Domestic abuse is a serious global problem and has greater, negative effects on long-term health than more obvious diseases, such as diabetes. Nurses and midwives are well-placed to recognise and respond to domestic abuse but many lack confidence in this area. There is firm evidence that training can increase the confidence of registered nurses and midwives in responding to domestic abuse. But the issue of undergraduate preparation is significantly under-investigated. We undertook a qualitative study in the UK to investigate student nurses’ and midwives’ knowledge, confidence and educational needs regarding recognition and responses to domestic abuse. We ran eight focus groups with a total of 55 students.
Students in the study viewed the issue of domestic abuse as important and they possessed sound theoretical knowledge of its nature and consequences. However, they lacked confidence in recognising and responding to abuse and they perceived this as a cyclical state of disempowerment that would impact negatively on their practice and on their own ability to support nursing and midwifery students of the future. Two students told us:
I think it perpetuates itself because if we leave not being prepared, then we're going to feel embarrassed or not sure how to talk to our students about it. And then that's probably why they don't want to talk about it, because they [Registered Nurses] feel that ‘oh it's this thing that I should know stuff about - but I don't’.
We've got to the end nearly [of our programme] and like my biggest concerns are how my training has prepared me - or hasn't prepared me – and the feelings of anxiety that I've got. And so it was productive use of my time to come to something like this [focus group], than to just complain and moan and internalise worries that I might have had about the three years that have gone already.
Interactive learning opportunities that engaged with service-users and involved experts from practice were viewed as important educational requirements. Since undertaking the study we have begun to integrate coverage of domestic abuse into the nursing curriculum locally. This is a small step in the right direction, but it needs to be more widespread if we are to avoid the culpability of producing future generations of graduates who are ill-prepared to deal with such an important area of nursing practice.
Caroline Bradbury-Jones, RN, RM, PhD
University of Birmingham, School of Health and Populations Sciences
Bradbury-Jones, C & Broadhurst, K. (2015) Are we failing to prepare nursing and midwifery students to deal with domestic abuse? Findings from a qualitative study. Journal of Advanced Nursing, DOI: 10.1111/jan.12666