labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Friday, February 27, 2009

You Can Lead A Horse To Water...

You may have noticed that whenever you have a health care encounter- an office visit, your gyn exam, an emergency room visit, when you birth in a hospital- you are asked if you are safe in your relationship. This is typically asked by your nurse, and (hopefully) asked in private. It has become a standard question on the admission process in hospitals, regardless of your age or gender or why you are there, and even at your primary care doctor's office.

This is a good thing- it can help those who may be in a bad situation. The unfortunate thing about asking about abuse and domestic relationship issues is that many do not disclose this information. It may be because the person doesn't want to, or doesn't believe they are a "victim" of domestic abuse, or because they are afraid to. I remember going to a conference on domestic abuse in the health care setting and hearing that it takes a women seven encounters by the same health care professional before she will disclose her domestic abuse situation. That may never happen for many women- except for the prenatal care setting. Where else does a woman consistently see her health care provider so frequently in such a short period of time?

I work with a nurse, Kerry, who is one of those women. But she is one of those who doesn't realize that she is in an abusive relationship. She comes to work, many times visibly upset or distracted, taking 20 phone calls before the shift is half over from her husband, who calls to check on her. She makes numerous calls to him, as well, where you can hear her making excuses for her "behavior" or apologizing for whatever angered him most recently. Kerry talks about how he controls her money, her friends, and her contact with family. Her husband even checks on her computer history everyday to see what websites she is on, and must keep her passwords to accounts open to him.

Kerry has for years talked about how much she hates all this. But yet she doesn't see it as abuse. And she so desperately wanted a child. She even said, to every one's surprise, that she thought a child would help her husband be a better person and would love her more.

Kerry's husband did not want to have a child, but she did become pregnant. She recently gave birth to her son, and chose a doctor that we work with. Kerry was now one of our patients, and the admission nurse asked the requisite question about domestic abuse. Of course, Kerry poo-pooed this question, saying something along the lines of, "Oh, no, never!"

And so what do you do? This situation is different than most, as most of the nursing staff knows Kerry well and has heard and seen all sorts of things that point to an abusive relationship. No one did anything more than ask the question; and I can't think of what else could be done. I have been witness to, as well as part of, conversations at various points in the past few years with Kerry where she has been confronted with the nursing staff's suspicion's and concerns. Kerry never admitted to being in an abusive marriage, but would often cry- something that made me believe that she knew something wasn't right. Another nurse set her up with a therapist, another gave her a book about women in abusive relationships. She accepted these things, but never followed through.

If Kerry was a minor or a senior, this abuse would have to be reported to the police for investigation. But with an adult women, all you can do is lead her to the available help. It's up to her if she is ready and willing to accept it. This is so frustrating, especially when it's one of your own.


Joyce said...

Apparently Kerry is not ready to move on from this relationship. Many abused women stay in a bad relationship because they can't see themselves on their own, they need their husband's money, etc. There are many reasons. She needs to come to this conclusion on her own similar to an alcoholic admitting they have a problem; it takes a LONG time.

Anonymous said...

After being in an emotionally and verbally abusive relationship, I still wonder how I could have bee so stupid. I thought at the time that I deserved it because of something I had done. I only see in hindsight that regardless of what I did it is no excuse. People expressed concern that I was being used, and they did not know about the rest, but I always shrugged it off and made excuses. When it is not outright physical abuse t is maybe easier to not see it for what it is.

Mama K said...

Hard situation. I wonder if she sees a potential risk to the baby she's carrying, if it would make a difference - maybe give hers sufficient reason to take action to improve things. Why do you think she's so firmly denying the problem?

Labor Nurse said...

Mama K- I think she denies the situation because of 2 things: straight up denial and poor self esteem.

Anonymous- I think you are right on with denial being a key factor when physical abuse is not the issue. It's very easy to say, "He doesn't hit me so it's not abuse" when in fact, he really isn't hitting you!

Ethel said...

Denial... whatever.

Whenever I hear the question "Do you live in a safe home?" It makes me smile, it's such a wonderful to hear medical professionals strike a note that we so often ignored. But, the question is often obtuse - safe how? Is there radon in the attic, lead paint on the window sills, or is my husband hurting me? As far as I know the house is safe, I am absolutely certain my husband is totally wonderful and safe - that's why I chose him.

As for Kerry, it's not denial it's not being able to recognize it for what it is. You get so used to the abuse, it comes on slowly until like the boiled crab you're dead - it takes the right kind of mirror for you to be able to really see what's going on. For me it was my mother who was going to spend time with me but when she found out my husband was going to be home told me she couldn't be there, when I asked why she said "I don't want to be around Joe." Oh.

Sure there was the denial, I was the daughter of a woman's advocate, I had been active in volunteering at the women's shelter where she worked, but until I saw my reflection did I recognize what was happening and then I told her how he treated me.

Mirrors can be statements of what we would not accept in our partner, or how we expect freedom of will and choice, it can come in various ways. A simple "I would not allow my husband to come between me and my family/friends/whomever." And actually her child can be a bridge to freedom when she realizes she needs to protect her infant.

Good luck with the people in your life needing the proper mirror. It's not easy, and it's not fair - but we can speak about what we individually would or would not accept in a relationship.

Joy said...

I hate being asked this question, personally. Because I feel if I say, "No, my husband is not abusive" that they won't believe me. My husband has piercings and tattoos and looks intimidating but is gentle and sweet. He has automatic judgements placed on him just because of how he looks.

As a nurse, if I had to ask the question, I'd probably wonder how many women lied to me or were oblivious to their situation so I guess I can't blame them.