A nurse is caring for a client who experienced abuse. The client says, "It was my fault. I made my partner upset." The nurse should identify that the client is demonstrating which of the following manifestations?

Choice A reason: Requesting the police to gather evidence is not the role of the SANE. SANEs are trained to perform forensic medical examinations, collect and preserve evidence, document findings, and maintain chain of custody. While collaboration with law enforcement may occur, evidence collection is conducted by the SANE within the healthcare setting, ensuring integrity and admissibility. Delegating evidence collection to police at this stage would bypass established forensic protocols and compromise the quality and reliability of the evidence.

Choice B reason: Requiring the client to call the police violates trauma-informed, patient-centered care principles. Clients have the right to choose whether to involve law enforcement, and coercion can exacerbate trauma and undermine trust. SANEs provide information about options, support informed decision-making, and respect autonomy. Mandating police contact disregards consent and may deter clients from seeking care or disclosing details essential for medical and forensic evaluation.

Choice C reason: Protecting the client from further harm is a core nursing responsibility and a component of trauma-informed care, but it is not the defining role of the SANE. While SANEs ensure a safe environment during the exam and minimize retraumatization, their specialized role centers on forensic assessment, evidence collection, documentation, and coordination with legal processes. Safety is integral to care, yet the unique function of the SANE extends beyond general protection to expert forensic practice.

Choice D reason: Providing legal testimony on behalf of the client is a recognized role of the SANE. SANEs may serve as expert witnesses, explaining forensic findings, evidence collection procedures, and clinical observations in court. Their testimony supports the legal process by clarifying medical and forensic details, ensuring that evidence is interpreted accurately. This role complements their responsibilities in documentation and chain of custody, making it a key function of SANE practice.

Choice A reason: Suggesting that the client avoid making their partner angry places responsibility for the abuse on the victim rather than the perpetrator. This approach perpetuates victim-blaming and does not address the underlying issue of violence. It is not an appropriate or ethical nursing intervention, as it fails to empower the client or provide them with resources for safety and support.

Choice B reason: Providing information on community resources is the most appropriate action. This empowers the client by connecting them with support systems such as shelters, counseling services, legal aid, and advocacy groups. These resources can help victims of violence develop safety plans, access emergency housing, and receive emotional and psychological support. This intervention respects the client’s autonomy and provides practical assistance to improve safety and well-being.

Choice C reason: Offering strategies for interacting in social situations does not address the immediate issue of intimate partner violence. While social support can be beneficial, this option is not directly relevant to the client’s safety or access to resources. It may be useful in general wellness care but is not a priority intervention in the context of abuse.

Choice D reason: Instructing the client on how to behave to prevent anger from their partner reinforces the abusive dynamic and suggests that the victim can control the perpetrator’s behavior. This is harmful and unethical, as it shifts responsibility away from the abuser and onto the victim. Nurses must avoid interventions that perpetuate abuse or minimize the seriousness of the situation.