Nursing Component Task
Nursing procedures & clinical learning

Community Mental Health Nursing (RCMN)

COUNSELLING THE SEXUALLY ABUSED CLIENT AT HOME

This is when the RCPN uses counselling sessions to help victims of sexual abuse to overcome the trauma that might have been experienced.

Purpose

  • Prevent post-traumatic stress disorders (PTSD)
  • Improve client and family's wellbeing
  • Refer victim to the appropriate agencies for redress

Indications

  • Counselling a victim of sexual abuse at home to overcome the trauma experienced.
  • Preventing post-traumatic stress disorder (PTSD).
  • Referring the victim to the appropriate agencies for redress.

Equipment

  • Pen and paper
  • Table and chair
  • Topic for the session

Preparation

  • Knock, enter and greet the victim and family, and introduce self.
  • Ask about the general health of the victim and probe about the abuse gently.

Procedure steps

  • Knock, enter and greet victim and family
  • Introduce self to the victim and family
  • Provide privacy and ensure confidentiality
  • Establish rapport (refer to procedure) and allay victim and family's fears and anxiety
  • Ask about general health of the victim
  • Probe to find out when the victim was sexually abused
  • Probe to find out the incidence preceding the abuse
  • Find out if client has been to the hospital for proper investigations, assessment and treatment
  • Assess the psychological impact of the incident on the victim
  • Perform hand hygiene with the appropriate technique
  • Explain the procedure to victim and or parents in the case of a minor to perform physical assessment on the victim to identify signs of bruises and or struggles
  • Explain the procedure to victim and or parents in the case of a minor to perform vaginal, anal, and pelvic examination in the case of females
  • Explain the procedure to victim and or parents in the case of a minor to perform anal and pelvic examination if the victim is a male
  • Refer victim for emergency contraceptive if applicable
  • Assist victim and family on support system available to them
  • Encourage victim to ask questions and gives appropriate answer
  • Empathize with victim and family
  • Counsel victim and family based on your findings upon assessment
  • Refer victim for further management to the appropriate facility
  • Leave your contact with victim and or family and encourage them to call in case of emergency
  • Document the care and findings in the report book
  • Express appreciation and depart

Precautions

  • Provide privacy and ensure confidentiality.
  • Establish rapport and allay the victim's and family's fears and anxiety.
  • Explain procedures before any physical assessment, especially in the case of a minor.
  • Perform hand hygiene with the appropriate technique before assessment.
  • Refer the victim for further management to the appropriate facility.

Aftercare

  • Refer the victim for emergency contraceptive if applicable.
  • Assist the victim and family with the support system available to them.
  • Leave contact details with the victim or family and encourage calls in case of emergency.

Nursing considerations

  • Assess the psychological impact of the incident on the victim.
  • Explain procedures before performing physical, vaginal, anal or pelvic examinations as appropriate.
  • Assist the victim and family to access the support systems available to them.

Patient education

  • Empathize with the victim and family and counsel them based on the findings of the assessment.
  • Encourage the victim to ask questions and give appropriate answers.

Documentation

  • Document the care and findings in the report book.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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