"No woman ever has to leave that hospital and go home to her abuser. We can get her to safety, quickly and discreetly. But first, she has to drop the secret and tell us. To do that, we must keep asking the right questions until she can trust us," says Elda Ramirez, assistant professor of clinical nursing at the UT School of Nursing and division head of emergency care.
Ramirez has seen it all and screened it all during triage at Memorial-Hermann Hospital Emergency Center. "And the best screening tool for domestic violence is the question, 'Is this injury, condition, accident due to any trauma at home?' In other words, 'do you feel safe at home?'"
Ramirez applauds relatively recent mandates that require emergency room personnel to ask the tough questions of their patients and most important, to pay attention to what is not said. "The Joint Commission of Accreditation of Healthcare Organizations (JCAHO) provides good screening guidelines for both male and female patients; for adult and child abuse. If you screen well for domestic issues, oft times, you will find them."
Fresh assault wounds that match the mechanism of injury and don't match a flimsy cover story are usually discernable by a trained eye. "It's the vague headaches, odd pregnancy pains that two extra minutes of careful questioning can pinpoint as abuse," Ramirez says.
Abused women are often brought to the hospital by the abuser. "And he will not leave her bedside for fear that she will talk. He will often answer all medical questions for her, even when we assertively direct him to quit answering," Ramirez says. "If we can get her alone, we can offer her immediate assistance, shelter and security from that moment forward through a variety of social agencies."
Ramirez says it is a straightforward process. "Two questions: 'Are you being abused by this man?' If so, we can take you from this hospital to a safe place. 'Are you ready to do this?' If so, we call for security protection and we start the ball rolling."
UPDATED: 1-08-2005
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Dr. Ann Coker is an associate professor of epidemiology at the UT School of Public Health.
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Dr. Joan Engebretson is a professor at the UT School of Nursing.
See Dr. Engebretson also at:
Men: Pay Attention
to Your Bicycle Seat
Men who bike more than three hours a week should be aware that standard bicycle seats, ridden for extended periods, can cause temporary numbness and, in some, more serious problems, such as erectile dysfunction.
Such problems are caused by compression of an artery and a nerve connected to the penis. New seat designs to minimize compression are now available.
Other preventive measures you can incorporate:
