Intimate partner violence (IPV) can affect anyone. Nurses are often uniquely positioned to recognize the early warning signs of IPV and to support clients through thoughtful, compassionate and client centred care.
This resource page provides practical guidance to help nurses recognize potential signs of IPV, respond in a trauma informed way and connect clients to appropriate support.
Intimate partner violence is any form of violence or harassment directed toward an intimate partner, including both spousal and non spousal relationships. It can involve coercive control, criminal harassment, stalking, emotional or psychological abuse, economic abuse, physical abuse, reproductive coercion, sexual violence, spiritual abuse and cyberviolence. Intimate partner violence among adults aged 65 and up is any act or lack of action, within an intimate relationship where there is an expectation of trust, that harms an older adult and causes them distress or risks their health or welfare.
Who experiences intimate partner violence
Anyone, regardless of age, sexual orientation, gender identity or expression, race, ability or ethnicity can be impacted by IPV. In Canada, instances of IPV are highest among women, with Indigenous women, 2SLGBTQIA+ individuals, women with disabilities, young women (aged 15 to 24 years) and racialized women, all facing an increased likelihood of experiencing IPV. Additionally, women aged 65+ are five times more likely than men of the same age to be killed by an intimate partner.
Potential warning signs of intimate partner violence
As identified by the RCMP and the World Health Organization, the following are signs a client may be experiencing IPV.
If the client:
- has unexplained bruises or questionable explanations for injuries
- acts differently when their partner is around (for example, doesn't speak up, doesn’t speak for themselves)
- tries to change the subject if they are questioned about their partner's behaviour
- appears to be controlled by their partner and seems reluctant to make decisions by themselves
- withdraws from their friends and family
- is pressured to have their online activity monitored by their partner
- has an uncharacteristic change in risk-taking behaviours (for example, doing drugs, drinking alcohol)
- experiences a drop in school or work performance
- is humiliated or criticized by their partner in front of others
- is frequently contacted by their partner wanting to know where they are and what they are doing
- has poor physical health, cognitive impairment, low income and functional dependence specifically in older adults
Working with clients experiencing or at risk of intimate partner violence
People who experience IPV can have long lasting physical and psychological impacts. Those seeking nursing care may face additional barriers related to culture, language, stigma, systemic inequities or fear of escalation of violence. Nurses play a key role in providing respectful, non judgmental client-centred care, supporting informed decision making, and connecting clients to appropriate resources. We encourage nurses supporting clients who may be experiencing IPV to use a trauma informed, culturally sensitive approach that prioritizes client consent, autonomy and safety.
Nurses should consider the following:
Use evidence based risk assessment tools, such as the ones below, and safety planning approaches to help identify potential risks and support client safety. Risk assessments should be conducted collaboratively, with the client’s consent and in a manner that recognizes the client as the expert in their own lived experience.
Respecting client confidentiality and obtaining consent is essential when supporting individuals experiencing IPV. In some circumstances, nurses may be required by law to disclose information to a third party to prevent serious harm to the client or others. For example, when there are reasonable grounds to suspect that a child needs protection under the Child, Youth, and Family Services Act, or when the individual resides in a long-term care home and needs protection under the Fixing Long-Term Care Act, the nurse has a duty to report. These decisions should be guided by professional judgment, applicable legislation and CNO practice standards, while minimizing risk to client safety.
When nurses discuss IPV with a client, provide education or offer resources or referrals, these interactions should be documented in the clinical record in accordance with CNO’s Documentation practice standard. Thorough documentation supports continuity of care, ongoing client support and accountability.
Employers must also support clients who experience IPV by developing clear policies that outline nurses’ accountabilities in situations involving IPV. We encourage nurses to follow up with their manager or broader health care team for additional organization-specific guidance.
It is important to recognize supporting someone who is experiencing IPV can be challenging and emotionally exhausting. Practicing self-care, meaning intentionally making time to restore your energy and well being, can help reduce stress and burnout. Caring for yourself and accessing support as needed helps you stay grounded and better able to offer meaningful, sustained support for your clients.
A shared effort to address rising cases of intimate partner violence
When an unexpected or unfortunate death occurs, the Office of the Chief Coroner (OCC) in Ontario may conduct an investigation or inquest. Insights gained from these investigations inform reports and recommendations aimed at improving public safety and preventing similar deaths in future.
In some cases, these reports include recommendations related to nursing practice. As the nursing regulator, CNO reviews the recommendations and considers them in the context of existing standards and guidelines. This work helps clarify nursing accountabilities and expectations and informs how emerging learnings can strengthen CNO’s regulatory approach.
As a direct result of this recommendation from the OCC, CNO developed this web resource to support nurses in learning more about IPV, so they can better identify early warning signs and support clients through thoughtful, compassionate and client centred care. Nurses are well positioned to support clients in this way because nurses play a central role in the health care system, supporting clients in a wide range of situations.
CNO is working with our peers from across health colleges to support the OCC’s recommendation. On Tuesday, Sept. 22, 2026, the Health Profession Regulators of Ontario will host a free webinar on the topic of IPV. Open to all health professionals, the webinar will cover tools and strategies health care providers can use to support clients.