The Pixel Project is pleased to welcome our 3rd guest “16 For 16” article from RANZCOG – the leading standards body responsible for the training and education of doctors in obstetrics and gynaecology in Australia and New Zealand. RANZCOG provides consultative leadership and advocacy in #WomensHealth to ensure excellence in #obstetrics and #gynaecology training.
There are lots of different ways, both big and small, that hospitals and clinics can support survivors of gender-based violence that are both preventative and responsive. We checked in with some of our clinicians from around the country to find out what types of support their hospitals offer and we’ve come up with 16 ways that you and your institution can support survivors of gender-based violence.
Written by Nastashjia Katu and Lisa Westhaven from RANZCOG.
Action For Hospitals & Clinics #1: Celebrate women
We have made this point before, but it is so important that we’ll say it again: normalising behaviours and actions that call out degrading attitudes towards women promotes change. Movements like #metoo and #16days have permeated mainstream awareness, bringing violence against women discussions to the fore. Celebrating women, whatever that might look like is a way of recognising, reinforcing and encouraging these shifting perceptions.
Action For Hospitals & Clinics #2: Be aware of long-term support services
Building partnerships with women’s shelters and response services are important for providing a smooth referral pathway. Depending on the circumstance and need, there may be a network of support services a woman experiencing violence might need to access. While these pathways are generally well-defined between hospitals, clinics and organisations that offer acute housing, legal and financial support, long-term support services are also important. Having access to community and social groups are an integral part of providing holistic care and this should not be overlooked as a component of referrals.
Action For Hospitals & Clinics #3: Demonstrate positive relationships with police
Depending on the community in which a woman may live, negative perceptions of the police force may exist. It is important for all women, but particularly survivors of gender-based violence to see positive relationships between healthcare services and police authorities as a demonstration of trust and of safe spaces.
Action For Hospitals & Clinics #4: Standardised domestic violence screening training
Even though hospital staff often care for women who have experienced violence, it is not uncommon for doctors to feel ill-equipped. In Australia, while there are tools available for domestic violence screening, there is no standardised screening approach. Health professionals may fail to screen for violence because of a lack of knowledge, limited understanding of referral pathways or fear of offending patients. Training at all levels and in all health settings will support continuous care to ensure that staff are confident in knowing how to respond, or where to direct patients in their workplace.
Action For Hospitals & Clinics #5: Upskill in communications
When caring for patients, broaching difficult discussions, particularly in the screening stages can be difficult even for long standing professionals. Access to ongoing communications training that provides healthcare workers the skills to communicate respectfully and manage confrontation is another way to create safe spaces. Making these workshops accessible adds a layer of accountability and awareness.
Action For Hospitals & Clinics #6: Understand why women don’t leave violent circumstances
While this should be part of domestic violence screening training, it is worth highlighting how important it is to understand why women sometimes choose to stay. Being isolated from support networks and families can make leaving impractical and difficult. Leaving a violent relationship can place a woman at increased risk of danger and feelings of denial, shame and low confidence can hinder them from seeking help. Being aware of the reasons why women stay and addressing biases that often exist about these reasons is very useful to ensure respectful and equitable care.
Action For Hospitals & Clinics #7: Make it visible that your hospital is a safe space
In addition to celebrating women and upskilling knowledge around screening for domestic violence, having messaging and information available for different response services will demonstrate that your hospital/clinic is a safe place to disclose or report experiences of violence.
Action For Hospitals & Clinics #8: Make privacy a priority
In small towns, privacy is often limited and reporting violence can be even more challenging especially when the perpetrator is known to the clinician. Considering ways to enhance privacy in consultations will not only reduce risk of harm but build trust that will encourage confidence to seek care.
Action For Hospitals & Clinics #9: Showcasing diversity
Even though violence occurs in all communities and is not intrinsic to any culture, religion or region, disadvantaged communities often experience higher rates of violence. This adds another layer of complexity that prevents help seeking. Hospitals and clinics by nature cannot always escape the institutional look or feel. However, making diversity visible through staff, artwork and messaging demonstrates inclusion and being mindful that lived experiences influences how services are accessed and making sure that understanding of this is visible is a great way to support survivors of violence.
Action For Hospitals & Clinics #10: Provide childcare and breastfeeding-friendly spaces
Providing parent and breastfeeding areas in hospitals and clinics help women feel comfortable and safe to have their children with them when seeking or considering care. Having clear signage to indicate these spaces will reinforce an environment of safety.
Action For Hospitals & Clinics #11: Use translation services
In Australia, healthcare institutions have access to a national translating and interpreting service. Generally, this service is well-utilised and can also be used as part of the referral process. Making sure that women who do not speak English as their first language have access to interpreters is important to ensure that they are heard, informed and understand the care and support available to them.
Action For Hospitals & Clinics #12: Reinforce zero tolerance of violence
It might seem like an obvious point to reinforce but having reminders that violence is not tolerated in the workplace is not only important for health professionals but also for the women they care for. This can be acted upon in lots of different ways and at all levels. For example, any leave or counselling entitlements relating to experiences of violence can be highlighted during induction for new staff, managers can demonstrate what respectful conversations sound like and all staff can be encouraged to call out actions or comments that disregard these values. Keeping zero tolerance at the front of mind and holding people accountable is a meaningful way to support a culture of respect.
Action For Hospitals & Clinics #13: Make leave and counselling available for staff
When caring for patients, health professionals can sometimes neglect to care for themselves. Doctors and health professionals are not immune to experiences of violence and also require support, especially given the nature of their work. Having leave policies and counselling support available for staff is part of a holistic approach to eliminating violence.
Action For Hospitals & Clinics #14: Partner with academic institutions to build literature and research
The link between research and how this can support responses to violence can be strengthened through partnerships. Hospitals may wish to work with local universities on research projects, symposiums or events to facilitate the sharing of the most recent studies and research.
Action For Hospitals & Clinics #15: Support a charity, cause or organisation that supports prevention of violence against women
Having fundraisers, morning teas or staff events that raise money, promote volunteering or raise awareness in support of a charity, cause or organisation is a simple way hospitals and clinics can lend their support to survivors of gender-based violence.
Action For Hospitals & Clinics #16: Rally with like-minded organisations for legislative change
While there are situations where abortion is permissible in Australia, the narrative around abortion can still be extremely daunting and deter domestic violence survivors with unwanted pregnancies from help seeking or lead them to consider unsafe procedures. While institutions lending their voice to social issues may sometimes be challenging and pose business risk, it can bring about real and actionable change.
All pictures used are Creative Commons images (from top to bottom):