Beyond the Bedside, Nurses Work to Stop Violence

    • July 15, 2015
Mother looks over her son as he lies in a hospital recovering from a violent attack.

Maine may be much better known for its quaint fishing villages than for its violent crime. But that reputation masks an epidemic of child abuse, says Kathleen Wall, RN, a nurse turned youth advocate. The number of cases of physically abused children in the Pine Tree State is surging—and is much higher than the national average, according to news reports.

Abuse and neglect often go unnoticed in Maine, Wall says, because the population is spread out and resources are spread thin. When it comes to child abuse, she concludes, “Nobody’s watching.”

Wall, for one, is watching. After seven years working with the state’s only physician who specializes in child abuse, the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program alumna decided to take action to prevent more kids from experiencing abuse and neglect. In 1999, she teamed up with local advocates to build a safe haven for low-income youth after school—a high time for abuse and neglect.

Today, the Augusta Boys and Girls Club for Teens provides no-cost after-school programming, a summer camp, an alternative-to-suspension program and other services for low-income youth. It has spurred more than 100 youth to go back to school or to complete higher degrees—many of whom are the first in their families to do so. This program has applied the brakes to cycles of abuse. Many participants have gone on to become “better parents to their children than their parents were to them,” Wall says.

Like many other nurses, Wall is working to end violence and help survivors—in homes, schools, communities and through state and federal policies.

These nurses—some of whom are supported by RWJF—are conducting groundbreaking scientific research and launching and leading initiatives to raise awareness and prevent child abuse and neglect, interpersonal and domestic violence, sexual assault and rape, stalking, bullying, gang and youth violence.

They are working independently to support RWJF’s mission to create a culture in which all people have the means and the opportunity to make choices that lead to the healthiest lives possible and where businesses, government, individuals, and organizations work together to foster healthy communities and lifestyles.

“To build a Culture of Health we need to ensure that all families—especially those with young children—have access to the social and emotional building blocks of physical and emotional well-being,” RWJF President and CEO Risa Lavizzo-Mourey, MD, MBA, said in her annual president’s message. “We must work to reduce the number of children exposed to adverse experiences of extreme poverty, family violence, substance abuse and other forms of toxic stress that can compromise their lifelong health.”

Nurses like Tina Bloom, PhD, RN, MPH, an associate professor at the University of Missouri Sinclair School of Nursing and an RWJF Nurse Faculty Scholar, are working toward that goal. Bloom is studying ways to reduce women’s and children’s exposure to violence and mitigate its long-term health consequences. Currently, she is developing and testing access to an online tool to help women at risk—especially those in rural or remote areas—make plans for their safety.

Battered women frequently take steps to protect themselves and their children, Bloom says. But many don’t make formal safety plans because they aren’t aware of or don’t have access to safety planning services, or because they fear their abusers will find out if they reach out for help.

A Virtual Advocate

Bloom aims to help these women get virtual support from an online safety planning program that can help them assess their risk for violence, identify social services and supports in their communities and make plans to achieve short- and long-term goals.

“Giving abused women feedback about their risk is eye-opening and important,” Bloom says. “We need to connect women with the information and resources that can help them and develop innovative ways so abused women can help themselves.”

In New Jersey, Tracy Perron, PhD, RN, is tackling a different kind of violence: bullying.

An assistant professor of nursing at the College of New Jersey and an RWJF New Jersey Nursing Scholar, Perron developed an interest in the subject as a substitute nurse in her local school, where she cared for students who were victims of bullying.

School nurses have a critical role to play in the effort to prevent and respond to bullying, she says. They can treat physical and mental health problems caused by bullying—which can range from depression and mental health problems to violence inflicted on themselves or others. And they are trusted providers for kids who may be reluctant to confide in parents, teachers or administrators. “The best thing about school nurses is that they’re not part of the administrative system,” she says.

Yet nurses are vastly underutilized in efforts to combat bullying—a phenomenon that Perron is working to change through her post-doctoral research. She is surveying school nurses to determine their level of participation in New Jersey’s newly mandated bullying task forces—now in place in every school district—and to identify other work they do to stop bullying.

The results are not yet in, but early signs suggest that school nurses have the potential to play a much bigger role on the school task forces and in combating bullying more generally. “People don’t understand the role that school nurses play and why they are such a valuable part of preventing the problem,” she says.

Learn more about RWJF-supported work to stop violence such as Cure Violence