Nova Scotia launches assault on assault
CMAJ 2000;162:1465
In addition to asking patients where it hurts, doctors and nurses in emergency rooms, hospital admitting centres and clinics throughout Nova Scotia will now be asking if they have been "hit, kicked or punched by your partner or somebody else" in the past year.
This assault on assault is part of a new provincial department of health policy. "This project certainly demonstrates the health care sector's support for family violence prevention and our commitment to achieving zero tolerance toward violence," says Health Minister Jamie Muir.
Data point to a need for action. It is estimated that about 25% of all Canadian women are abused, and Statistics Canada says the figure is even higher for Nova Scotia — 32%. Although not all victims of abuse are female, the vast majority are, and many — 27%, according to the literature — end up in an emergency room for treatment of some problem.
"If a women comes in with an ingrown toenail, she still has a 27% chance of having been abused or being in an abusive relationship," explains Dr. Sam Campbell, an emergency room physician at the Queen Elizabeth II Health Sciences Centre in Halifax. "That emergency department visit might be our only chance to catch her and try to intervene in her particular situation."
It appears that many women currently slip through the cracks. Last year at the QE II only 68 patients, 2 of whom were men, were referred for help as a result of abuse. "This represents 0.18% of the female patient load that the literature suggests we should be identifying," notes Campbell.
Although it is up to each hospital and health care facility to develop its own screening policies and processes, the Department of Health will spend $25 000 on a training program to ensure that health care professionals are asking the right questions in the right way. — Donalee Moulton, Halifax
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