Looking in hospital charts, a nurse practitioner and certified SANE examiner (sexual assault nurse examiner) noticed less than 10% had answers to the domestic abuse screening questions that healthcare providers are required to ask by JCAHO (Joint Commission on Accreditation of Healthcare Organizations).
This has been observed in at least two metropolitan hospitals within the same state, one of which is a Level I trauma facility.
When the nurse practitioner witnessing this inquired about her observations, the Head of Nursing replied, "Do you know how many of these nurses are abused themselves!" One might go on to wonder:

• How many of these individuals are in controlling relationships in which they are the aggressive partner?
• How many of these individuals witnessed and/or experienced domestic abuse as a child?
• ...
  And how many know the devastating loss of their own child, a sibling, a cousin, a friend or a co-worker to the insidious condition of domestic abuse?

As you are reading this, it may occur to you that one could say the same thing about any ailment/condition walking through the doors of healthcare: hypertension, migraines, ulcers, irritable bowel syndrome, chronic pain conditions, fibromyalgia, arthritis, infectious disease, degenerative disorders and numerous other stress-related illnesses.
Silent Insidious Problem So what is it about "intimate partner violence" that makes the healthcare provider fail to embrace screening for this condition just as they do for any other condition? We are convinced that it is not the incidence of this condition among the general population (also reflected in their own healthcare provider circle); rather it is the social stigma associated with this condition.
Further, we would venture to say that this stigma is different than that attached to contagious and deadly diseases.
It is a stigma that wears an all-engulfing social-emotional, psychological component, beyond blood and tissue.
When it's yours, it can permeate every fiber of your being-sometimes consciously, more often unconsciously.
We suspect this is one of the greatest barriers to healthcare intervention for domestic abuse.
Until this barrier is addressed, the regulations and requirements of hospitals and health associations are all in vain.
And more seriously, our patients who are in an abusive relationship remain in danger.
It is important to note that firsthand knowledge of domestic abuse is a "human issue.
" Its impact with respect to the healthcare provider is only more significant than it would be for other professions because the healthcare provider is expected by hospital regulations and state laws to see it clearly in the patients they treat.
Copyright 2008, Dr.
Jeanne King, Ph.
D.