A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions. Each time, she returned to work wearing dark glasses. Facial and body bruises were apparent

Question

Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse. What should the nurse first focus on as she meets the patient? a. Notifying the police of the abuse
b. Documenting the woman's injuries
c. Establishing trust and building rapport
d. Collecting evidence to prosecute the abuser

Answer 1

C
Establishing an effective, therapeutic, nurse-patient relationship is the foundation for all further work and should be the initial focus of the nurse's efforts. If there were any indications that the woman was in danger due to her injuries, assessing and treating those injuries would be the priority, but that is not the case here. The injuries are bruises and have been noted on several occasions, making them less emergent. Notifying the police at this early stage would fracture the patient's trust and possibly increase the danger to the woman in the short-term, in that the abuse could escalate before there is an effective, dependable safety plan in place. In many locales, the patient's permission is needed to notify police of domestic violence involving adults. Although nurses should always preserve any evidence they happen upon, active collection of evidence is the province of the police; the exception is a nurse who is specially trained to collect evidence related to sexual assaults.