During a recent trip to the ED for a sudden onset arrhythmia, I too was "screened" for domestic violence. Without making eye contact-and with my husband at my bedside-the nurse asked, "Is anyone at home hurting you physically, emotionally, or sexually?" The question was one of many; essentially no different from the one regarding my last bowel movement.

The nursing instructor in me couldn't be still. Later, when my rhythm was stabilized and the nurse was preparing to transfer me to the telemetry unit, I gently explored the nature of her questioning. She told me she was fearful of a "positive answer" and felt ill prepared to deal with a discovery of domestic violence.

Whether because of an actual or perceived lack of community resources, many nurses continue to be uncomfortable with the possibility of uncovering domestic violence, a point Ms. Roush addresses eloquently. Nurses need to recognize that failure to screen, intervene, or advocate in situations of domestic violence constitutes a gap in practice and a failure to meet the minimum standards of care.

Here at the University of Massachusetts, Worcester, we cover this topic, and I've added the Web site recommended by Ms. Roush to the syllabus.

Margaret Trussler, MS, MSN, ANP-BC

Worcester, MA