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Domestic violence screening may be part of UMC

A UA trauma surgeon is leading an effort to screen patients for domestic violence as they come to the University Medical Center's Emergency Department.

Dr. Amy Sisley, an assistant professor in the University of Arizona Department of Surgery, said emergency health care workers have more contact with victims of domestic violence due to the nature of the victims' injuries.

"You ask a bank robber why do you go to a bank? Because that's where the money is. Well, why do you screen in the ER? That's where the patients are," Sisley said.

This fact presents the opportunity for workers to distribute referral information to victims of domestic abuse, she said.

"We recommend a blanket screening of all female patients above the age of 18," Sisley said. "They are asked if any one has hit, punched or kicked them in the last year."

Fran Bartholomeaux, UMC nursing director for emergency services, said domestic violence is not a new issue.

"The first thing is that this is a problem that we have been dealing with forever," Bartholomeaux said.

Yet, merely acknowledging an abuse problem is necessary for UMC officials, Sisley said.

"The other really important thing to do is reinforce that this is not OK," Sisley said. "You are a person in authority and if you say 'oh, that's too bad, that's wrong, no one deserves to be hit,' it's amazing the difference that it makes to affirm that it is not OK."

She added that often times victims of domestic violence believe that there is a reason that they are being abused, thus believing it is their fault.

But the intention of the screenings is not necessarily to get the women to report the abuse, Sisley said.

The American Medical Association concluded recently that it is "unethical" to require medical personnel to report domestic abuse, Sisley said.

She added that domestic violence screening is quite different from cases of child abuse or even gunshot or knife wounds, all cases in which the police must be contacted.

The screeners of this department recognize that often times the worst domestic violence occurs when women are attempting to leave the relationship, so they want to assure that the woman is ready to make that decision, Sisley said.

"We don't get them to try to report it against the woman's wishes," Sisley said. "We just want to show them that there are people that will help them, there are people that do care. Its more like just opening a door for them."

Sisley said she has found that medical personnel are much more willing to screen for domestic violence if they have a standard procedure and they have the resources to help victims.

In this case, Sisley said, UMC has a kit to distribute that refers victims to various places throughout Tucson where they can receive the proper care.

The project is a joint effort between Sisley, Bartholomeaux and Dr. Daniel Spaite, UMC director of emergency medical services.

Sisley said research on domestic violence has been a focus of her entire career.

In 1999, Sisley led a collaborative effort to write a Domestic Violence Surgery policy paper for the Violence Prevention Task Force.

In the paper, Sisley said domestic violence is the leading cause of serious injury to women between the ages of 15 to 44.

Bartholomeaux said the screening program would provide health care workers with the necessary tools to deal with domestic violence, and could eliminate any hesitancy that workers may feel about discussing the issue.

Bartholomeaux added that more awareness could bring an end to domestic violence.

This program is already in place in the Obstetrics and Gynecology department, and Sisley said she hopes the emergency department will serve as a springboard to bring this screening process to the rest of the hospital.

"Many people don't understand how prevalent and dangerous it (domestic violence) is," Sisley added.