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Gender-based violence nursing: this rewarding new role and its responsibilities

A nursing career that’s improving the healthcare experience of domestic abuse survivors

Gender-based violence nurses are a hub for multi-agency healthcare and safeguarding, and they are meeting an increasingly urgent need

In November 2020, I started my new role as a gender-based violence nurse with NHS Fife in Scotland.

I had not heard of this type of role or service before my post was advertised, but much like trauma, violence against women and girls runs like a thread through every area of mental health.

Violence against women was particularly prevalent in my previous role in a community drug and alcohol service. In Scotland, drug-related deaths among women are increasing despite declining rates of use, with a 2018 report from the Scottish Government showing domestic abuse to be a potential factor as an ongoing source of

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Gender-based violence nurses are a hub for multi-agency healthcare and safeguarding, and they are meeting an increasingly urgent need

Picture: iStock

In November 2020, I started my new role as a gender-based violence nurse with NHS Fife in Scotland.

I had not heard of this type of role or service before my post was advertised, but much like trauma, violence against women and girls runs like a thread through every area of mental health.

Violence against women was particularly prevalent in my previous role in a community drug and alcohol service. In Scotland, drug-related deaths among women are increasing despite declining rates of use, with a 2018 report from the Scottish Government showing domestic abuse to be a potential factor as an ongoing source of stress and trauma.

Multi-agency approach to addressing life factors that put women’s safety at risk

Some of the best work we do as mental health nurses involves addressing the perpetuating factors of distress – the barriers to safety, stability and well-being. To achieve this, we need to ensure good partnership working across services and agencies; one service cannot be all things to all people, nor should it be.

Shared risk management and responsibility means increased support for survivors of gender-based violence from agencies including the police, housing, social work and healthcare.

A gender-based violence team is the key link between external agencies and healthcare services, ensuring good information-sharing and improved health outcomes for survivors and their families.

How gender-based violence nurses support clients

Gender-based violence nursing services offer a more coordinated approach to patient care for survivors of domestic abuse, rape and sexual assault. This includes coordinating follow-up care and screening for survivors of rape and sexual assault, providing periods of support, and referring victims to relevant services and organisations for ongoing counselling or mental or physical healthcare.

‘Healthcare staff do not feel confident identifying important signs. This can lead to missed care, missed opportunities to safeguard women and children and missed opportunities to save lives’

As most services are in their relative infancy, it is not known how many gender-based violence nurses there are across the UK. But much of our work is already well established, with services taking part in multi-agency risk assessment conferences (MARAC), where information is shared about domestic abuse cases.

Referrals come via a number of routes from partner agencies and healthcare services. Some teams provide training to other NHS staff and services on recognising the signs and symptoms of domestic abuse, routine enquiry of abuse, and practical support with making referrals to MARAC and other agencies.

Picture: Christopher Woods

How can I become a gender-based violence nurse?

  • Nurses from every adult speciality have something important to bring to the role, which means you don’t have to have a background in mental health nursing
  • You will need experience of working with women affected by trauma and abuse
  • You should understand the role of MARAC and forensic care pathways
  • You should be willing to undertake further training to develop your knowledge
  • You will need to be tenacious

Gendered risk and vulnerabilities

The title gender-based violence nurse is something of a misnomer because of the broader remit of the role. Existing services support survivors aged 13 and over, including women, men, transgender and non-binary people, survivors of female genital mutilation and women affected by forced marriage and honour-based violence.

The unique risks and vulnerabilities affecting different patient populations are important to understand, but the vast majority of patients accessing gender-based violence services are females affected by male violence, reflecting the broader social patterns of female inequality.

Forensic medical examinations

Following the introduction of The Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill in November 2019, funding has been made available to train female forensic nurse examiners.

For survivors, this means more women available to perform a forensic examination, and self-referral for examination following rape or sexual assault will soon be possible.

At present, forensic examination occurs only after the victim has filed a police report. But the prosecution rate for these crimes is woefully low, and women are understandably reluctant to put themselves through the stress and trauma of an examination and investigation if the chance of seeing justice is limited.

‘The need for nurses to develop their understanding and confidence in navigating violence against women and girls is only becoming more important with time’

Under the Bill, survivors are given the option to retain forensic evidence for several years whilst they decide whether or not to make a police report. We anticipate that bypassing the police will lead to increased numbers of reports, with gender-based violence services also likely to also see an increase in referrals from nurse examiners for follow up care and support.

Healthcare professionals’ lack of confidence in identifying signs of abuse

Despite the prevalence of domestic abuse, rape and sexual assault, these crimes are vastly under-reported by women. Survivors are often in contact with acute healthcare services for injuries and will present to other services with physical or emotional signs of abuse. But research repeatedly shows healthcare staff working across a variety of services do not feel confident identifying and responding to these important signs.

This can lead to missed care and missed opportunities to safeguard women and children. In the worst-case scenarios, they are missed opportunities to save lives.

Gender-based violence nurses are an essential pivot between services and agencies

Reports of domestic violence and abuse have risen significantly during the COVID-19 pandemic, with the level of risk escalating as women are forced to remain indoors with their abusers. The need for nurses to develop their understanding and confidence in navigating violence against women and girls is only becoming more important with time.

Gender-based violence nurses provide an important link in a variety of different areas that support an improved and more coordinated healthcare response. It is my hope we can continue to invest in growing and developing these services to deliver on global and national strategies to end violence against women, and to provide support and care co-ordination for anyone affected by abuse, rape and sexual assault.


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