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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
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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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#a$il% ViolencePre*alence o (use in 9anada
Saskatchewan $revention Institute
Family Violence (Violence durin!pre!nancy) Incidence o *iolence during pregnanc%
ranges ro$ 4< to 1@
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#a$il% ViolencePre*alence o (use in 9anada
Family Violence ("hildren#$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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#a$il% ViolencePre*alence o (use in 9anada
%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 $ost likel% to
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#a$il% ViolencePre*alence o (use in 9anada
%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$il% Violence ,!e 9%cle o Violence
6alker 7. (. :he -attered woman. ;ew
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#a$il% Violence ,!e 9%cle o Violence
,!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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#a$il% Violence ,!e 9%cle o Violence
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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Nursing Practice & #a$il%Violence
"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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Nursing Practice & #a$il%Violence
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$
Nursing Practice & #a$il%
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
Nursing Practice & #a$il%
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
Nursing Practice & #a$il%
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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
Nursing Practice & #a$il%
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