Ep. 57 - I Need to Keep Her Safe: Domestic Violence in the Emergency Department

J S

0:02

Welcome to the Social Work stories podcast. I'm your Producer Justin Stech. Before we jump into the next episode, and it's a great one, I want to ask a big favor. Our podcast relies on word of mouth, iTunes rankings and social media algorithms to reach the wider social work community. We've created a quick guide to four easy things that you can do to help support the podcast. And they won't cost you a cent. You'll find the guide on our Twitter, Instagram, Facebook and LinkedIn on at SsWK storiespod. And on our website, social work stories.com Can you press pause right now on the podcast and go check it out. Awesome, thanks. Welcome back. We really appreciate all of your support, it makes a big difference for us. Now let's get on to the episode

LM

Lis Murphy

0:58

Welcome to the Social Work stories podcast. Hello, my name is Lis Murphy. And I am recording with my dear friend, Dr. Mim Fox. Hello Mim.

MF

Mim Fox

1:08

Hi, Lis. Hi, everyone.

LM

Lis Murphy

1:12

And hello, Justin down there in the corner. So this is an exciting episode, aren't they all but tonight is really exciting because it's another traditional practice piece story.

MF

Mim Fox

1:25

Yeah, yeah. This one's from the coalface Lis,

LM

Lis Murphy

1:28

I'm in my homeland.

MF

Mim Fox

1:29

I know. I know, you feel like

LM

Lis Murphy

1:31

ts based in an emergency. It's in a hospital. I'm on solid ground.

MF

Mim Fox

1:39

That's something it's like. It's like a little homing pigeons or something and someone took someone goes, emergency department hospital and we go, Oh, I know the place. I know where our hearts are.

LM

Lis Murphy

1:54

Now, before we get right stuck into it Mim I want to acknowledge that I am doing this recording from Dharawal Country, beautiful Dharawal country. And I wanted to pay my respects to elder's past, present and emerging. And I also wanted to pay my respects to any indigenous First Nations people who are listening to this episode. Awesome. So, back to our episode. So tonight, let me just set the mood. It's in an emergency department.

MF

Mim Fox

2:29

Oh, I can feel the I can feel the fluorescent lights flickering.

LM

Lis Murphy

2:33

It's it's around a domestic violence call out. Yep. But it's got a pandemic twist. Mim hasn't it? Yeah. So it's very contemporary. It's very much about the bread and butter of hospitals social work in an emergency department. And this is such a detailed practice piece. So it's going to be wonderful for social work students, it's going to be wonderful. I'm going to use this in our on call training for staff who are wanting to do on call in our hospital. Because this social worker, methodically talks through the Social Work intervention, she we have the story of the woman, Sally, but we have this beautiful, step by step intervention by this social worker.

MF

Mim Fox

3:21

Yeah, that's right. It's really, really clear. And I guess for our listeners, while you're hearing the story, really, I'm trying to imagine the assessment process that the social worker is going through, you can almost start to visualize how the notes would look after she saw this woman. And, and I think, you know, for all you social work students out there, or new graduates, this is a bit of a training piece in writing and assessment. I think

LM

Lis Murphy

3:49

that and also, I really, really strongly ask our listeners to listen with a safety lens. Because this is the way in which this social worker will be practicing is at safety for this woman is at the forefront of everything, everything that she does, is through the lens of keeping this woman as safe as possible. Because this is a woman who is very, very much at risk. And I also want to say when you listen to this, if you choose to listen to this, just know that the social worker is quite descriptive in the injuries that this woman has experienced. And she goes into quite a good deal of detail around that. So it is very confronting. So if this is something that you're not up for today, we understand that, we reckon that this piece goes through about 13 minutes. So if you want to meet us on the other side, Mim and I will definitely be talking about some of the practicalities we'll be we'll be talking about the assessment, but we'll also be talking about the services that she refers her to and we'll we'll also be talking about the police involvement.

MF

Mim Fox

4:56

Yeah, yeah, I think that's a really good point to make Lis that have, you know, all of our stories have a bit of a confronting edge because they're about the reality that social workers work with everyday, right? So you are going to always hear something that has a level of discomfort. But this particular story does, it does get a bit graphic. So if if you need to take care of yourselves, listeners, just jump ahead 13 minutes. Or pop back to one of the other episodes, and we'll see you next time. But yeah, this is a great story. So if you're up for the ride, folks, we'll see you on the other side.

SW

Social Worker

5:34

I work in a busy Regional Hospital in the emergency department, and no two days are ever the same. My primary work consists of crisis intervention work, where I support patients, their families and carers. The work is challenging, and I really enjoy the work. What we noticed is throughout COVID, there was a significant increase of presentations to the department following domestic violence incidences women who have not presented to our department in the past women who have presented with significant injuries and women who are afraid to return back home. I want to tell you about Sally, Sally was one of those presentations. I received a call from the triage nurse letting me know that a patient has just been triaged, the patient had disclosed domestic violence and she wanted to be seen by the doctor. The triage nurse let me know that Sally didn't want to be seen by the social worker. She wanted to be medically assessed to make sure that her injuries were not significant because Sally needed to return back home.

SW

Social Worker

6:37

The doctor sees Sally about an hour after she arrived in the department. A full head to toe assessment happens and Sally then agrees to see social work. I let the nurse know that I don't want Sally to have any visitors. I want her to be safe. While she's in the department. All the staff are made aware. Before I see Sally, my questions are who did this? Where are they? I need to keep Sally safe. I do a quick scan of her notes to see if this is her first presentation to the department following a domestic violence incident or if indeed there have been others. I also have a look at her other presentations to see if there's been any patterns in those presentations which may be concerning. When I go through Sally's notes. I see that she has a child not sure of their age precisely, but I think they might be about five or six years old. After scanning the notes and making sure Sally has no visitors. I go and see Sally.

SW

Social Worker

7:36

As I approach Sally, I see a woman laying very still in a hospital bed. She has a blue hospital blanket pulled up to her chin. Her legs are pulled up to her stomach and her hair is partially covering her face. She's not moving. I walk close up to Sally and draw the curtains behind me. I sit on my chair and get down to Sally's level. I introduce myself as a social worker. Sally looks at me slightly and then turns her head back to rested on the pillow. I let Sally know that the hospital is a safe place and that whatever she tells me will remain confidential except the serious safety concerns that I have for Sally and her child. I asked Sally if she has a child. Sally lets me know she has a six year old son called Chris. Chris is safe. He's at Sally's sister's house, and he's been there for the last few nights. And thankfully, Chris was not home when the assault happened this morning.

SW

Social Worker

8:31

I asked Sally if home is a safe place for her. And if someone had hurt her this morning, Sally tells me about her partner Jack. She's been with Jack for the last 10 years and he was the one that assaulted her earlier today. Sally tells me they got into an argument because Jack lost his job due to the pandemic. Sally tells me it's the first time Jack has ever physically hurt her. She lets me know they got into a heated argument in the bedroom. Jack started to punch her face repeatedly with a closed fist. He then started to pull her hair and then Sally was pushed down to the ground. While Sally was laying on the ground helplessly Jack put his hands around Sally's neck and attempted to strangle her. While Sally was telling me her story. She pulled her hair over her face and her neck to cover her injuries while saying sorry repeatedly. I leaned in closer to Sally, and in a soft voice. I thank her for telling me her story as I know how hard it is to tell a stranger in such a public place. I let Sally know that this is not her fault. And it's not okay what's happened to her and I want to let Sally know that I'm here to help her Sally turns to me and with that ever slide a smile says thank you. This is really hard. I quickly build rapport with Sally from behind the mask. I use my body language and the expressions from my eyes to make that connection with Sally. I let Sally know that I'm here to help her.

SW

Social Worker

9:55

I stay at Sally's level for the duration of my intervention, ensuring I work at a pace that is comfortable for Sally, whilst allowing for silences, and pauses and stopping when I know Sally needs a break. I asked Sally about her relationship with Jack, getting Jack's full name and date of birth. Because I know I'll need that later to record in my documentation. Knowing that this is the first time that Jack has assaulted Sally, I asked if there's any other controlling behaviors, any coercive control that Jack may be displaying. Sally lets me know that Jack doesn't let her see her family or friends. He's also been controlling her finances for the last few years. And when Sally goes to work, Jack rings her continuously, just to make sure that she's at work, and that she's not somewhere where she shouldn't be. Sally tells me I know this is not okay. And "I know this relationship is not right. But what do you want me to do? This is my normal. I don't know any different."

SW

Social Worker

10:16

I asked Sally to tell me a little bit more about Jack about his mental health if he's had any previous financial difficulties, if Jack possesses any weapons, and what's happened in the past during that during the pandemic with his employment. I asked if Jack's been arrested, if there's any substance or alcohol misuse, or if he has spent any time in jail. Sally tells me they've always had savings. She works full time. But throughout the pandemic, the savings have all been exhausted. Sally tells me they've been having ongoing arguments, and she's gotten to the point where she doesn't know where to turn. Sally tells me Jack has no mental health diagnosis, no drug or alcohol misuse, and he's never spent time in jail. I asked Sally about Jack's relationship with Chris. Sally reassures me, they have a good relationship, and Jack has never hurt or assaulted Chris in the past. Sally smiles ever so gently when she tells me about Chris, telling me that he's a good kid, that he likes reading books, and he likes kicking the ball in the backyard. He attends school on a regular basis, and then teachers have never expressed any concerns about his behavior.

SW

Social Worker

12:25

I asked Sally about who her support networks are. Who does she turn to for help? She said that's difficult. She knows that Jack controls who she talks to. Sally tells me about her sister, a sister that lives locally. A sister that she has a close relationship with and a sister she knows will come in to support her if needed. Sally tells me she's embarrassed to tell her sister, but she wants her to come in. I let Sally know that I can call her sister and I can give her a brief overview of Sally's presentation. Sally's happy with that. I asked Sally if she'd like her sister to come into the hospital and sit at bedside to support her. Sally agrees.

SW

Social Worker

13:11

Sally tells me she's not engaged with any services. She predominantly moves from home to work, and home. Jack does all the shopping. I asked Sally if she knows where Jack is currently. she shrugs her shoulders and says, "I don't know." She said she believes that the neighbor had called triple zero. And when Jack had heard the sirens approaching the house, Jack ran out the back door. She thinks he's jumped to neighbor's fence, and she hasn't seen him since. While Sally has been in the emergency department, Jack made no attempts to contact her. I've also told Sally that if he does try to contact her not to answer his calls. I don't want Jack to know where Sally is. I need to keep her safe.

SW

Social Worker

13:53

Sally tells me about their home and how it's mortgaged. She's been wanting to leave Jack for the last six years but has been afraid to she doesn't know how she can repay the mortgage on her own. She knows on a single income, she just can't afford to do that. She knows she can pick up additional shifts at work. But first and foremost, she's a mum to Chris and she needs to be there for him. I let Sally know that I can refer her onto supports in the community, we'll be able to assist her with that. Sally's happy with my suggestion. I let Sally know that I'm extremely worried about her injuries that she sustained this morning and about the controlling nature that Jack displays. As a social worker. I'm mandated to call police if there's significant danger if a patient presents with a broken bone or attempted strangulation or if the perpetrator has access to a weapon. Sally tells me if Jack finds out that the police have been called he's gonna get really angry and she's really fearful for her life as well as Chris'.

SW

Social Worker

14:54

I reassure Sally, the hospital is a safe place. I also let her know that when police arrive I will support her in her conversation with them. I explained to Sally what an AVO is. She said she's heard of an AVO in the past but she doesn't really know what that means. Sally says at this point she doesn't want to take out and AVO she still wants Jack in her life. More so for Chris than for her. I let Sally know that police will probably take out an ADVO on her behalf. She won't have a choice due to her injuries. I also let Sally know I need to complete a child protection report due to Chris's age. I see the fear in Sally's eyes. She says I don't want my child removed. A reassure Sally that Chris won't be removed. I let her know that it's a mandatory requirement to ensure Chris's safety. I let Sally know that I'm going to go and call police. I offer her a sandwich and juice Sally declines. Sally thanks me for listening to her and believing her. I leave Sally alone for a few minutes while I go and update the treating doctor and the clinical manager of my intervention so far.

SW

Social Worker

16:04

Sally goes off to have a CT scan. She returns about 45 minutes later, I sit with Sally and ask her if she's ready for me to contact her sister. She said she is Sally tells me once again she's so embarrassed about what's happened this morning and she just doesn't know how she's going to tell her sister. I let Sally know I can do that. Police arrive a short time later and meet with Sally. At this stage of the day. The department is so busy. There's so much noise and his patients everywhere. I'm able to move Sally to an alternative room where Sally can record her video statement uninterrupted. I sit with Sally throughout the recording, and I let Sally know that she can start and stop as required. Police go into detail about the importance of providing a video statement and where a video statement can be used. They let her know how it will be recorded. One of the Senior Constable asks Sally specific questions whilst the other Senior Constable records a video statement on their phone. Sally completes her video statement with the police which takes around 15 minutes. Once the statement is complete. The police take photographs of Sally's injuries. I praise Sally for her actions saying how brave she is as it's such a difficult thing to do. Police let Sally know that they're unsure of Jack's location. They let her know they have crews searching the local area. They question Sally as to where Jack may have gone. Sally tells them his mum lives close by and he may have gone there. Police thank Sally and let her know though they'll send a car out trying to find Jack.

SW

Social Worker

17:39

The police leave a short time later and I start to discuss safety planning with Sally. I let Sally know that while Jackie is at large it's not safe for her to return back home. We start exploring other options. I asked Sally if she's able to go to her sister's house. She lets me know that she doesn't really get on with her brother in law. And Chris has already been there for two nights. She doesn't want to burden the family. We look at other friends and work colleagues. All options come to no end. I let Sally know of a service locally that provides emergency crisis accommodation to women and children who are escaping domestic violence. They're called SASSI. I go into detail about the type of accommodation available. I let her know that I'm happy to ring the worker to see if they've got availability. Otherwise we need to contact Link to Home. Sally gives me consent to call the Women's Refuge. The worker lets me know they've got some rooms available and that Sally and Chris are able to go to the refuge.

SW

Social Worker

18:37

Once we're able to secure the accommodation I speak to Sally about supports in the community. Sally agrees for me to make a referral to WDVCS Sally knows by me making this referral she's going to be supported in the community. I let Sally know I'm going to put the referral in once she goes home and the service will make contact with her in the next day or so. Sally is happy with that.

SW

Social Worker

19:01

Sally's sister arrives a short time later and she stays with Sally until she's ready for discharge. I give Sally a domestic violence information pack. I also encourage Sally to contact victim services where Sally will have access to victim support. I also encourage Sally to contact 1800 respect or the DV line if she wants to talk to somebody once she leaves the hospital. I also tell Sally, she can ring the domestic violence liaison officer at the local police station to talk about the AVO Sally said she'll think about that. I provide Sally with a change of clothes and some toiletries.

SW

Social Worker

19:39

Sally thanks me for all my intervention and acknowledges she's tired. It's been a difficult day, but he's grateful for all the assistance given. Sally was one of the lucky ones. I see my role as a social worker in the emergency department as a role where I can acknowledge and validate a woman's disclosure, a role where I can walk alongside their journey and support them and ensure their safety in the hospital. And for the next 24 to 48 hours. Nobody deserves to be a victim of domestic violence. And if I can change one woman's life, I know it's a job well done.

MF

Mim Fox

20:19

What a story lays I'm so pleased that right now we're actually showcasing a practice story from a COVID context. Because I guess before we get into what I wanted to acknowledge that at the moment in Australia, we're having, what they terming a second wave, but gosh, it feels like a millionth wave. But a lot of our country is in lockdown at the moment. And which means a lot of our practitioners are doing this difficult work right?

LM

Lis Murphy

20:46

Behind a mask.

MF

Mim Fox

20:47

Behind a mask. And, and on this podcast, we have spoken before about the limitations that COVID has raised, especially in the areas of death and dying. But But I think this story actually showed also some of the potential and opportunity for really solid work in the COVID space.

LM

Lis Murphy

21:06

Well, before we get to that, I thought it was really, really telling that she the social worker, was saying that they're seeing presentations of domestic violence that they normally wouldn't see. And that it their presentations have doubled. And so that that, to me is shocking. It makes sense. It makes sense that you add a nice twist of pandemic, and that'll be like a pressure cooker for some relationships. Yeah. And of course, we know that in this case, there was coercive control that have been going on for several years. So losing your job. Pandemic lockdown, you know, it's just adding kindling, or a flame to it.

MF

Mim Fox

21:49

Yeah, absolutely. And look, this isn't the first time that this has been spoken about since the COVID pandemic started, right. And domestic violence has been an issue that's been discussed, globally, as well as definitely in Australia. And I guess, for us here, in this context, this story comes out at the New South Wales Health context, which means that a lot of this story is really grounded in the policy and procedures of New South Wales as a state and the law in this state as well as New South Wales Health as an organization, right.

LM

Lis Murphy

22:20

Yeah, that's really good to mention. And maybe later on, when we're explaining some of the decisions that the social worker made, we'll be able to say, and that's because it is part of the way that we do things here in New South Wales Health.

MF

Mim Fox

22:34

Yeah, that's right. And so really conscious of that. There's probably people listening who are coming from either another state in Australia, where, or let alone around the world where you might be saying, Oh, we don't do it like that here. Or else might even be coming from a different organizational context where you think, Oh, that's not how we would manage that. So it is really important to say that, isn't it that is very much in New South Wales Health? And

LM

Lis Murphy

22:59

And can I add? Look, I don't like policies at the best of times. Let's just put that one on the table. I don't. And isn't that funny for someone who's he's worked in a government organization for 30 years. Yeah. However, I will say that the New South Wales policy on identifying and responding to domestic violence is such a good read in relation to stepping through an intervention, but also explaining why it takes a feminist perspective in in the approach that we take here in health. Yeah, marvelous. So if you can have the opportunity, especially if you're wanting to work in health, look at that policy. It's a really good supporting piece for the for the story, actually.

MF

Mim Fox

23:47

Yeah, definitely. I think that's really important. Liz to point that out. So they're

LM

Lis Murphy

23:53

Also saying I'm sorry, one other thing I just want to say about COVID. Yeah, yeah, it is. It's it's crappy. Yes. But in the context of this COVID can be a really useful reason to not allow a perpetrator to come into emergency department. So we've been finding social workers have been using that as a great excuse to keep the woman safe in emergency department, so that she can tell her story, be assessed, be treated without having to respond to the pressure of of a violent partner.

MF

Mim Fox

24:29

So I have to say, for me listening to this story, when the social worker said that she informed the nurses no visitors allowed. My social anxiety or social isolation fears came right up. And I actually had this response of what do you mean, she can't have visitors? What do you mean, she's going to be all alone and by herself in that situation? So it makes perfect sense to me that from your perspective, that's actually a supportive mechanism for this woman, because she's preventing the perpetrator from actually being able to come in. She's using this really easy excuse of Oh, no, sorry. It's because of COVID. You can't come in. What exactly

LM

Lis Murphy

25:05

That's exactly right. But again, it's that safety lens that starts from the minute she gets that referral. She's thinking about the woman's safety hasn't even met her yet. But she's going straight to that. The person in admissions. Yeah. And just saying, uh, no visitor alert on this one. It's just a done practice in that particular emergency department.

MF

Mim Fox

25:29

Yeah, very clever. That's great. That's great. So that was kind of the beginning for me of the stepping through of the really well laid out intervention plan that then came after that.

LM

Lis Murphy

25:43

Mim the other thing that I wanted to mention before we even get to the social worker meeting, Sally, is that we have a opt out approach to a domestic violence referral, in this setting. Okay, so we don't ask so you know, often in in health will say, Would you like to see a social worker about that particular issue. We don't do that around domestic violence, where we're seen as part of the the team that works around the woman. Of course, if the woman insists that that when we go and meet her that she will not be speaking to us will respect that. But we won't be asking before you know, where we come in, whether she wants to see us, it's an opt out, not an opt in.

1

Speaker 1

25:44

You know that that's really different to an emergency department I worked in about 1520 years ago now, where it was a battle to get social workers involved in cases like this. And, and I remember in meetings going, "Oh, I'll come in and see that person, I'll get involved," and having to kind of put my hand up and make sure the social work role is was really fought for. So that's actually really comforting to hear that change that's happened.

LM

Lis Murphy

26:58

And look, I would go even further and say that social worker pivotal in it now. Yeah, they do a lot of the training of staff. They actually work very, very closely, as you heard that that medical assessment was followed by the doctor making an instant referral to social work. Yes. Like you're saying 10 years ago, that wouldn't have happened. Now. It's just part of the of the procedure, if you like, yeah. Um, the other thing that I wanted to point out, so a couple of things about this person's approach. So she has a few things before she meets Sally, including having a scan through the notes are really good practice that we want to encourage our social workers to do, just to get a sense of she come in before, has, you know, and we found out that this was a first presentation for this particular person. And that's significant. This is a first presentation of domestic violence. So again, you're formulating a bit of a picture before you even meet Sally. We also know that there's a child. Yeah. So she's starting that assessment already. She walks in. And did you note how quickly she builds rapport with Sally? Yes. Yeah, Sally has gone from I don't want to see a social worker to she's telling the story of of the assault.

MF

Mim Fox

28:21

Yeah. And it was actually what struck me was when she's looking through the notes, she's already got her assessment list, that she's ticking off in her head, right, she's already got her risk factors, safety indicators, that she's already starting to think through, and starting to get an idea or a picture of what are going to be the really important areas to be discussing, and to be talking through with Sally. So that then when she's able to get into the room with her, she's actually coming in with a really clear perspective on what she's about to hear.

LM

Lis Murphy

28:58

One of the most moving parts I found in the story was when Sally kept on apologizing, yeah, too. And I think that that's very typical. And I liked the social worker's response that came from a point of compassion, about acknowledging that how difficult it was to talk about this, but to also acknowledge that this is really serious, and you do not deserve to have had this experience and yeah, had this happened to you. And so she quickly built rapport through things like that, through statements like that through really engaging in nonverbal, you notice that she even talked about sitting down at the eye level, and really doing a lot of eye expressions Beyond The Beyond the mask.

MF

Mim Fox

29:49

I think that's one of the things that's actually quite different about social work practice in hospitals to other disciplines. Yeah, is that often the patient will be in the bed and there'll be a group have professionals around them who are all standing up above them. And there's actually nobody at the same eye level as the patient. So I really liked the way she described that it was evocative to me, like I could see what was actually happening and unfolding in that in that room. And that situation, yeah.

LM

Lis Murphy

30:17

And I liked the way that she pretty much stayed by bedside for the entire time. And that would have been to be honest with you Mim, there would have been a lot of time pressure on that emergency bed. So we know that in, in Australian emergencies, anyway, there's his time limit. And she would have had that pressure, but would not have been wanting to convey that at all to Sally, and she would have been running between Sally and the ED manager, just saying this is where I'm at, yes, what we're needing to keep her here for these reasons, the police are going to have to come in, we're going to have to take a statement. So she'd been informing the team every step of the way. So that that pressure that would be off. And Sally would be not aware of that at all. MIm back to your point about the order in which the social worker would have been helped helping Sally to tell her story so that she was able to elicit the important information that she required to get a real understanding of what's been going on in that relationship, she was able to pull out some points. So that really pointed to the fact that this relate the violence in this relationship was becoming quite dangerous. And one of the things that Sally said and shared with us was that she had been strangled. Now in, in an emergency department when we hear that now it like it, the lethality measure in our head just goes through the roof. But we also have to let doctors know about that, because there are a series of tests that need to take place to check out. You know, Sally's health.

MF

Mim Fox

31:58

yeah, whether there's any internal damage that's been done. And

LM

Lis Murphy

32:02

that also became part of the reason why the social worker had to report to the police. So it was a write serious injury. And I imagined that there would have been some people listening saying, hang on, she said she didn't want the police involved. Yeah, back to that policy that we talked about earlier. When there is significant, I think even the social worker mentions that when there's been significant injuries, when there's weapons involved, we have to actually alert the police whether the woman wants that or not.

MF

Mim Fox

32:35

Yeah, there's actually no choice about that. Is there? No, yeah. And, and I think that's a really important sort of organizational framework to put to this that often as social workers were balancing the wish of the client or the patient in this situation, with the organizational requirements, right. And that's a really perfect example of that.

LM

Lis Murphy

32:58

And it's also about saying, this is really serious, and we take it seriously. And even at the moment, you might not understand that fully. We know that an injury like strangulation means that you are at risk of, you know, the next time they may, you may actually be you might be killed. So yeah, whilst we wouldn't say it like that to the woman, that would certainly be part of explaining that this is really serious. And we need to now then the police come in, and one of the changes in practice, it's reasonably new now is that they will record it on their phones as as the social worker describes. So that can be quite harrowing for the woman. So as the social worker did, she actually stayed. And I've heard this social worker say, I will insist on it, even when the police will say, No, you don't you don't come in here. She'll say, Oh, yes, I do. I'm support this woman through this. And often, she will also take notes from that police statement to stop the woman from having to repeat her story. Again. If she picks up some salient points from that, she'll she'll notate that and put it in the notes.

MF

Mim Fox

34:12

Yeah, that's just really compassionate, isn't it to actually be considering what's down the track for this woman, because she will have to tell her story in different ways to different people to kind of support her in that process moving forward. Really, I think I just think it's really compassionate.

LM

Lis Murphy

34:30

It is and I think, given that she'd built such strong rapport, when she had to actually explain that she had to also report to child protection authorities that this incident had occurred, she was able to talk about it in light of supportive, supportive nature as opposed to having the risk of having this child removed. So that was also really good how she languaged that so people will learn a lot about how to explain them. All of making that notification in a way that is, is, is more understandable for the woman so that they're not fearful of that as well.

MF

Mim Fox

35:11

Oh, absolutely. Which is I mean, there's so many points in this story isn't there where the woman, the fear that the woman has come into emergency carrying, could potentially be amplified. Right. And so the social worker is often pre empting. It and definitely being present at those various points to actually minimize that, to make sure that that's not where the locus of fear is that the fear actually sits with the event that brought the woman in, not what's now coming, and what's happening to her in the present moment.

LM

Lis Murphy

35:44

And about understanding that this is part of the process of keeping you safer than you were before. This assault. Did you like the way that she scanned for who were the supports in this woman's life? Yes. And often, as is the case with Sally, a lot of the supports have had dwindled, because of the coercive control.

MF

Mim Fox

36:07

that that tried to get out of the domestic violence dynamic.

LM

Lis Murphy

36:10

Yeah, exactly. But knowing that there was a sister that she could include in the support in the emergency department was really an important part of providing that ongoing support, and also tell it helping to tell the story to the sister. Yeah.

MF

Mim Fox

36:26

Yes. Which would have been a hard story to tell, right? Like that. That's a really difficult moment for the woman, I think, to have to actually disclose what happened, and there's a lot of shame attached to that. Yeah.

LM

Lis Murphy

36:39

Often what will happen is that in, you know, women will be discharged home perhaps with the sister, this wasn't the case, because she can get on with a brother in law. So then the social worker had to quickly scout around for possible accommodation for this person. And you know, she should buy a lottery ticket because she actually found some appropriate accommodation and support for her. And that was a SASSY service that, that she referred to. So that just for people just to know that that was a domestic violence, accommodation and support service that she was lucky to, to find available room for. Yeah. The other thing that people may not have heard of before is the DVCAS that she talked about. And that's another service here in New South Wales, where it's a support process and service for women going to court, and so that the DVCAS service will provide a worker to support them through that part of the process.

MF

Mim Fox

37:41

Okay, so and it felt to me that those referrals she was making towards the end of this intervention, were really an extension of the cushioning that she had provided up to that point. And that safety lens, that that was continuing from the minute that she came on, and was involved with this case and talking to the nurses about no visitors, it actually extended all the way until the very end, where she's referring to the most appropriate safety focused services.

LM

Lis Murphy

38:12

Indeed, and even down to the telephone services that she can link into 24 hours. In case she wants to talk about it with with someone who's trained and who's supportive, outside of the atmosphere from an emergency department. The other thing that she would have said Mim and she would have said, if at any time you feel unsafe, if at any time you're worried about something to do with your health. You can come in here we are we are open 24/7. And we stress that with people who are escaping domestic violence, you can always come in here. You can or you will not be judged. Just ask for the social worker if need be. We will always be here.

MF

Mim Fox

38:58

Yeah, I think I think that's really admirable isn't I think there's many emergency departments that would carry that forward. I worry for the people in our community who the emergency department is not a place of safety for and, and I really like that idea that, that that's the philosophy of this hospital emergency department.

LM

Lis Murphy

39:22

And I'd like to think that it's it's become better. I'd certainly was the philosophy of other hospitals that I've worked at as well. Just when in doubt, just come on in. This is a safe place for you.

MF

Mim Fox

39:34

Yeah, I'm just thinking about the groups of people like asylum seekers, people who have his difficult histories with police or with the law or, you know, in different situations where they can't see the emergency department in that way. And that means that when they are in situations like domestic violence, it's difficult to kind of come in and find that place as a refuge.

LM

Lis Murphy

39:59

Yeah, that's why we Don't run the podcasts mean, that's why we get the word out. So all those social workers working in those areas, yes, stress that point and build relationships with, with the ED social worker.

MF

Mim Fox

40:11

I think I think as well though, there's something to be said here for a organizational philosophy and culture that supports the people who are using the service. Right. Like, I think there's something that's bigger here at play, that is cushioning the social worker in her intervention. And she's almost working in tandem with that greater philosophy as well.

LM

Lis Murphy

40:33

Wow, I wow. Okay. Yes. Wouldn't that be wonderful? I also think there's, there's a turning of the worm, I think. Yeah, in Australia. Anyway, I think that we're become me, we're taking domestic violence a lot more seriously, thanks to you know, people like Rosie Batty. I think, you know, I listen to two young women talking about their, you know, relationships and the importance of safety. I just think we're better in this space. And it's only going to get better,

MF

Mim Fox

41:09

I think, yeah, I think that's really truly,

LM

Lis Murphy

41:11

because it's true, because social workers are there.

MF

Mim Fox

41:15

Yes,I would agree. I would agree. Just before we finish up talking about this really clear piece of intervention is I wanted to just explain to our international listeners potentially what an AVO is the social worker, the social worker, I use that phrase quite a lot. And, and I think, I know that's called different things in different places. least for us, it's an apprehended violence order. So it's actually a legal mechanism to prevent the perpetrator from being able to access the woman or the the domestic violence victim. So I think that's, that's really important that we kind of get set the legal context for this as well, that when the police were involved, that's very quickly one of their mechanisms that they're using to make sure safety is ensured.

LM

Lis Murphy

42:16

And that it can be tailored to suit the circumstances of the woman so that if there's a child involved, that the child will be included in the ADVO, it might be that sometimes you can have AVOs where where the couples still remain in the same household so they can be tailored. And so one of the things that the social worker says is, you don't have to take it out on your own behalf, the police will do it for you. That's right. And they're that that can be very important. Especially if that woman reunites with that person. It's you know, it because the police have taken it out on her behalf. It can't be rescinded. He can't pressure her to, you know, take it back.

MF

Mim Fox

43:03

Yeah. And also, you know, she can't be seen as having initiated it. Exactly. Which then can have repercussions for her safety later on. Yeah, yeah. What a, what a good example Lis of just really the stepping through of an intervention. Right. And, and it did take me back to my time in emergency departments, I have to say, so it's nice to hear a story like that. But can you really say domestic violence is nice to hear. Let me take that back.

LM

Lis Murphy

43:33

Now, in relation to the way in which this social worker, worked with Sally. I think it was a really nice fit.

MF

Mim Fox

43:45

It was it.

LM

Lis Murphy

43:46

It was a partnership that worked and hopefully has kept Sally safe or initiated Sally's you know, a new life.

MF

Mim Fox

43:56

Realigning text with audio

Yeah, that's right. That's right. Oh, awesome. Thanks so much to our social worker for providing the story. And one thing I wanted to say to our listeners is that we're at the moment seeking new stories for the podcast. So if you are out there in practice, and have a story that you would like to share, get in touch with us on www dot social work stories.com Or get on to Twitter or Instagram. And let us know because we'd love to be in touch with you and do a recording with you in the remote virtual virtual world that we are living in right now. So until another month, until another monthlies and thank you listeners for hanging in there and for our monthly and monthly episodes. And take care everyone it's a difficult time right now across Australia. So take care of your mental health take care of your well being. Keep in touch with your colleagues. And let's all support each other through this time. Thanks Lis. Take it easy.

LM

Lis Murphy

44:59

Bye Justin.

MF

Mim Fox

44:59

Thanks Justin. Bye

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