Nurses and midwives in Poland trained to help survivors of gender-based violence

"Empathy is key. This is a skill that every nurse and midwife should have," says Mariola Łodzińska, Head of the Chamber of Nurses and Midwives of Poland. Mariola was a participant in a recent WHO training session for nurses and midwives on how to screen and support survivors of gender-based violence (GBV). She describes how the initiative, organized in collaboration with the WHO Country Office in Poland, is set to benefit survivors across the country.

"Active and careful listening gives you much more information and gives the survivor the understanding that the intimate information they share is listened to. It is about raising awareness among nurses, and it is truly valuable."

Mariola notes the role that the Chamber of Nurses and Midwives plays in training, as well as the enthusiasm for continued education among the nursing and midwifery community. Nurses and midwives serve as the first point of contact for many survivors of GBV, particularly in emergency rooms.

"If you don't approach survivors the right way, you may inadvertently discourage them from taking that crucial first step towards getting help," Mariola stresses. The programme therefore provides nurses and midwives with a structure, helping them to approach and interact with survivors in a way that fosters trust and encourages help-seeking behaviour.

Raising awareness and building skills

A lack of training had previously impacted the ability of nurses and midwives to respond effectively to GBV survivors. "Not all health-care providers are really complying with employment standards for nurses and midwives, and are often understaffed," Mariola says. Understaffing leads to time constraints on face-to-face contact with patients, preventing nurses and midwives from prioritizing this essential intervention.

There have been notable changes in how nurses and midwives respond to GBV since the training began. The course has raised awareness that responding to GBV is not just a health issue, it is also part of providing comprehensive care.

Mariola highlights the importance of creating a supportive environment that involves everyone - all medical and nonmedical personnel. "First, making sure that there is privacy, and that people feel safe," she notes, even in limited spaces. "Safety is critical in the situation, and we must build support for designed places for safety and privacy."

The training also opened new opportunities for nursing and midwifery leadership, a key focus area highlighted in the WHO Global Strategic Directions for Nursing and Midwifery 2021-2025. Participants are now running their own training sessions at workplaces or with county chambers in every province in Poland.

"The 43 chambers are engaged in the programme, supporting the rollout of the training, providing training venues and any additional support," Mariola shares.

GBV faced by nurses and midwives

Nurses and midwives themselves can also be victims of GBV, often within their workplaces. Up to 62% of health workers globally have experienced workplace violence. WHO's 2022 report "Our duty of care: A global call to action to protect the mental health of health and care workers" highlights that this rate increased during and after the peak of the pandemic.

Mariola stresses the importance of recognizing and addressing this issue. "Nurses and midwives are not immune to GBV, and it can occur in various forms, including verbal, physical and sexual harassment," she says. "The course equips health professionals with the skills to support their colleagues who might be facing GBV."

Mariola continues, "We need to ensure that there are clear policies and support systems in place for nurses and midwives who experience GBV. This includes providing 'zero tolerance for violence' policies in the workplace and survivor-centred counselling services, legal support, and rights-based protocols for reporting and addressing incidents of GBV within health-care settings."

Vision for the future and WHO support

Looking ahead, Mariola envisions better coordination of activities for GBV survivors. "If we have a GBV survivor, we don't have coordination on the next step that should be taken," she says, emphasizing the need for protocols involving the police, social assistance and GBV organizations. "It would be good to think about such coordinated activities in county chambers in all regions."

To better support nurses and midwives in recognizing the signs of GBV, Mariola advocates for continuous training and refresher courses. "Each year, nurses should have refresher training, [which could include] the GBV refresher," she suggests. Plans are underway to establish an education platform for nurses and midwives, including webinars and training sessions.

The WHO Country Office in Poland is working closely with the Chamber of Nurses and Midwives to institutionalize this training through e-learning and a digital platform offered by the Chamber. This will enable more nurses to acquire critical knowledge and enhance their confidence in responding to incidents of GBV.

Nino Berdzuli, WHO Country Representative in Poland, shares, "Our collaboration with the Chamber of Nurses and Midwives is delivering tangible results. Nurses and midwives, as the first responders to GBV, are key. But they can't do it alone - they need the backing of health facility managers and the entire health system."

She adds, "At the WHO Country Office in Poland, we're working closely with key medical professional societies and authorities to create standards for health facilities to handle violence and abuse, ensuring a consistent and compassionate response across the country."

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