Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Responding to Disclosure

When responding to a disclosure of woman abuse/IPV, keep the following tips in mind:

  • Always interview in private
  • Believe the client
  • Assess for safety
  • Offer support
  • Ask permission to refer to another resource person

Scenario #1:
Elizabeth, a 23 year old woman is brought to the Emergency Psychiatric Services after neighbours who were concerned about her safety called police.  Neighbours report that Elizabeth appeared to be repeatedly walking out in front of traffic.  Elizabeth is angry and insists that others are not keeping her safe.  The nurse determines from her old case file that Elizabeth has a history of sexual, physical and emotional abuse.  The nurse also notes that Elizabeth has scars on both arms and fresh cuts on both arms.  Elizabeth discloses to the nurse that she remembers something bad that happened in her past.   

 Response:  
  •  Always interview in private:
    o    “Let's go into the interview room or the office to talk about this”
  •  Believe the client:
    o    “Would you like to talk with me about what you are feeling?”
    o    “Did something happen to you before that you are remembering now?
    o    “Do you recall what happened to you in your past? Yes/No…”It’s OK if you don’t remember, that happens sometimes”
    o    “I notice you have cuts on your arms, do you want to talk to me about that?”
  •  Assess for safety: (never assume that a past history of abuse precludes a present history as well)
    o    “Elizabeth, you say ‘others are not keeping you safe’, do you feel safe now?”
    o     “Did something happen to make you feel unsafe?”
  • Offer support:
    o    “Are you receiving any support in the community for these feelings?”
    o    “What other supports do you need/require?” 
     
  • Ask permission to refer to another resource person:
    o    “Can I refer you to someone who can help you with your feelings?”
 
Scenario #2:
A nurse is completing an assessment on a woman with a diagnosis of Schizophrenia, Paranoid Type who is being admitted to a mental health facility. The patient is wringing her hands and looks distressed. The patient frequently stares intently at the nurse but does not seem interested in conversing.  The nurse finds it challenging to engage the patient.  After several hours, the patient comes up to the nurse and tells her that she was assaulted in her apartment last night and she wants to call the police.

Response:

  • Always interview in private:
    o    “Let's go into the interview room or the office to talk about this”
  • Believe the client:
    o    “That must have been a terrifying experience for you, thank-you for sharing this with me”  or “Your experience must have been very frightening” 
    o   “It is not easy to talk about this type of thing.”
    o   “It is not unusual to feel angry, embarrassed and fearful afterward”
    o   “How can I help you now?”
    o    “Are you experiencing any pain?”
    o   “Would you like me to sit and talk with you?”
  • Assess for safety:
    o    “What needs to happen to help you feel safe?"
     
  • Offer support:
    o    “Would you like some support when speaking with the police?” If yes, then:
  • Ask permission to refer to another resource person:
    o     “Can I refer you to someone who can support you when speaking with the police?”