Other statistics have revealed that of the women who visit the emergency room, approximately 22 to 40 per cent are likely there as a result, direct or indirect, of domestic abuse. However, in the past, only three per cent have actually been identified.

The studies and a similar program at St. Joseph's Hospital in Toronto spurred the Peterborough Regional Health Centre on to implement a women abuse protocol in 1998. "The centre has been very leading edge with this program," says Leanne Armstrong, manager of the Women's Health Care Centre. She says the PRHC was one of the first centres in Ontario to do introduce this specific of program. Other centres across the province have since put it in place as well.

Now when a woman steps into the emergency department at the Peterborough Regional Health Centre, she can expect to be asked three questions around abuse or potential abuse. Are you currently in a relationship in which you are being hurt or are afraid? Within the last year, have you been hit, slapped, kicked or otherwise hurt by someone? Within the last year, have you been forced by someone into sexual activity?

Those who come in to receive maternal/child services are also asked the same questions.

Every registered nurse and registered practical nurse in emergency and maternal child has been trained on the cyclical nature of abuse and its stages. Abusive relationships typically have three stages, the tension-building phase, the acute phase, and the calm phase. "Watching for all those pieces of the cycle of abuse is important," Leanne explains.

If a woman does disclose that she has been abused or may be abused, a whole program for supporting and empowering her to make a healthy choice in response is implemented through the centre. She will be helped to establish a safety plan for her and her children. She can also get information on resources in the community and counseling.

Because of the high in-take levels for the Emergency Department, and the startling statistics for the Maternal Child Services, only these two departments utilize the women abuse protocol at this time. However, the centre has received funding to expand the program under the umbrella of domestic violence. The next phase will be to implement the protocol throughout the institution.

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