February 26th, 2020 
Violence does not discriminate against any social or economic position or situation. It can be physical, emotional or psychological and usually is inflicted by a close family member (Ford-Gilboe, 2016). Characteristics that trigger providers of violence taking place is patients arriving at the emergency room with a trauma that is not related to an illness, withdrawn behavior or changes that are not normal in their everyday mood, depression, and anxiety. Other behaviors that something is wrong, is observing self-harm, suicide comments, and anything from the persons norm (Mayo Clinic, 2017).
Working in a Cardiac Unit, I have seen the abuse of a patient where the patient is abandoned or not cared for the way they should be. I see many patients where the family members (spouse, son or daughter), no longer want to be apart in their care. Once, I received a call from a daughter wanting to know if her mom has died yet. I had trouble responding because it was cold-hearted.
My facilitys procedure is to report these types of abuse as soon as possible. We wait for the right time when the patient is alone to approach them with another nurse and question them about the abuse signs or abandonment noted by family members. We also inform the Charge Nurse so a message can be sent to a Social Worker and Adult Protective Services can be notified. Most of the time, once APS is involved, we do not know the outcome of the investigation. The goal is to protect a victim of abuse of any age (Mayo Clinic, 2017).
Reference
Ford-Gilboe, M., Wathen, C. N., Varcoe, C., MacMillan, H. L., Scott-Storey, K., Mantler, T., Hegarty, K., & Perrin, N. (2016). Development of a brief measure of intimate partner violence experiences: the Composite Abuse Scale (Revised)-Short Form (CASR-SF). BMJ Open, 6(12), e012824. https://doi.org/10.1136/bmjopen-2016-012824
Mayo Clinic. (2017, March 1). Domestic violence: How to leave a dangerous situation. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence/art-20048397
National Domestic Violence Hotline. (2020). Is This Abuse? Retrieved from https://www.thehotline.org/is-this-abuse/
There are various concerns that hinder healthy living among families. Such include; domestic violence, child abuse and elder abuse. By definition domestic violence which generally involves intimate partner violence describes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. Child abuse on the other hand is any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child. Lastly elder abuse refers to an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult. (CDC, 2019). Some of the characteristics to look for while assessing domestic violence are; when an individual is fearful of their partner who is in most cases the abuser, when the abuser acts in a controlling manner, when they yell and throw things around, when the victims sustain but hide body injuries, when the victims isolate themselves, are depressed and engage in health risk behaviors like smoking, excessive drinking and even suicidal attempts. Secondly, ways of recognizing child abuse include; when the child has unexplained burns, bites, bruises, broken bones or black eyes, seems frightened by the presence of the abuser who may be a care giver, when a child becomes watchful as though preparing for something worse to happen, when the child starts abusing animals or other kids, when they show change in behavior by being rude or intentionally careless and when they get overly protective of their private parts among others. Lastly, signs of adult abuse include; poor hygiene, injuries such as bruises, cuts and broken bones, symptoms of anxiety, depression or confusion, weight loss, unexplained transactions of money and withdrawal from family members et cetera (CDC, 2019)
Due to the negative impacts of health from such issues, health institutions have devised policies and procedures of reporting these types of abuse. In my facility, the purpose of the abuse policy is to identify, document and report suspected abuse, neglect and/or assault and to offer appropriate resources to patients and their families. If a healthcare professional suspects any of the above types of abuse or neglect, they are legally mandated under the state of North Dakota to report it by completing a given form specific to the type of abuse. Once completed, they are expected to notify the social worker or case manager of its completion, who will then make contact with the appropriate agency. The social worker then documents pertinent information related to the specific forms in power form. Also, while doing these necessary procedures, the professionals first priority is ensuring safety of the patient from the suspected abuser. If the victim is a child for example, the child may be kept in the custody of the hospital for not more than 96hours and the healthcare provider must notify the juvenile court and the department of children in order that child-protective proceedings may be instituted. Conclusively, it is important to educate families on such signs of abuse and also provide them with contact information of resources that can ensure their safety in the event that any of these abuses is suspected (Falkner, 2018)
References.
Center for Disease Control and Prevention, (2019). Injury center: Violence prevention. Retrieved from https://www.cdc.gov>violenceprevention
Falkner, A. (2018). In GCUs Health Promotion: Health and Wellness Across the Continuum. Retrieved from
https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php
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