Reference no: EM133511601

Question: Angela is a 25-year-old woman who lives with her mother in a small home. She currently works in the accounting office at a nearby elementary school. Angela is seeing Sam, a mechanic from a nearby town. He is attentive and interested in being part of Angela's life. After three months of dating, Sam moved in with Angela and her mother (to the delight of Angela's friends and family). Angela became pregnant and is a bit nervous about how they will afford their growing family, but she is happy to have a baby with Sam. Sam seemed indifferent to the pregnancy at first but now showers Angela with care and presents. One night Angela arrived home late from work; Sam was angry. As she walked in the house, he yelled "Where the hell have you been?! I come home early one day and you're out with God-knows-who doing whatever you please when you're supposed to be here when I get home. Who were you with?!" Angela tried to explain, but Sam's anger scared her, and she wanted to resolve the conflict as quickly as possible. Sam stormed out the door and drove off. An hour later, he returned and apologized to Angela. He told her, "I don't know why I got so angry-it's just been a bad day at work. And you know I don't really like that friend of yours very much. I'm sorry, honey." The public health nurse (PHN) who will be following Angela through the pregnancy sees her for the first visit the following day. The PHN notices the bruises and that Angela is favoring her finger. The PHN asks Angela about the injuries, and she states she tripped and fell.

During the last trimester of her pregnancy, Sam's abuse escalates in frequency and severity. On several occasions, Angela threatens to leave Sam. He responds at first by laughing and telling Angela she could never make it on her own, but then he begins to threaten to kill Angela if she tries to leave. The PHN notices Angela's change in behavior. Sam continues to be present at all the visits. The PHN's suspicion of intimate partner violence are growing stronger. The PHN reports this situation to their supervisor. During the time the PHN has seen Angela, she has presented with a broken finger, a displaced shoulder, an injured foot, and a laceration on her arm. Because Sam has always been present for the visits, the PHN is unsure of the true nature of the injuries. Today, Angela calls the PHN to come for a prenatal visit, as soon as possible. The PHN arrives and Sam is not present. Angela reports Sam has been physically abusing her, but she is not yet willing to leave. What might the PHN discuss with her at this point? Using the Safety Plan provided to you, discuss how you would work with Angela on developing a safety plan. Examine what resources are currently available in your community that you could provide to Angela if she decides to leave the abusive relationship.