rape, can alert women to the characteristics of men
who are likely to commit dating violence. Examples
include negativity about women, acting tough, heavy
drinking, jealousy, belittling comments, anger, and
intimidation.
Rape treatment centers (emergency services
that coordinate psychiatric, gynecologic, and physical
trauma services in one location and work with law en-
forcement agencies) are most helpful to the victim. In
the emergency setting, the nurse is an essential part
of the team in providing emotional support to the vic-
tim. The nurse should allow the woman to proceed at
her own pace and not rush her through any interview
or examination procedures.
Giving as much control back to the victim as pos-
sible is important. Ways to do so include allowing her
to make decisions, when possible, about whom to call,
what to do next, what she would like done, etc. It is the
woman’s decision about whether or not to file charges
and testify against the perpetrator. The victim must
sign consent forms before any photographs or hair and
nail samples are taken for future evidence.
Prophylactic treatment for STDs, such as chlamy-
dia or gonorrhea, is offered. Doing so is cost effective:
many victims of rape will not return to get definitive
test results for these diseases. HIV testing is strongly
encouraged in high-risk areas such as New York, Cal-
ifornia, New Jersey, and Florida but it is not required
for low-risk areas. Women are also encouraged to en-
gage in safe-sex practices until the results of HIV test-
ing are available. Prophylaxis with ethinyl estradiol
and norgestrel (Ovral) can be offered to prevent preg-
nancy. Some women may elect to wait to initiate inter-
vention until they have a positive pregnancy test result
or miss a menstrual period.
Rape crisis centers, women’s advocacy groups,
and other local resources often provide a counselor or
volunteer to be with the victim from the emergency
room through longer-term follow-up. This person pro-
vides emotional support, serves as an advocate for
the woman throughout the process, and can be totally
available to the victim. This type of complete and un-
conditional support is often crucial to recovery.
Therapy usually is supportive in approach and
focuses on restoring the victim’s sense of control; re-
lieving feelings of helplessness, dependency, and ob-
session with the assault that frequently follow rape;
regaining trust; improving daily functioning; finding
adequate social support; and dealing with feelings of
guilt, shame, and anger. Group therapy with other
women who have been raped is a particularly effective
treatment. Some women will attend both individual
and group therapy.
It often takes 1 year or more for survivors of rape
to regain previous levels of functioning. In some cases,
survivors of rape have long-term consequences such222 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS
because the woman may have done some of these
things before seeking care. If there is no report of oral
sex, then rinsing the mouth or drinking fluids can be
permitted immediately.
To assess the woman’s physical status, the nurse
asks the victim to describe what happened. If the
woman cannot do so, the nurse may ask needed ques-
tions gently and with care. Rape kits and rape proto-
cols are available in most emergency room settings
and provide the equipment and instructions needed to
collect physical evidence. The physician is primarily
responsible for this step of the examination.
Treatment and Intervention
Victims of rape fare best when they receive immediate
support and can express fear and rage to family mem-
bers, nurses, physicians, and law enforcement officials
who believe them. Education about rape and the needs
of victims is an ongoing requirement for health care
professionals, law enforcement officers, and the gen-
eral public.
Box 11-6 lists warning signs of relationship vio-
lence. These signs, used at the State University of
New York at Buffalo to educate students about date
Box 11-6
➤ WARNINGSIGNS OF
RELATIONSHIPVIOLENCE- Emotionally abuses you (insults, makes belittling
comments, acts sulky or angry when you initiate
an idea or activity) - Tells you with whom you may be friends or
how you should dress, or tries to control other
elements of your life - Talks negatively about women in general
- Gets jealous for no reason
- Drinks heavily, uses drugs, or tries to get
you drunk - Acts in an intimidating way by invading your
personal space such as standing too close or
touching you when you don’t want him to - Cannot handle sexual or emotional frustration
without becoming angry - Does not view you as an equal: sees himself as
smarter or socially superior - Guards his masculinity by acting tough
- Is angry or threatening to the point that you
have changed your life or yourself so you won’t
anger him
Adapted from the State University of New York at Buffalo
Counseling Center (1999).