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What is the cycle of violence?
What are the characteristics of "perpetrators?"
- People who want power and control
- Military, law enforcement, MDs, lawyers, athletes etc.
- When things are going well, they do well.
- When things are bad, they can be violent.
- Perpetrator steps on boundaries
- People who have poor coping skills.
- Like the tip of an iceberg. Rage underneath can come out, sometimes for some small, stupid mistake.
Characteristics of the perp while in treatment?
- Court ordered
- Is in denial
- Uses minimization
- May have 1 or more personality disorders (antisocial, narcissistic)
- Lacks empathy
- Are narcissistic, aggressive, sadistic, passive aggressive
- 95% of time the perpetrator was drunk or using drugs at the time of violence
What is involved in court-ordered DV treatment?
- Court ordered 36 weeks of domestic violence treatment.
- AMEND in Denver
- Group- treatment of choice without the spouse
- Victim contacted to see if the violence has stopped
What is involved during the 36-week treatment for DV?
- Cycle of violence
- Time outs
- Anger management
- Conflict resolution
- Education about power and control
- Communication skills
- Male/female roles
- Teach empathy (put yourself in other’s shoes)
- Stress management strategies
- Appropriate ways to express feelings
- Address drug and alcohol abuse
What are some nursing interventions in treatment of DV?
- Interview victim alone
- Perpetrator may insist on staying because it’s his right
- Questions to ask:
- --Are you in any kind of danger?
- --Is someone hurting you at your home?
What are you looking for when you suspect DV?
- Inconsistent stories
- Suicide attempts
- Substance abuse
- Inability to sleep
- Injuries in various stages of healing
At what point is the victim at highest risk?
- Victim is the best judge of when it’s time to leave.
- When they leave, they are at higher risk to be seriously hurt or killed.
- He feels really alone and out of control and may threaten to kill her if she ever leaves.
What are the nurse's legal/ethical options/responsibilities?
- Be aware of community resources and refer
- Ask police for a welfare check (not a financial check, ask police to check on well being of couple under suspicion.
- A lot of perpetrators are arrested in the ED
- Victim can call 911 and hang up. The police investigates.
- MD is required to report spouse abuse
- RN only required to report child/elderly abuse (under 18 & over 65)
- What to do if you get a phone call:
- --Ask the question about abuse, i.e. “Are you in immediate danger?”
- --Tell her you’ll stay with her until the police comes
- --Encourage her to call again,
- --Ask: Why not leave now? I’ll help.
- --It’s a crime and you have the right to protection
What is Project Safeguard?
- Local resource available through the county courthouse.
- Will go to court with victim
- Knows the victim’s legal rights
- Helps get a restraining order
- Should they get a restraining order? Maybe, restraining order will have victim's address on it so anonymity is out the window.