"I'm taking a news holiday." I was startled by this recent statement from a friend. A news junkie myself, I believe I have a social and professional responsibility to stay informed. But my friend's statement also reminded me of a radio interview I heard years ago. In discussing how people could improve their health, a guru of complementary health care recommended taking periodic breaks from the news because it's filled with conflict, violence, and tragedy.FIGURE
Although it's only human to want to take a holiday from violence, as nurses we can't. Violence is a public health problem; our patients are its casualties. This month's AJN offers two articles that may help us to recognize violence in our patients' lives and to prevent further trauma or help convict a perpetrator.
Judith McFarlane and colleagues present research funded by the U.S. Department of Justice on helping abused women adopt behaviors that may keep them safe from future attacks from their partners, such as finding hiding places for money or an extra set of car keys or alerting friends and family members through a code word that indicates help is needed. (Although this study focused on women, men can also suffer abuse from their intimate partners.) The researchers used the Safety-Promoting Behavior Checklist (see page 42) to measure the effectiveness of telephone counseling sessions in promoting participants' use of these behaviors, which they were still using at their last follow-up phone call.
McFarlane's research and checklist have relevance for nurses in many settings, including acute care, public health, ambulatory care, and pediatrics. Consider the following points, which suggest opportunities for discussing safety-promoting behaviors with patients you suspect are victims of abuse:
* The reported prevalence of abuse among pregnant women by their intimate partners ranges from 5% to an astounding 23%, noted Margaret H. Kearney and colleagues in a study published in the January-February 2004 issue of Nursing Research. They suggested that clinicians treating pregnant women can improve the outcomes for both women and newborns by screening for abuse and offering support.
* Children of abused women are more likely to have behavioral problems (including anxiety, depression, and withdrawal, which are associated with risk of suicide) than are children of nonabused women, according to another study by McFarlane and colleagues. The findings, reported in the September 2003 issue of Pediatrics, led the researchers to conclude that early detection of and intervention in intimate-partner violence has the potential to prevent these problems.
* In the July 2003 issue of the American Association of Occupational Health Nurses Journal, Ann Malecha, an author in this month's AJN, wrote compellingly about the need for occupational health nurses to be alert for signs of intimate-partner violence and, if it's suspected, to discuss steps the person might take to escape it.
This issue of AJN also reports on the growing field of forensic nursing: internationally known forensics expert Ann Burgess and coauthors Anne Berger and Rachel Boersma outline various dimensions of forensic nursing and argue for the importance of graduate-level preparation. Burgess also speaks to the need for all nurses to recognize when a patient's death or health condition may have a criminal context and to know how to respond when a crime is suspected. Next month, AJN will premiere a periodic series of case studies in forensics by Burgess. The cases are real and riveting.
Vigilance against violence in our workplaces and our patients' lives may be an unavoidable necessity. But that said, my friend and that radio guru may be right-a break from the news might be an essential component to healing and restoration. So I'm off for a real vacation. And I'll try not to think about news or nursing, at least until I go through airport security or pass someone hiding a black eye behind sunglasses.