Treating the wounds of domestic abuse

Editor's note: This story is part of an eight-day series on domestic violence in Central Louisiana.

Amanda Walker has nightmares about what she sees working the overnight shift in Rapides Regional Medical Center’s emergency room.

“There are some cases that just stick with you for a very long time,” she said. “I have learned to deal with it — it’s part of the job. But sometimes it does get overwhelming.”

One of those cases involved a woman hospital staff suspected was a victim of domestic abuse.

“It was a bad situation. She came in every few weeks, and each time her injuries were worse.”

When asked about her injuries, “she always had a well-thought-out story to tell us,” but something didn’t add up, Walker recalled.

The woman was treated in the emergency room “eight or nine times, at least” with bruises and broken bones. Once, Walker said, the injuries were “much worse than the other times.”

“That time, she was beat up so bad that she was on life support,” Walker said. “I don’t think she made it out of the hospital.”

“We knew that she was not telling the truth about her injuries,” she continued. “Her story didn’t match up to how bad her injuries were. When things like that happen, you always wish that there was more you could have done to help.”

The high number of unreported incidents is one of the saddest statistics behind domestic violence, according to Dr. David Holcombe, the regional administrator/medical director for the Office of Public Health, Region VI.

According to the National Coalition Against Domestic Violence, 70 percent of domestic violence incidents go unreported.

Underreported numbers at hospitals are a common occurrence.

“We are mandated reporters for children, but if it’s an adult, it’s different,” Walker said. “If they don’t tell us directly that they’ve been abused and want to press charges against their offender, then we cannot do a lot legally to try to help them out of that situation. All we can do is treat the injuries.”

Walker said she sees injuries she suspects are a result of domestic violence every shift, though Rapides Regional records show staff treat only four to five victims each month.

“If we suspect that the patient is a victim of domestic violence, we give them a paper when they’re released from the hospital that has a list of numbers they could call for help — advocacy groups, shelters,” Walker said.

“I try to do more,” she added. “We have to be empathetic and talk to the patients, so I talk to them and try to let them know that they can leave (their relationship) and get help."

Many times, she said, the patient is at the hospital with their partner — who may be the offender.

Holcombe said that sexual assault and rape are forms of domestic violence, and 42 percent of rapes by partners or acquaintances are not reported.

Fortunately, he said, there has been some progress in addressing those incidents.

Act 229 of the 2015 Legislature mandated that every region have a sexual assault response plan. Holcombe worked with coroners, law enforcement and other agencies in development of the Sexual Assault Response Team for Region VI, and the plan is updated annually.

“The goal is to have all the (sexual assault) victims taken to a hospital that has SANE nurses — sexual assault nurse examiners,” Holcombe said.

SANE nurses go through rigorous training to ensure the victims are treated properly, that the examinations meet all standards and that evidence will stand up in court.

As a result of Act 229, Christus St. Frances Cabrini Hospital has been designated as the sexual assault response hospital for Rapides, Avoyelles and Grant parishes.

Holcombe said victims who don’t report domestic violence to authorities “rarely get out of their situation, and those people are the ones end up being killed because the aggressor just won’t stop," and noted that Louisiana ranked second in the nation in the rate of murders by partners in 2014 at 30.3 per 100,000 inhabitants.

“Early reporting is going to avoid aggravation of the situation which can end up in more violence or even death. The victim shouldn’t ignore it, but people that surround them, family members, neighbors, … can have a positive role” by reporting cases of domestic violence to police, Holcombe said.

“Although hidden behind closed doors, the disgrace of domestic violence, both physical and psychological, should be exposed to the light of day. If you are a victim of abuse, including rape or date rapes, or a witness to domestic violence, please report it,” he said.

When Amanda Walker thinks back to the some of the cases she has seen at work, "at times, it just makes me really angry.”

Sometimes, she even finds herself wondering about the offender.

“How can someone intentionally hurt another person so bad and not have any remorse for it? A wife, a child… It makes me really angry at first, but I have to find ways to move on. Then, I am just upset. I feel bad for the victim.”

To cope with the emotional strain that comes with the job, staff members are offered in-house counseling at Rapides Regional Medical Center.

“It gets easier over time to deal with, because you have to tell yourself ‘I did all I can do to help.’

"Still, there are some nights where I come home and all I can do is cry. I don’t want to talk to anyone about what happened during my shift.

"I just want to go to bed and cry.”

How to report domestic violence:

Domestic violence can be reported by the Louisiana Coalition Against Domestic Violence hotline at 1-888-411-1333 or the national hotline at 1-800-799-7233.

Child abuse and neglect can be reported to the state Department of Child and Family Services at 1-855-4LA-KIDS (1-855-452-5437).