Violence (%buse of the&lderly)

8ost oten rustration anger or despair -as t!e

apparent $oti*e or a$il%7perpetrated!o$icides against seniors. In contrast /nancialgain -as t!e $ost co$$onl% identi/ed reason(e!ind senior !o$icides co$$itted (% non7a$il% $e$(ers.

14.; < o seniors in saskatc!e-an

et-een 4< 7 10< o seniors )in 9anada+eperience so$e t%pe o a(use

Victi$s -!o are elderl% are $ost likel% to


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%overnment of anada &!""'(. )uick *acts on +lder

,-use in anada. Retrieved from

#a$il% Violence )(use o t!e 'lderl%9ontinued+ 2lder adults $a% eperience diFerent t%pes

o a(use includingG P!%sical or seual a(use

Ps%c!ological or e$otional a(use

#inancial a(use

Neglect unintentional neglect sel neglect ,!e% are doing t!is to take control o t!eir lie


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#a$il% ViolenceAealt! 9are I$plications o (use

Red ross &http/00www.redcross.ca0article.asp1id23"435tid2"'3

dults -!o eperience a(use are 103< $ore likel% to (eco$e s$okers

;5< $ore likel% to (eco$e o(ese

103< $ore likel% to (eco$e alco!olics 1;< $ore likel% to de*elop drug

addictions

43< $ore likel% to (eco$e suicidal


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#a$il% Violence

"onse'uences of %buse of Women Aealt! conseHuences

'cono$ic conseHuences

I$pact o a(use on c!ildren


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Aealt! 9onseHuences o (useo Wo$en

P!%sical

Seual and Reproducti*e

Ps%c!ological and e!a*ioral

#atal Aealt! 9onseHuences


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'cono$ic 9onseHuences

urden on societ%

I$pact on e$plo%$ent

Indirect costs sick ti$e c!ild care


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I$pact on 9!ildren

P!%sical 'Fects

Ps%c!ological and e!a*ioral 'Fects) itaFects sleep


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#a$il% Violence ,!e 9%cle o Violence

6alker 7. (. :he -attered woman. ;ew


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,!ree Stages o t!e 9%cle o Violence

1. ,ension (uilds and escalates

. Violent Incident 7 lo- up

3. (sence o Violence – Re$orseRo$anceP!ase


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Phase ension *uildin! Phase

urationG da%s -eeks $ont!s %ears

Initial inatuation o t!e relations!ip ades

(user 7 starts e!i(iting aggressi*ea(usi*etendencies Victim > attempts to stop aggression -y pleasing placating or

staying out of the way thinking those actions can control the

a-usive -ehavior

W!en t!ese actions do not control or stop t!ea(use t!e *icti$ -it!dra-s

,-user feels re?ected and tries harder to control the victims

activities

,t this point an a-usive incident will inevita-ly happen


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#a$il% Violence ,!e 9%cle o (use

,raits o t!e abuser in p!ase 1 )tension(uilding+ Jealous%

ctions t!at isolate t!e *icti$) orcedcon/ne$ent+

Rule c!anging

Na$e calling

o$inating


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*amily Violence

:he ycle of ,-use

,raits o t!e victim in p!ase 1 )tension(uilding+ Use o cal$ing tec!niHues

8ini$i>ing a(users (e!a*iours nger suppression

#atigue

9onusion

Sel7dou(t

Wit!dra-al

#ear


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*amily Violence

:he ycle of ,-use

Phase 2 Violent +ncident Phase

P!%sical e$otional $ental spiritual or seuala(use

,!e *iolent incident relie*es t!e stresstensiono t!e a(user

W!ile t!e perpetrator eels instant relie t!e*icti$ eperiences s!ockdenial

Police are usuall% in*ol*ed at t!is stage *icti$$a% seek sae s!elter onl% 11713< *icti$sreport to t!e police


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*amily Violence

:he ycle of ,-use

,raits o t!e abuser in p!ase )*iolentincident+ nger

ssault on t!e *icti$ Uncontrolled tension

'!austion


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*amily Violence

:he ycle of ,-use

,raits o t!e victim in p!ase )*iolentincident+ #ear

nger 8a% call t!e police

8a% seek saet%


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*amily Violence

:he ycle of ,-use

Phase , -emorse#-omance Phase

(user (eco$es tender apologetic git gi*ingproclai$s lo*e one ti$e e*ent etc.

(user $a% take actions and de$onstrate-illingnessdesire to c!ange )i.e. re!a( stopdrinking etc+

Aig! nu$(er o -o$en return to t!e a(userduring t!is p!ase (elie*ing t!e a(user and

t!eir actions to (e sincere


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*amily Violence

:he ycle of ,-use

,raits o t!e abuser in p!ase 3)Re$orseRo$ance+ pologies and pro$ises

S!o-s insecurities Ko*ing

e$onstrates dependenc% on t!e *icti$


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*amily Violence

:he ycle of ,-use

,raits o t!e victim in p!ase 3)Re$orseRo$ance+ Luilt

Aope Koneliness

Ko-7sel estee$

ependenc%


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9!allenges #acing Wo$enGW!% do t!e% sta%C

#ear o inDur% )or deat!+ #inances #a$il%

#ait! #at!er #atigue #antas% and #orgi*eness

#a$iliar #oresig!t

)P,As 005+


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;ov #' !" !""8

http/00www.youtu-e.com0watch1v2?=AlB"a-y,C

http://www.youtube.com/watch?v=jHZlO0abyAUhttp://www.youtube.com/watch?v=jHZlO0abyAU


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;ursing $ractice 5 *amily Violence

What is the !oal of nursin! interventions inrelation to family violence? )9N 1;;+

to e$po-er t!e client to take control

to pro*ide support

to $ai$i>e saet%

S i R l t!


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ScreeningG Role o t!eNurse sk t!e Huestion

ckno-ledge t!e a(use

Validate t!e -o$an6s eperience

ccess i$$ediate saet%

'plore options

Reer to ser*ices at t!e -o$an6s reHuest

ocu$ent t!e interaction


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Screening or (use

Uni*ersal ) general+

Routine)speci/c to do$estic *iolence+

Indicator ased )-ords t!at points

to-ards *iolence+

i t S i d


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arriers to Screening andisclosure arriers to screening ro$ t!e pro*ider6s

perspecti*e

arriers to disclosure ro$ t!e client6s

perspecti*e


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sking t!e Muestion

Responding -!en s!e sa%s B'SO

Responding -!en s!e sa%s N2O and %oususpect B'SO

Responding -!en s!e sa%s N2O

)RN2 005+

u ng r nc p es or


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u ng r nc p es orScreening97'R %ttitude and approachability o t!e

!ealt! care pro*ider *elief in t!e -o$en6s account o !er

eperience "on.dentiality is essential or

disclosure /ocumentation t!at is consistent and

legi(le docu$ent -!at t!e *icti$eactl% sa%s

&ducation a(out t!e serious eFects o*iolence & a(use

-eco!nition t!at dealing -it! *iolence

& a(use !as to (e at !er pace directed

N i P ti & # il


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Nursing Practice & #a$il%Violence /ocumentation

ocu$ent Huotes o(ser*ed (e!a*iourp!%sical assess$ent and inter*entions )actsnot opinions+

ccurac% is i$portant )speci/cs –-!o-!at-!ere-!en+

ocu$ent as soon as possi(le – docu$entp!%sical and ps%c!ological s%$pto$s – (e

o(Decti*e Huote t!e client+ -!en possi(le Use tools suc! as (od% $aps to docu$ent

locations and patterns o p!%sical inDuries

Wit! a clients per$ission p!otograp! inDuries


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N i P ti & # il


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Nursing Practice & #a$il%Violence

9!allenges o a rural setting related toa$il% *iolence includeG Kack o access to pu(lic

transportationp!one ser*ice ecreased anon%$it% and con/dentialit%

Kack o ser*ices ineFecti*e ser*ices

Increased nu$(er o -eapons in t!e !o$e

)i.e. !unting+ #e-er resources )i.e. e$plo%$ent c!ild

care etc.+

http/00www.mincava.umn.edu0documents0nursing0nursing.html


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N i P ti & # il


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"hild 3altreatment Proessionals $ust report cases in -!ic!

t!ere are reasona(le and pro(a(le

grounds to (elie*eO or reasona(legrounds to suspect t!at a c!ild is or $a%(e suFering or $a% !a*e suFered a(useO)p. 4+

9!ild protection o*errides o(ligation tocon/dentialit%

N i P ti & # il


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Nursing Practice & #a$il%Violence -eportin! child abuse#ne!lect

n%one -!o !as a reason to (elie*e t!at ac!ild is (eing a(used or neglected !as a legaldut% to report it

Bou are not epected to deter$ine i a c!ild is(eing a(used or neglected

8e$(ers o t!e pu(lic are o(ligated (% t!e la-to report suspected a(use or neglect

9onseHuences or ailing to report a suspiciono a(use or neglect )in Saskatc!e-an+ includeG /ne up to 5000

Dail ter$ o up to 4 $ont!s

2r (ot! s nurses – roessional licensin (od -ould also (e

Nursing Practice & #a$il


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Who do + report to? Social Ser*ices 9!ild Protection 2Qce )30?7

@=@73@00 Regina+

%fter 4ours "risis 5ervices Prince l(ert 30?7@?471011 Saskatoon 30?7;337?00

Regina 30?75?;7@4

co$$unit% crisis centre or unit

police oQcer #irst Nations 9!ild and #a$il% Ser*ice

genc%

Nursing Practice & #a$il%


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Nursing Practice & #a$il%Violence %dditional -esources for "hild

3altreatment ids Aelp P!one )17=007??=7?=?=+

!ttpG---.kids!elpp!one.ca

9!ild Welare Keague o 9anada !ttpG---.c-lc.ca

National 9!ild 'ploitation 9oordination 9entre

!ttpG---.rc$p7grc.gc.cancecc7cnceeinde7accueil7

eng.!t$ 9anadian 9!ild Welare Researc! Portal

!ttpG---.cec-7cep(.ca

#irst Nations 9!ild & #a$il% 9aring Societ% o 9anada

!ttpG---.nccs.co$


http://www.kidshelpphone.ca/http://www.cwlc.ca/http://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.cecw-cepb.ca/http://www.fncfcs.com/http://www.fncfcs.com/http://www.cecw-cepb.ca/http://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.rcmp-grc.gc.ca/ncecc-cncee/index-accueil-eng.htmhttp://www.cwlc.ca/http://www.kidshelpphone.ca/


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Nursing Practice & #a$il%Violence %dditional -esources for Family

Violence National 9learing!ouse on #a$il% Violence

!ttpG---.p!ac7aspc.gc.canc7cn

P,AS )Pro*incial ssociation o ,ransitionAouses and Ser*ices o Saskatc!e-an+

!ttpGa(use!elplines.orgresourcesa(use7!elp7lines

!ttpGa(use!elplines.orga(out7a(useinor$ation7or7proessionals


http://www.phac-aspc.gc.ca/nc-cnhttp://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/about-abuse/information-for-professionals/http://abusehelplines.org/resources/abuse-help-lines/http://abusehelplines.org/resources/abuse-help-lines/http://www.phac-aspc.gc.ca/nc-cn


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Nursing Practice & #a$il%Violence (use against 2lder dults

Reassurance

Unlike c!ild a(use reporting is not

$andator% (use !elp lines in S ,el p!one(ooks

Re*ie- a*aila(le ser*ices



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Nursing Practice & #a$il%Violence K'LISK,I2N

Lo*ern$ent o Saskatc!e-an Luns!ot and Sta( Wounds 8andator% Reporting ct

)eFecti*e Sept 1 00@+

nd pro*ince in 9anada to enact t!is legislation

2*errides con/dentialit% reHuire$ents

!ttpG---.Hp.go*.sk.cadocu$ents'nglis!StatutesStatutesL;71.pd


http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdfhttp://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/G9-1.pdf


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Nursing Practice & #a$il%Violence ,!e Po-er and 9ontrol W!eel

e*eloped (% t!e o$estic (useInter*ention Progra$ )ulut! 8innesota+

ddresses *iolence in a co$$unit% contet !ttpG---.t!edulut!$odel.org-!eelgaller

%.p!p

http://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.phphttp://www.theduluthmodel.org/wheelgallery.php


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,!e Po-er & 9ontrol W!eel

http/00www.theduluthmodel.org0training0wheels.html


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,!e 'Hualit% W!eel

Documents

N304 Week 10 Interpersonal Violence College of Nursing (Student Copy)