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OB Tutoring
Vulnerable Populations
| Term | Definition |
|---|---|
| IPV | any actual or threatened psychological, sexual, or physical harm of one current or past partner by the other. It's characterized by a power imbalance, where one partner exerts control over the other IPV often accelerates during pregnancy |
| IPV: Vulnerable Populations | are groups of people at higher risk for poor physical, psychological, or social health due to various factors like: ○ Age ○ Sex or Gender ○ Genetics (Incl. Disability) ○ Marginalized Communities ○ SES |
| IPV: Affected Groups | ○ SMWs are at increased risk for IPV, STIs, substance abuse and mental health issues due to discrimination, stigma, and civil and human rights violations |
| IPV: Affected Groups | ○ Incarcerated Women: should be screened for pregnancy upon incarceration and receive the same standard of care as a non-incarcerated pregnant woman |
| IPV: Affected Groups | ○ Patients with Eating Disorders: Pregnancy can have detrimental changes to the body of a person with an eating disorder, focus on supporting these patients by not including any information about weight gain |
| IPV: Affected Groups | ○ Sexual Assault: Pregnancy at this time may be forced due to the patient's beliefs, or state/country regulations and laws. A reminder that RNs are mandated reporters* |
| IPV Red Flags | ● Scripted or inconsistent history. ● Unwillingness or hesitancy to answer questions about their injury or illness. ● Fearful or nervous behavior, or avoidance of eye contact. ● Resistance to assistance or hostile behavior. |
| IPV Red Flags | ● Being accompanied by an individual who does not allow the patient to speak for themselves, refuses to let the patient have privacy, or interprets for the patient. ● Being unaware of their location, the current date, or time. |
| IPV Red Flags | ● Exhibiting signs of being in a controlling or dominating relationship, such as excessive concern about pleasing a family member, romantic partner, or employer. |
| IPV Red Flags | ● Inability to provide their address or lacking possession of their identification documents. ● Being not in control of their own money, not being paid, or having wages withheld |
| Assessment (IPV & Vulnerable Populations) | ○ Nurses should question patients when they are alone. ○ Trust is essential in the RN-patient relationship, IPV may not be disclosed initially or in the first few encounters ○ A thorough assessment should include questions about safety at home |
| Assessment (IPV & Vulnerable Populations) | ○ It is crucial to avoid victim-blaming or judgment (verbal or nonverbal) during an assessment/screening ○ Safety should be continuously assessed and considered, however, most victims of IPV are not in immediate danger |
| Safety Planning (IPV & Vulnerable Populations) | ○ Reduce the risk of escalating violence and/or create signals to alert other staff for help in removing the patient ○ Victims know their situation and RN should support the patient's decision |
| Safety Planning (IPV & Vulnerable Populations) | ○ RNs should assist patients in developing a safety and exit plan |
| Clinician Interventions | ○ Safety: the highest priority ○ Empowerment: Facilitate self-determination ○ Abuser Accountability: Hold the perpetrator responsible for the violence and resolution, NOT the victim |
| Clinician Interventions | ○ Advocacy: Advocate within and beyond the healthcare setting for political, legal, and social change ○ Change: Continuously seek ways to improve the delivery of care to victims |
| Clinician Interventions | ● Nurses should be aware that their words and actions are very important and can have a significant positive or negative impact on the situation. |
| Clinician Interventions | ● Victims of IPV may experience long-term consequences such as post-traumatic stress syndrome, anxiety, suicidality, eating disorders, or chronic pain |
| Mandated Reporting | ● Mandated reporting laws vary by state and situation. ● In New York, nurses are required to report suspected child abuse or maltreatment when they have reasonable cause. |
| Mandated Reporting | ● Mandatory reporting laws also extend to other vulnerable populations such as dependent adults, the elderly, and patients with disabilities. ● Documentation of abuse is crucial and should include physical examination findings and the patient’s report |
| Human Trafficking | is the recruitment, transportation, transfer, harboring, or receipt of people through force, fraud, or deception, to exploit them for profit ○ Exploitation Types: Labor or Sex |
| Human Trafficking: Vulnerable Populations | ■ Individuals with unstable living situations ■ Those with a history of abuse or neglect ■ Those with a history of substance abuse ■ Those with mental health conditions |
| Human Trafficking: Nursing Care & Considerations | ○ Confidentiality: ■ Victims of human trafficking and those who care for them are at risk of harm from traffickers. ■ Care should be taken to maintain confidentiality and clinic security. |
| Human Trafficking: Nursing Care & Considerations | ○ Documentation: ■ Careful documentation of findings is required. |
| Human Trafficking: Nursing Care & Considerations | ○ Resources: ■ Patients are not always able to leave immediately once identified. ■ Information given to them should be memorized if possible, as they may not be able to safely keep written documentation |
| Human Trafficking Differentiation from IPV | ○ Although both IPV and human trafficking involve abuse and control, human trafficking is fundamentally about exploitation for profit, whereas IPV is about power and control within a relationship. |
| Human Trafficking Differentiation from IPV | ○ However, there is a strong overlap between IPV and human trafficking, and those experiencing IPV may be at risk of being trafficked |
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