Screening for abuse in the clinical setting

Physical examinations can be positive patient experiences, providing reassurance, education, and case finding. However, examinations also can be extremely anxiety provoking because of feelings of shame and embarrassment about visible injuries from an abuser. They also may provoke flashbacks related to incest, child sexual abuse, and rape. Nurses involved in clinical assessment of any kind need to be aware that a patient's history often affects her response to clinical evaluation. Asking a patient about abuse before evaluation is respectful and empowering and often establishes a valuable opportunity for intervention.