By Carol A. Cates, MSN, MBA, RN, NEA-BC
Chief Nursing Officer
Odessa Regional Medical Center
If you are being admitted into a hospital and even sometimes at the doctor’s office, there are several questions you might be asked by the staff. They’ll ask about allergies, the medications you are taking, how you get around at home, and many other questions about your current health, health history, and environment. All of those are very important, but today, I want to talk about the ones that are hard to ask — and for many people hard to answer. Those are the questions about domestic violence, sexual assault, depression, and thoughts of suicide.
I remember as a young nurse how hard those were for me to ask, because I didn’t really know what I would do with the answers. I would try to ask them as quickly as I could and just get past them. Then I had a cousin lose one of her children to suicide. One of the things she said about a year after he died has stuck with me ever since, “I wish I had known to ask if he was suicidal, I wish someone who knew had told me to ask.” Ever since then, asking has not been nearly so hard, because I now understand why those questions are so important. Asking those questions could save a life.
Just as important — if not more important than the questions about domestic abuse, sexual assault, depression, and suicidal thoughts, are the answers. A few years ago, The University of Utah published a study in which 47.5% of patients who felt like they faced one or more of those four threats did not disclose this information to their caregivers. The authors stated embarrassment, fear of judgement, and fear of long-term implications as reasons people did not share the information. The authors discussed that those numbers were probably low because they were depending on people to disclose information that they had been hiding. I’ll be honest, that study breaks my heart. Because I have seen, not just with my cousin’s son, but far too many other times, where someone asking, and someone answering would have saved a life. Embarrassment and fear shouldn’t weigh heavier than life.
Doctors and hospitals can help people get the resources they need to make sure they are safe. Doctors also need to know this information to provide the best care to their patients. For instance, if someone has been sexually assaulted, their doctor is going to know to watch out for sexually transmitted diseases or post-traumatic stress disorder. The issue with talking about these things is trust. This is one of the many reasons why having a relationship with a primary health care provider is so important. Trust is earned — and that takes a relationship. Patients have to trust their health care provider is not going to judge them, further endanger them, or embarrass them. Doctors and healthcare providers need to make sure that they give the space and time for patients to bring up those difficult subjects and/or answer those difficult questions, and that they demonstrate to patients that they can be trusted.
One of the things I remind nurses and other healthcare professionals on a regular basis and try to live by in my own practice is that we are in the caring business, not the judgement business. I wish I could say that is true for every health care provider, every day, and with every patient. Unfortunately, we are not always perfect at that — myself included. But I do know that people in the healthcare business want to make a positive difference for patients — and that means we don’t judge, we don’t embarrass, we help.
If you are one of those people who can answer yes to one of those 4 hard questions: Are you a victim of domestic violence? Are you a victim of sexual assault? Are you suffering from feelings of depression?
Have you ever felt suicidal or felt like killing yourself? If so, please, please reach out to a healthcare provider or someone else you trust. They won’t judge and they won’t embarrass you. They will help and protect you.
If you are experiencing or have experienced domestic violence, sexual assault, stalking, dating violence, or other forms of related abuse, help is available. Call the Teen Dating Abuse Hotline at 1-866-331-9474; Victim Connect at 1-855-484-2846; or the National Domestic Violence Hotline at 1-800-656-4673.
For 24/7 mental health support in English or Spanish, call the Substance Abuse and Mental Health Services Administration’s free help line at 800-662-4357. You can also reach a trained crisis counselor through the Suicide and Crisis Lifeline by calling or texting 988.
