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Untying our hands : the social context of nursing in relation to violence against women

University of British Columbia

Violence against women and children is acknowledged to be a health problem of epidemic proportions, yet the health care response has been inadequate at best. This ethnographic study examined the relationship between the social context of practice and the way in which nurses recognize and respond to women who have been abused. Data collected over two years in two hospital Emergency units and communities included about 200 hours of field work, as well as interviews with 30 health care providers and five women who had been abused. These data support other research showing that violence against women is neglected within health care. Abuse was largely unrecognized, with "blatantly obvious" consequences of physical violence being most recognized. Importantly, violence was often anticipated predominantly among poor and "non-white" people. When abuse was recognized, intervention focused on the physical results of violence, and the social and emotional consequences were often ignored. When abuse was addressed, such efforts were often attempts to influence the woman toward choices that she may not want or actually have, or worse, choices that may endanger her further. However, health care providers also intervened by offering and respecting choices in a manner that was congruent with the needs of the women interviewed. Data analysis suggested that the predominant pattern of routine practice in Emergency, in which patients are efficiently processed in accordance with an ideology of scarcity, fosters the neglect of violence. It is argued that violence and abuse are neglected because the power of dominant interests is exercised through ideologies which are congruent with neglect. As individuals work within a social context in which dominant interests shape their everyday worlds and provide the lenses through which they interpret their world and personal experiences, practices are mostly congruent within dominant interests. In order to attend to violence against women in a meaningful manner, it is argued that individuals at all levels of decision-making in society, from the corporate elite, to health care policy-makers, to nurses at the bedside, must develop a critical consciousness regarding domination, and the ways certain interests in society are served.

Thesis/Dissertation

application/pdf

2009-04-17

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http://hdl.handle.net/2429/7342

Nursing

University of British Columbia

UBCV

DSpace