Definitions
How does intimate partner violence (IPV) differ from general conflict in a relationship? Provide two defining features that make IPV unique.
IPV is a pattern of power and control exerted by one partner over another.
Unlike normal conflict (which can be mutual and situational), IPV is repetitive, intentional, and rooted in domination, often involving coercion, threats, intimidation, isolation, and/or abuse (physical, emotional, sexual, financial).
CNO Code of Conduct, Principle 1: Nurses respect clients’ privacy and confidentiality (CNO, 2019).
How does this principle apply when caring for Meredith in an IPV situation?
Confidentiality protects Meredith’s immediate safety, as disclosure could increase risk if her partner finds out.
It helps build trust and rapport, creating conditions where she may feel safe enough to disclose in the future.
RNAO BPG emphasizes that maintaining privacy is a critical first step in safe screening for abuse (RNAO, 2012).
What is the primary goal of the BC Domestic Violence Response Framework?
To improve safety for victims/survivors and their children
To create a consistent, coordinated response across sectors
To support best practice development at the community level
Which Way of Knowing is applied when the nurse uses an IPV screening tool and draws on research evidence?
Empirical knowing → grounded in science, research, and evidence-based tools
Involves facts, organized descriptions, and objective knowledge (Lindell & Chinn, 2022).
How does “leadership at the bedside” go beyond managing tasks, and how does the RNAO Woman Abuse BPG support this interpretation?
Leadership is not about authority but about shaping care practices in real time.
Bedside nurses lead by identifying abuse cues, prioritizing safety, and initiating conversations.
RNAO BPG: Nurses have a professional duty to recognize and respond to woman abuse using evidence-informed approaches (RNAO, 2012).
Supported by Patrick & Jackson (2022), who highlight nurses’ role in early recognition and intervention.
In Meredith’s case, where she minimizes her injuries but then accepts her partner’s apologies, how does the cycle of abuse help us interpret her behaviour?
Meredith minimizes her injuries and later accepts her partner’s apology, which reflects the reconciliation phase of the cycle of abuse.
The cycle explains why survivors may remain in or return to abusive relationships. Temporary affection creates hope for change.
Recognizing the predictable pattern helps nurses identify risk factors and intervene, even when disclosure of abuse is limited.
CNO Entry-to-Practice Competency 1.8: Advocates for health equity and access to resources (CNO, 2019).
What advocacy action could the nurse take for Meredith?
Advocate by connecting her to appropriate resources (e.g., shelter, legal aid, counselling) and ensuring she is aware of her options.
Act as a liaison with the interprofessional team so her needs aren’t minimized or overlooked.
RNAO BPG directs nurses to actively provide and explain available supports, rather than leaving the responsibility solely with the client. Don't simply provide a pamphlet!
What does applying a “power lens” mean in this framework?
Shift from gender lens → focus not only on women, but all survivors
Recognizes IPV as a power-based crime (control, domination, fear, isolation)
Frames nursing care around patterns of power and control, not just physical violence
Ensures practice is inclusive (any gender, relationship type)
When the nurse reflects on her own biases and emotional reactions before approaching Meredith, which Way of Knowing is she using?
Personal knowing → requires self-awareness and authentic engagement with others
Guides nurses in building trust without projecting bias (Lindell & Chinn, 2022).
In Meredith’s situation, her partner remains in the room during the assessment. What informal leadership action should the nurse take, and how does the RNAO BPG justify this decision?
Leadership = advocating for private screening by requesting to speak with Meredith alone.
Protects confidentiality, reduces intimidation, and increases likelihood of disclosure.
RNAO BPG: Screening should occur without partner or children >3 years present (RNAO, 2012).
“Coercive control” and “social abuse” are sometimes confused. How are they distinct, and why does this distinction matter in nursing assessment?
Coercive control = an overarching pattern of domination (restricting freedom, decision-making, independence).
Social abuse = a specific tactic within coercive control (isolating someone from friends/family, sabotaging relationships).
Why it matters: Nurses must recognize coercive control as the bigger picture, not just individual acts; otherwise, the severity of IPV may be underestimated.
CNO Code of Conduct, Principle 2: Nurses work with clients to promote safe care environments (CNO, 2019).
What does promoting a safe environment look like for Meredith?
Requesting to speak with her privately without her partner present to reduce intimidation and promote disclosure.
Using trauma-informed communication (calm, nonjudgmental, validating) to avoid retraumatization.
RNAO BPG notes women should be screened alone, never with a partner or children >3 years present, as this compromises safety. (RNAO, 2012).
Why is coordination across services considered a best practice in responding to domestic violence?
No single service can meet all survivor needs
Promotes integrated response (healthcare, social work, child protection, justice system, settlement services, etc.)
Improves safety and access for marginalized groups
Linked to lower re-offending rates
Meredith avoids eye contact and appears hesitant. The nurse softens her tone, leans forward, and asks gently: “How are things at home?” Which Way of Knowing guides this response?
Aesthetic knowing → the art of nursing; perceiving meaning in a situation and responding intuitively
Uses empathy, creativity, and skillful communication (Lindell & Chinn, 2022).
How can a nurse demonstrate leadership when collaborating with the interprofessional team if Meredith is hesitant to disclose?
Leadership = facilitating coordination (social work, child protection, shelters, legal resources) even if disclosure is limited.
Involves initiating respectful communication and ensuring Meredith’s story is not minimized or dismissed.
RNAO BPG: Stresses the importance of linking survivors to community supports and ensuring care is coordinated across sectors (RNAO, 2012).
Supported by Jack et al. (2023), who argue that IPV is a “wicked problem” requiring multi-sector collaboration.
Trauma bonding is often misinterpreted as “choice” or “dependence.” How would you explain trauma bonding to a patient or family member in a way that reduces stigma and blame?
Trauma bonding = a psychological and neurobiological attachment formed when cycles of abuse are paired with intermittent affection.
To reduce stigma: frame it as a survival response, the brain bonds to the abuser as a way of coping with unpredictability, fear, and relief.
Clarify: It is not a sign of weakness or poor judgment, but rather an outcome of manipulation and trauma.
CNO Entry-to-Practice Competency 4.1: Demonstrates leadership in providing care, even without a formal title (CNO, 2019).
How can a nurse demonstrate leadership in influencing the interprofessional team’s response to Meredith’s situation?
Leadership = not just acting at the bedside, but shaping the team’s approach to IPV.
Example: Ensuring Meredith’s safety concerns are raised during interprofessional huddles or handover.
Encouraging colleagues to use trauma-informed language and approaches when interacting with her.
RNAO BPG: Nurses contribute leadership by coordinating with other providers to ensure consistent, supportive care for survivors (RNAO, 2012).
Why is confidentiality such a critical principle in the BC Domestic Violence Response Framework?
Breaches can increase danger for the survivor if the abuser finds out
Maintaining privacy builds trust with survivors
Information sharing must follow legislation and prioritize safety planning
The nurse advocates for system-level changes to improve access to shelters and IPV resources in the community. Which Way of Knowing is being applied?
Emancipatory knowing → understanding and addressing social, political, and systemic inequities
Requires recognizing injustice and working toward change (Lindell & Chinn, 2022).
Meredith expresses fear but also loyalty to her partner. How does a strengths-based leadership approach guide the nurse’s response, and how does the RNAO BPG reinforce this?
Strengths-based leadership = acknowledging Meredith’s resilience, survival strategies, and autonomy instead of framing her as powerless.
Nurse leads by creating space for Meredith’s voice and reinforcing her capacity to make choices.
RNAO BPG: Emphasizes empowerment as central to all nursing interventions in woman abuse (RNAO, 2012).
Gottlieb et al. (2021) also highlight empowerment as a core element of strengths-based leadership in nursing.
The term vulnerable populations is often used broadly. In the context of domestic violence, which groups might be overlooked when we apply this definition too narrowly, and what are the implications for nursing practice?
Commonly listed: women, children, older adults, LGBTQ+, newcomers, and low-income groups.
Often overlooked:
Men and male-identified survivors (due to stigma).
People with disabilities or chronic illness (higher dependency on caregiver/partner).
Indigenous and racialized communities (systemic inequities, racism).
Pregnant individuals (heightened risk of IPV).
Nursing implication: Expanding the definition ensures inclusive screening and safety planning; prevents reinforcing stereotypes (e.g., only women as victims).
CNO Code of Conduct, Principle 3: Nurses are guided by ethical practice: beneficence, nonmaleficence, autonomy, and justice (CNO, 2019).
What ethical tension/problem might the nurse face in Meredith’s case, and how could it be addressed?
Tension: Respecting Meredith’s autonomy (her right to choose whether to disclose or leave) vs. the nurse’s duty to protect her children from exposure to harm.
Address: Balance both by respecting Meredith’s wishes while fulfilling mandatory reporting obligations if children are at risk.
RNAO BPG stresses empowerment and non-coercion, while CNO standards hold nurses accountable for child safety; therefore, this requires a balanced, ethical response (RNAO, 2012; CNO, 2019).
What does “responsivity of services” mean in the framework? Give one example in practice.
Services must be timely, proactive, empowering, and respectful
Example: Nurse provides immediate referral to social work so Meredith doesn’t leave the hospital without supports
Meredith tells the nurse, “I don’t want to get him in trouble, I just need help with my headaches.” How could the nurse apply ethical knowing in this moment?
Respect her autonomy while prioritizing her safety
Balance confidentiality with the duty to report if children are at risk
Ethical knowing involves moral judgment guided by principles of right and wrong (Lindell & Chinn, 2022).
If Meredith declines immediate referral to community resources, what leadership behaviours allow the nurse to uphold safety and trust, while still aligning with RNAO BPG recommendations?
Leadership = balancing advocacy with respect for readiness.
Provide discreet, non-coercive resources (e.g., written info, safety planning tools) and communicate openness for future support.
Maintain trust by not pushing, while ensuring risk assessment and safety remain prioritized.
RNAO BPG: Recommends offering resources in a supportive, nonjudgmental, and non-coercive manner, while prioritizing safety planning (RNAO, 2012).