Learning Objective #1: Identify domestic violence as a major opportunity to break the cycle of violence

Learning Objective #2: Understand why women do not reveal DV to medical personnel and understand how battered women perceive the ED

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Abstract Introduction: Domestic violence (DV) on women accounts for three times as many Emergency Department (ED) visits as motor vehicle collisions, muggings and rapes combined. For many women the ED is the only point of entry into the medical system and a major opportunity to break the cycle of violence. ED staff can therefore play a crucial role in addressing this public health crisis. This study attempted to understand why women do not reveal DV to medical personnel and understand how battered women perceive the ED using a qualitative methodology.

Methods: Four female victims of DV were interviewed about their ED experiences related to abuse. Interviews were tape-recorded, transcribed verbatim, and the women's perceptions were compared using van Manen's strategies. Themes were arranged thematically by significance from the perspective of the participants.

Results: Interview themes included: 1) the need for empathy; 2) the need to directly address the issue of DV; 3) the need to educate women on what happens once the abuse is disclosed; and, 4) the need to establish a safe, private ED environment.

Conclusion: Nursing and medical staff must learn to see DV as a complicated psychological, socioeconomic and social problem. ED staff can positively impact these women's lives: 1) empathy may provide the key to disclosure and intervention; 2) education empowers the victim; 3) support networks provide long term options. These women must learn they do not deserve the abuse; they have choices and can make educated decisions regarding their futures. ED personnel must also take steps to ensure these women are safe upon discharge.