Gender-based violence (GBV) refers to harmful acts directed at an individual based on their biological sex or gender identity. In Nigerian clinical practice, nurses encounter survivors across emergency departments, general outpatient clinics, and maternal health spaces. Power imbalances, cultural norms, and economic dependency frequently trap victims in cycles of abuse. Recognizing that GBV is not merely a private domestic issue but a critical public health emergency shapes how healthcare professionals approach affected individuals. Victims often present with vague physical complaints, somatic pain, or chronic stress symptoms rather than explicitly disclosing abuse during their initial hospital visit.
When a survivor presents to a healthcare facility, clinical assessment must balance urgent medical stabilization with meticulous evidence preservation. Nurses must conduct physical examinations in a private, secure room with a chaperone present. Documentation requires objective, non-judgmental language, quoting the patient's exact words regarding the incident rather than summarizing with subjective interpretations.
Forensic evidence collection involves gathering clothing, documenting bruising patterns, and utilizing sexual assault evidence collection kits when applicable. Maintaining a strict chain of custody for all collected items ensures that physical evidence remains admissible if legal proceedings follow.
Immediate medical priorities include treating life-threatening injuries, preventing sexually transmitted infections (STIs), and providing emergency contraception. For survivors of sexual assault presenting within 72 hours, post-exposure prophylaxis (PEP) for HIV is critical to minimize infection risk. Emergency contraception should be offered promptly to prevent unwanted pregnancy resulting from assault. Routine screenings for hepatitis B, syphilis, and chlamydia form part of the standard emergency care protocol, alongside offering tetanus boosters for physical trauma.
Trauma-informed care shifts the nursing mindset from asking 'What is wrong with this patient?' to 'What happened to this patient?' Psychological First Aid (PFA) focuses on humane, supportive practical assistance without forcing survivors to recount distressing details before they are ready. Nurses must establish physical and emotional safety, maintain absolute confidentiality, and validate the survivor's feelings. Avoid asking intrusive probing questions about the trauma; instead, focus on immediate coping mechanisms and stabilization.
Navigating legal protections requires understanding national legislation, such as the Violence Against Persons Prohibition (VAPP) Act in Nigeria, which outlaws various forms of domestic and sexual violence. Healthcare providers must understand mandatory reporting guidelines while balancing patient autonomy and informed consent. A multi-sectoral referral pathway connects the survivor to social workers, legal aid organizations, safe shelters, and police authorities. Effective collaboration ensures that medical treatment seamlessly transitions into legal justice and social rehabilitation.