The emergency department response to women experiencing intimate partner violence: Perceptions from emergency clinicians

Prof. Margaret Fry1, Associate Professor Angela  Dawson2, Chris  Rossiter2, Dr Anna  Doab2

1University of Technology Sydney / NSLHD, Sydney, Australia, 2University of Technology Sydney, Sydney, Australia

Introduction

Intimate partner violence, most commonly perpetrated by men against women and exerts a substantial burden on the health systems and economies of every nation. Emergency departments are essential providers of compassionate, immediate treatment and referral for women experiencing Intimate partner violence. There is little known about how emergency clinicians respond to Intimate partner violence. We therefore examined the health service response in two large metropolitan emergency departments.

Methods

Semi-structured interviews and focus group discussions with 35 social workers, nurses and doctors were conducted. We analysed the data thematically.

Results

Themes to emerge were: i) Intimate partner violence -a hidden problem; ii) Asking the right questions; iii) Keeping women safe; iv) Call social work; v) The intersection of the personal and professional and vi) Working as a team.  Respondents emphasised challenges identifying intimate partner violence resulting from professional uncertainty or discomfort and women’s fear of the ramifications of disclosure. Clinicians routinely referred women to social workers after medical treatment and described effective collaboration across professions. Staff highlighted challenges maintaining non-judgemental attitudes and managing their own feelings especially clinicians who had personally experienced violence.

Conclusions

This qualitative study provides important insights into the knowledge, attitudes and practices of professionals in large metropolitan EDs about IPV. The findings indicate consistent teamwork and commitment to keeping women safe. Many nurses and doctors were not aware of screening tools or IPV-related polices and protocols within their hospitals.

Emergency departments are essential providers of compassionate, immediate treatment and referral for women experiencing IPV. This study demonstrates effective teamwork between all professionals and prompt referral to social workers in two busy metropolitan EDs. A connected multi-systems-level response is required to co-ordinate and resource services for all affected by violence. Supportive workforce environments can improve staff understanding, reduce stigma and counsel health professionals experiencing violence.


Biography:

Professor Fry is the Nursing and Midwifery Director Research and Practice Development for Northern Sydney Local Health District which is a conjoint Professorial Chair position with the University of Technology Sydney. She is also an adjunct professor with the School of Nursing University of Sydney. Professor Fry has 25 years emergency experience as a Clinical Nurse Consultant and authorised Nurse Practitioner (NSW).  Professor Fry has extensive emergency nursing experience and a proven research track with 137 peer reviewed publications and over $2.9million in grant, research tenders and or scholarship funding. Professor Fry’s program of emergency care research has established her as a national and international leader with strong clinical credibility. She has been involved, as Chief Investigator, in numerous research projects in emergency care evaluation, advanced nursing practice, and pain management and has undertaken significant workforce health services and practice research. Her program of research has led to significant Australian state and national emergency nursing practice change. Her recent program of research involves pain management, emergency care service utilisation, effective models of care, advanced nursing practice, the use of care bundles to support patient outcomes, and emergency discharge processes. In the acute in-hospital environment, she is working on interventions to reduce the occurrence of hospital acquired complications and representations