By CAROLINE ALPHONSO
TORONTO— From Tuesday's Globe and Mail
With six simple, yet weighty words – “Do you feel safe at home?” – St. Michael’s Hospital in downtown Toronto has taken a pro-active approach to helping victims of domestic abuse. The hope is that by asking all women who come to the emergency department the question, patients will be more forthcoming.
More polls
About 12 per cent of all police-reported violent crimes in Canada are incidents of spousal violence, and the majority of victims are women, according to Statistics Canada data from 2007, the most recent year available. That number could potentially be higher, as many victims are afraid to come forward. Hospitals say abuse is more prevalent at this time of the year because of the stresses that come with the holidays.
“If you don’t ask someone, you’ll never know,” said Aynsley Young, a nurse at St. Michael’s who initiated the program earlier this year. “Screening is in itself a very important intervention and it’s the first step to providing help to somebody who may be fearing for their lives or in a very dangerous situation.”
The success of the program so far can be measured in a variety of ways: 73 female patients of the 2,433 screened since the program began in June reported abuse, and despite their immediate reservations, emergency-room nurses have asked the question to half of all female patients in early December, up from 10 per cent six months ago.
The emergency room’s stories, though, make the success of the program even more apparent. One nurse tells of a woman who revealed abuse: “Before I left the room to get the MD for assessment, she hugged me again, and now smiling rather than weeping said, ‘I can’t thank you enough for helping me,’” the nurse wrote to Ms. Young. Another wrote: “I have had several women thank me for asking even though they answer ‘no’ to the question.”
Other hospitals in Toronto tend to ask questions about abuse only if a patient shows physical injuries. At least one expert wonders if the St. Michael’s approach of asking every woman whether she has visible injuries or not may be seen as too intrusive, or drive patients away.
Arthur Schafer, director of the University of Manitoba’s Centre for Professional and Applied Ethics, said data need to be kept on how patients feel about being asked the question, and on the number of women reporting abuse. Some patients, he said, may not feel comfortable coming to an emergency room if they feel they’re going to be questioned.
“I can’t answer the question if this is a good thing or not, and whether it should be adopted by every hospital in Ontario or in Canada, by every other emergency department, without knowing more. If they’re going to do it, they should do it properly,” Prof. Schafer said. “Good public policy requires that it be based on good evidence.”
St. Joseph’s Health Centre, also in Toronto, tried a similar initiative in its emergency department about a decade ago, but abandoned it, opting instead to hand women a card listing resources and phone numbers. Donna Hess, the patient-care manager in the emergency department, said there were problems trying to get nurses to ask the question on top of all the other assessment they had to complete. Some were uncomfortable asking about abuse. “And sometimes women would say, ‘Now, what is it about me that made you ask that?’ It kind of made women uncomfortable at times,” Ms. Hess said.
Experts who help abuse victims say that planting a seed, whether it’s through a question or a card, allows women to realize that there is help if they want it. Ms. Young said sometimes women have to be asked as many as eight or nine times before they report abuse. She noted that one study showed between 17 and 30 per cent of women treated in hospital emergency departments are victims of domestic violence.
At St. Mike’s, those who report abuse are directed toward counselling and other help, she said.
“If we live in fear of asking people, they may never get asked that question. As an emergency department, we wanted to make sure that we were letting clients know that St. Mike’s emergency is a safe place, and that they can return if they ever need help,” Ms. Young said.
TORONTO— From Tuesday's Globe and Mail
With six simple, yet weighty words – “Do you feel safe at home?” – St. Michael’s Hospital in downtown Toronto has taken a pro-active approach to helping victims of domestic abuse. The hope is that by asking all women who come to the emergency department the question, patients will be more forthcoming.
More polls
About 12 per cent of all police-reported violent crimes in Canada are incidents of spousal violence, and the majority of victims are women, according to Statistics Canada data from 2007, the most recent year available. That number could potentially be higher, as many victims are afraid to come forward. Hospitals say abuse is more prevalent at this time of the year because of the stresses that come with the holidays.
“If you don’t ask someone, you’ll never know,” said Aynsley Young, a nurse at St. Michael’s who initiated the program earlier this year. “Screening is in itself a very important intervention and it’s the first step to providing help to somebody who may be fearing for their lives or in a very dangerous situation.”
The success of the program so far can be measured in a variety of ways: 73 female patients of the 2,433 screened since the program began in June reported abuse, and despite their immediate reservations, emergency-room nurses have asked the question to half of all female patients in early December, up from 10 per cent six months ago.
The emergency room’s stories, though, make the success of the program even more apparent. One nurse tells of a woman who revealed abuse: “Before I left the room to get the MD for assessment, she hugged me again, and now smiling rather than weeping said, ‘I can’t thank you enough for helping me,’” the nurse wrote to Ms. Young. Another wrote: “I have had several women thank me for asking even though they answer ‘no’ to the question.”
Other hospitals in Toronto tend to ask questions about abuse only if a patient shows physical injuries. At least one expert wonders if the St. Michael’s approach of asking every woman whether she has visible injuries or not may be seen as too intrusive, or drive patients away.
Arthur Schafer, director of the University of Manitoba’s Centre for Professional and Applied Ethics, said data need to be kept on how patients feel about being asked the question, and on the number of women reporting abuse. Some patients, he said, may not feel comfortable coming to an emergency room if they feel they’re going to be questioned.
“I can’t answer the question if this is a good thing or not, and whether it should be adopted by every hospital in Ontario or in Canada, by every other emergency department, without knowing more. If they’re going to do it, they should do it properly,” Prof. Schafer said. “Good public policy requires that it be based on good evidence.”
St. Joseph’s Health Centre, also in Toronto, tried a similar initiative in its emergency department about a decade ago, but abandoned it, opting instead to hand women a card listing resources and phone numbers. Donna Hess, the patient-care manager in the emergency department, said there were problems trying to get nurses to ask the question on top of all the other assessment they had to complete. Some were uncomfortable asking about abuse. “And sometimes women would say, ‘Now, what is it about me that made you ask that?’ It kind of made women uncomfortable at times,” Ms. Hess said.
Experts who help abuse victims say that planting a seed, whether it’s through a question or a card, allows women to realize that there is help if they want it. Ms. Young said sometimes women have to be asked as many as eight or nine times before they report abuse. She noted that one study showed between 17 and 30 per cent of women treated in hospital emergency departments are victims of domestic violence.
At St. Mike’s, those who report abuse are directed toward counselling and other help, she said.
“If we live in fear of asking people, they may never get asked that question. As an emergency department, we wanted to make sure that we were letting clients know that St. Mike’s emergency is a safe place, and that they can return if they ever need help,” Ms. Young said.
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