New Australian study shows nearly half of female healthcare workers have experienced domestic abuse

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A landmark study investigating domestic and family violence among female healthcare workers in Australia has found that almost half of them (45%) have experienced family violence, including one in nine who had experienced abuse and violence by a partner during the previous 12 months. The study, involving 471 Victorian female healthcare workers, also found that one in eight women had been sexually assaulted by a partner since the age of 16.

Published in the journal BMC Women’s Health, the study "It happens to clinicians too": an Australian prevalence study of intimate partner and family violence against health professionals is the first to show that domestic and family violence are common in the personal lives of Australian healthcare workers.

Lead researcher Elizabeth McLindon from the University of Melbourne and the Royal Women’s Hospital said the study had important implications, particularly as healthcare workers often provided front line support for patients experiencing domestic and family violence.

“Healthcare workers are increasingly required to identify and support women and children who have experienced family violence,” Ms McLindon said. “For some workers, it may result in them going the extra mile in supporting survivor patients, but for some women, it could also trigger personal trauma to hear stories of other people’s experiences of violence.”

“Hospitals have an important role to play in supporting their healthcare workers to ensure their wellbeing is not negatively impacted by their day to day work. This may also improve the support provided to survivor patients. Hospitals should implement greater workplace supports that include workplace manager training to respond to disclosures from staff, special leave provision, staff counselling services, family violence training and online resources,” she said.

Ms McLindon said the research also showed that violence occurred across a woman’s lifetime, with around one in four women experiencing family violence in childhood and almost one in eight experiencing both childhood violence and partner violence in adulthood.

Melbourne’s Royal Women’s Hospital Centre of Family Violence Prevention Director and University of Melbourne Professor Kelsey Hegarty is study co-author. She said the study reinforced the reality that domestic and family violence affected all women in the community, even those with high education and financially secure employment.

“As women who experience violence are much more likely to experience depression and anxiety, self-harm and suicide attempts, sleeping and eating disorders, lower self-esteem and alcohol and other drugs misuse compared to women who live free from violence, it is crucial that healthcare staff are supported to have access to services that assist them in their experience of family violence,” Professor Hegarty said.

"I made it my business to try to engage those women"

Sarah* is a nurse in Victoria and said while the rate of family and partner violence among her colleagues seemed high, it did not shock her. 

"I don't know if this is a cliche, but I do feel like people who survive trauma do feel compelled sometimes to then go on and work in helping professions," she said. "I think that makes sense and that inevitably supports the patients, which is really a healthy outcome."

Her own story is testament to this point. Sarah was just a teenager when she was sexually assaulted by her uncle. After moving overseas and putting her life back together, she returned to Melbourne only to experience emotional and physical abuse at the hands of a boyfriend. Then another boyfriend after that.

"Sadly as a 30-something I then found myself in a relationship with a man who was very physically and emotionally abusive," she said.

He too worked in the health sector and what followed was a gruelling time that included Sarah having to get an intervention order.

Now, however, she is happily married with two kids and is using her experience to help others, saying she takes an "entirely different" approach to her job than she otherwise would have. She has gone through extensive therapy to help her process the violence she has experienced, but she is often reminded of the trauma when patients disclose their personal experience of violence to her.

"It took me 14 years after my sexual assault to go and have a pap test because I was completely traumatised by the idea of it," she said. "And I think as a result, certainly in my previous work in community health, it made me much more empathetic to women. I made it my business to try to engage those women who had gone decades without screenings, knowing that it's a very important screening, but also to just allow women to feel comfortable in my space to be able to get that screening done."

Sarah said speaking to those who had suffered family violence could be confronting for her given her own experience, but she considered herself lucky to have had an understanding manager and workplace to help her deal with it.

Sadly, that hasn't always been the case for others.

There is a greater awareness of the profound traumatisation of someone experiencing or recovering from family violence

Katie** is a social worker in Victoria and knows all-too-well the toll that family violence can take on someone. Now in her 50s, she has experienced emotional and physical abuse at the hands of her father, husband and de facto partner.

"When we look at my husband and de facto that's probably a total of just under 20 years. The father of my child continues to perpetrate violence against us. The days of physical violence have gone - it's serious psychological harm, neglect of our child, financial abuse, damage to social reputations, our housing," she said.

She said while her experience makes her an expert as both a healthcare professional and survivor of family violence, she also had to be aware of when the work takes its toll.

"The hindering is that I have to be very aware of my triggers and when I notice them to seek debriefing, clinical supervision, my own personal therapy and time away," she said. 

"I've learnt to step forward and back, depending on what's happening in my own life. This has been made easier by a more understanding work culture now that didn't always exist in the "old days", Katie said. 

"I worked with one person who said, ‘When you turn up to work I expect you to be fit for service. If you're not you should not be here, send in a sick certificate’. So that was the old approach, that's what I experienced when I was going through the breakdown of my marriage. The new approach is incredible because there is a greater awareness of the profound traumatisation of someone experiencing or recovering from family violence,” she said.

And it's not just Katie who is finding this.

In response to the Victorian Royal Commission into Family Violence, Victoria has introduced a number of policies to help staff who have suffered, including access to 20 days of family violence leave. A new program, titled Strengthening Hospital Responses to Family Violence, is being led by the Royal Women's Hospital and rolled out across 89 healthcare services. It is focused on providing services and training for healthcare workers to support both staff and patients.

Katie has a few ideas to add to the list. "There's a lot of vicarious traumatisation that goes on for healthcare workers at the frontline, such as hospitals. So we do need a lot of support. We need flexible support — debriefing, clinical supervision, maybe even some short-term changes in the duties. I think we've become more aware of [family violence] as a society and we're standing up and saying this is morally intolerable," she said.

Sarah said, “having experienced violence and not knowing where to go for help at the time, I always make sure that patients are connected to services where they can receive additional supports. The impact of those disclosures on me personally vary from day to day. Having a brilliant manager who was a trained counsellor was a big support and ensured I had an opportunity to debrief. I was lucky and this is not necessarily standard practice across the healthcare sector. It is hugely important that employers provide training for managers, supports and processes to ensure those of us who have been affected by violence can best support our patients while keeping ourselves healthy.”

CKN Domestic Violence Resources

For more information see the many recent domestic violence articles and resources available on CKN, for emergency and paramedic staff, nurses, midwives, paediatric staff, obstetrics and gynaecology, and all Queensland Health staff coming into contact with women and children: 

* Name has been changed
** Surname withheld