This reflection is about the forum theatre we had on this day about domestic violence and abuse. Jennifer Foster who is 24years old came to A&E with wound on her hand. She is 32 weeks pregnant and came to the hospital with a man who was later known to be the husband. In the drama a student nurse had handover and afterwards was asked to check the observations of Jennifer. The student nurse on reaching there was engage in conversation by the husband although, he introduced himself he did most of his conversation with the husband. Anytime he asks question the husband quickly responds instead of Jennifer. The student nurse manage to do the observation. We were the observant. Afterwards we the observants through what we observed had class discussion about the drama and offered the student nurse some changes to do to enable him achieve effective goals and quality of care.

The student nurse who arrived late had some time to settled down and received the handover about the patient this was to enable him to know what the patient came to hospital with, her name, date of birth, allergies if any, past medical history and most important she came with pregnancy. The student nurse was now more relaxed and confident before approaching the patient to do the observation. He followed infection control by maintaining his hand hygiene. He introduced himself by mentioning his name and position. He then asked the patient how she preferred to be called and seek her consent to check her observation. While checking the observation he was having effective conversation with the patient. This time he focused more on the patient then the husband. He asked the patient if she was in pain and needed paracetamol, if she is feeling the baby moving in her and how she had all those wounds on the hand. Jennifer was also communicating very well this time all though the husband was still trying to answer and ask questions the student nurse focused more on Jennifer. We the observers cut in to suggest how the student nurse can get the husband off the scene to enable him have therapeutic communication with Jennifer. On continuation of the drama the husband then had a call that was when the student nurse told him he can not receive the call there so he then went outside. The student nurse now reassure the patient that she is in safe hands so she should say exactly what happened to her if it not fall. After using open questions in his therapeutic communication, she started shivering and in sad tearful mood open up a bit to the student nurse. Although she did not say exactly what happened to her she confirm she did not have a fall as being said by the controlling husband. She said this only when the husband was not around. The student nurse then promise her of getting information to the midwife through SBAR, get her some pain relieve medication and also for x-ray. Afterwards, the student nurse went to report to his practice supervisor all that has gone on and suggested a safeguarding needed for her. He also informed the supervisor of the observations News score, pain relieve medication and the colour of the bruise so to be documented on the body map. The student nurse then went to do his documentation under the supervision of his supervisor.

I learned that you should always be observant when you come across such signs and demonstrations and report it since there may be domestic abuse going on. I also learned how to use open questions and reassurance in communication with patients. Physical assessment such as inspection is very important for the patient. SBAR communication tool is to be used to refer the patient to other multi-disciplinary team such as the midwifery and safeguarding team. I learned sometimes in the nursing career there will be some challenges but you must use your clinical judgment and evidence based skills to overcome them. I have learned how women and children are the most victims of domestic violence. I have learned some of the signs to look for in domestic abuse, when your partner is so controlling, jealous, tells you what to wear, abusive etc. One in five adults always experience domestic violence and abuse and victim support is one of the help and support agency in UK.

As a result of this focus theatre I have gained the experience and confident to approach any domestic violence and abuse should encase I suspect or come across it. I have also gain knowledge about Kelly`s six stage Model of domestic violence and abuse which I will be using. I can now overcome communication barriers and applied more of patient centred and shared decision making in their care and support. I can also use reassurance to let patient speak out what is happening to them because it is not always that domestic violence is physical, sometimes it is verbal ,psychological, social, financial and harassment.

Firstly this relates to Prioritise people. As I needed to treat patient with respect, kindness , compassion, seek informed consent and document all my findings.

1.1 Treat people with kindness, respect and compassion

1.5 Respect and uphold peoples human rights.

4.2 Make sure that you get properly informed consent and document it before carrying out any action.

Secondly this relates to Preserve safety. As I needed to

13.2 Make a timely referral to another practitioner when any action ,care or treatment is required.

17.1 Take all reasonable steps to protect people who are vulnerable or at risk from harm , neglect or abuse.