Recognizing victims of physical and sexual abuse

The continued victimization of children, women, and the elderly remains a problem for health care professionals. Although signs of physical and sexual abuse are easier to diagnose, patterns of neglect in children and the elderly and the terrorizing of women are not so apparent and require a level of detective work on the part of the nurse. Except for physical and sexual assaults perpetrated by strangers, victims of abuse or neglect are often hesitant to reveal the abuse or to cooperate with health care workers because their safety is often not guaranteed. This challenges nurses to be very skilled in detecting abuse and pursuing a course of action that does not further jeopardize the safety of the patient or victim. Combined competencies in physical assessment, interpersonal relationships, and interviewing are important in the assessment phase. Knowledge of protective laws and of community resources that could be immediately triggered to support the patient and family are critical intervention skills.