In emergency department, a client with facial lacerations states that her husband beat her with a shoe. After health care team repairs her lacerations, she waits to be seen by crisis intake nurse, who will evaluate continued threat of violence. Suddenly client’s husband arrives, shouting that he wants to “finish job.” What is first priority of health care worker who witnesses this scene?

Correct Answer: B. Calling a security guard and another staff member for assistance.

The health care worker who witnesses this scene must take precautions to ensure personal as well as client safety but shouldn’t attempt to manage a physically aggressive person alone. Therefore, the first priority is to call a security guard and another staff member. Domestic violence is defined as a pattern of abusive behaviors by one partner against another in an intimate relationship such as marriage, dating, family, or cohabitation. In this definition, domestic violence takes many forms, including physical aggression or assault, sexual abuse, emotional abuse, controlling or domineering behavior, intimidation, stalking, passive/covert abuse, and economic deprivation.

• Option A: After doing this, the health care worker should inform the husband what is expected, speaking in concise statements, and maintaining a firm but calm demeanor. This approach makes it clear that the health care worker is in control and may diffuse the situation until the security guard arrives. Nurses can play an important role in working toward the creation of a violence-free community but they must first become informed. They must then insist the organizations in which they work to accept this responsibility and work together to create environments that support people experiencing domestic violence.
• Option C: Telling the husband to leave would probably be ineffective because of his agitated and irrational state. Although the exact rates are widely disputed, especially within the United States, there is a large body of cross-cultural evidence that women are subjected to domestic violence significantly more often than men. In addition, there is broad consensus that women are more often subjected to severe forms of abuse and are more likely to be injured by an abusive partner. According to a report by the United States Department of Justice, a survey of 16,000 Americans showed 22.1 percent of women and 7.4 percent of men reported being physically assaulted by a current or former spouse, cohabiting partner, boyfriend, girlfriend, or date in their lifetime.
• Option D: Exploring his anger doesn’t take precedence over safeguarding the client and staff. Gender roles and expectations play a role in abusive situations, and exploring these roles and expectations can be helpful in addressing abusive situations. Likewise, it can be helpful to explore factors such as race, class, religion, sexuality, and philosophy. However, studies investigating whether sexist attitudes are correlated with domestic violence have shown conflicting results.