Abuse obscured: an ethnographic account of emergency nursing in relation to violence against women.
Violence against women is a significant health issue in Canada and around the globe, yet the health-care response has been inadequate. While various reasons for this inadequacy have been suggested, little systematic research has been undertaken. This ethnographic study of 2 hospital emergency units was conducted to describe nursing practice in relation to violence against women. Participant observation and interviews with 25 healthcare providers and 5 patients in the 2 units were complemented by interviews with 5 nurses from other emergency units. The findings illustrate that abuse is obscured and practice shaped by stereotypical thinking and a focus on physical problems and rapid patient processing. Perceptions of patient deservedness influenced care that ranged from "doing nothing" to actively offering the patient choices. This description provides a basis for designing meaningful education for nurses and systemic changes that will foster more effective practice.
Varcoe
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School of Nursing, University of Victoria, Lower Mainland Campus, Vancouver, British Columbia, Canada. cvarcoe@telus.net
D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002755:Choice Behavior; D003717:Denial, Psychological; D004509:Education, Nursing, Continuing; D016529:Emergency Nursing / Q000193:education / Q000379:methods* / Q000592:standards; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D020380:Needs Assessment; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000592:standards; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D010344:Patient Advocacy; D011209:Power, Psychological; D013179:Spouse Abuse / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D013240:Stereotyping; D011795:Surveys and Questionnaires