'Write your initials with the red marker.' A hospital's strategic message to abuse victims.

An unknown hospital clinic is giving patients an ingenious way to signal whether they are dealing with domestic or family violence.

The sign, which went viral on Twitter last week, gives the patient two ways to return a urine sample to nurses.

While typically patients would use a black marker to initial the cup, the sign offers patients the option to use a red marker instead, to indicate they are experiencing domestic violence.

“Please put only your initials on your specimen and place it on the back of the toilet. Your nurse will collect your specimen,” the black text on the sign read.

“Please write your initials with the Red Marker on the specimen cup if you are experiencing intimate partner violence, domestic violence, or anything else you wish to discuss in confidence with your provider,” the red text on the sign read.

“We will ask anyone accompanying you today to leave the room before discussing your concerns.”

Although it’s unclear where the sign originated, the strategy has clearly made its mark online, with the sign being shared widely internationally on social media.

In Australia, one in six women have experienced physical or sexual violence from a current or previous cohabiting partner.

According to White Ribbon statistics, one woman a week is murdered by her current or former partner.

In Australia, hospitals, medical centres and doctor’s offices implement strategies daily to spot and respond to potential cases of family violence.


At the Royal Brisbane and Women’s Hospital in particular, staff receive training in ways to identify domestic and family violence.

Royal Brisbane and Women’s Hospital Domestic and Family Violence Coordinator April Buchholz spoke to Mamamia about just some of the ways hospital staff identify and detect domestic violence.

“The most obvious way [domestic violence is identified] is when a victim will come to our Emergency and Trauma Centre with injuries as a result of physical assault,” Buchholz explained.

“If they don’t present for injuries related to assault, they can also be attending hospital for another reason but over the course of the conversation, they could make a disclosure about domestic violence.”

There are also other ways that domestic violence could be detected in more subtle ways.

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“We could have suspicions about injuries, for instance, if they’re not quite consistent with the explanation for the cause,” Buchholz explained.

“There might be concerns about the patient’s presentation of themselves. They might be very concerned, anxious, worried, appearing frightened of the person that is with them,” she continued.

“There might be observations of the interactions between the patient and the person who is accompanying them. The partner or the person with them might be speaking on behalf of them, not letting them answer any questions or glaring at them.”

When a potential case of domestic or family violence is identified, there are a number of ways that health professionals could respond to the situation.

“With the most straightforward cases – so perhaps a woman presenting with injuries or a woman making an immediate disclosure about domestic violence – if that’s happening in our emergency departments, they would initially be speaking to nursing or medical staff and they will immediately flag the matter,” Buchholz explained.


“It is then referred to the social work department in our emergency department, which is available 24 hours. [The fact that it’s open 24 hours] is fairly uncommon. We’re certainly the only hospital for Queensland that has 24 hour social work support now in the emergency department.”

If a victim of domestic violence does not wish to see a social worker, education and training is provided to nursing and medical staff at the hospital to ensure their ability to support the patient without making judgement.

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“It’s about being really respectful and supportive of the patient – that’s always the starting point,” Buchholz said. “So validating their experience, believing them, giving them the message that violence is not acceptable and that they’re to be treated respectfully.”

“It’s also about being guided by the patient and seeing what they want to do. Do they want support in exiting the relationship or finding safe accommodation or are they just looking for some emotional support in that moment?” she explained.

“The training for our staff has really emphasised that it’s really important not to ask a woman: ‘Why don’t you leave the relationship?’ Separation can actually be a time of high risk for women in domestically violent relationships.”

In the case that a victim of domestic violence requires or requests immediate support, social workers at the hospital work with a number of services to ensure the victim is supported.

“In Brisbane we have outreach service, Safer Lives, that’s a 24 hour service that will come to the hospital and provide support to that patient and help them arrange emergency accommodation,” Buchholz said.

“We work with DVConnect to arrange that refuge accommodation if necessary,” she continued.

“We also have a great working relationship with Queensland Police Service and the Vulnerable Persons and Domestic Violence Unit, so we might also make contact with them.

“There’s not one sort of straightforward answer about what to do when someone comes in with domestic violence because it really depends on each case – it really is a case by case scenario.”

Feature Image: Twitter.

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