NURSES’ EXPERIENCES OF INTIMATE PARTNER VIOLENCE IN HOME VISITING

Abstract

In the United States, intimate partner violence (IPV) is the most common cause of non-fatal injury for women. The Nurse-Family Partnership (NFP) is an evidence-based maternal and early childhood health program where nurse home visitors seek to develop therapeutic relationships and provide health promotion interventions with low-income, young pregnant women and first time mothers and their children, from early in pregnancy until the child’s second birthday. In this program, nurses have a responsibility to identify women exposed to abuse and provide supportive interventions. The purpose of this study is to understand the impact of this work on nurse home visitors’ professional and personal selves. A secondary qualitative content analysis was conducted using a sample comprised of 27 nurses, 18 community partners, and 4 nurse supervisors from an original case study by Jack et al. (2012) for the development of a nurse home visitation IPV intervention. Conventional content analysis and constant comparative techniques were used to code 8 nurse focus group transcripts and 43 transcripts from face-to-face, semi-structured interviews with the community partners and supervisors. Nurses identify that clients are exposed to multiple types of violence. These experiences increase the complexity of delivering the NFP home visitation program. Nurses also experience high levels of uncertainty related to how to respond to disclosures, and how to address IPV. The presence of IPV also significantly impacts many facets of the nurse-client relationship. At times nurses struggle with wanting to “fix” the client’s relationship with her partner; yet understand this is not a healthy response. Setting boundaries and clearly defining one’s role in this work is complex, and many nurses experience high levels of anxiety, worry and fear for their clients. Supervisors and community members confirm nurses’ experiences but also provide strategies for reflective supervision and community level support. Nurse home visitors are in a unique position to provide care for women exposed to IPV and recommendations are provided for nursing education, practice and research in this field.