Imagine a scenario where a patient reports or you suspect that this patient has been harmed by another. This could be a situation in which a patient with dementia in a long term care setting harms another patient or a patient reports that they have been harmed by a staff member caring for them or by a family member. Maybe they were pinched, punched, grabbed, shoved, sexually abused, roughed up during care, or verbally assaulted. Maybe they have been financially abused by another.
Abuse is not always as obvious as the written words on paper. As nurses we often see the symptoms exhibited over a period of time. These symptoms include but are not limited to: (https://www.forensicpanel.com/expert_services/medicine/criminal_law/domestic_violence.html)
- Unexplained bruising and injury
- Irrational fear
- Acting out
- Withdrawn behavior
Those in need of our care are in a vulnerable situation and they must rely on us as nurses to know our responsibilities, accept our responsibilities, and to act as an advocate for them. I discuss in my book “We are Gatekeepers: A Self-Reflective Leadership Challenge for Nurses at All Levels” that as Gatekeepers we must hold ourselves accountable, our behaviors, and our practice to do the right thing. “Simply, accountable behavior instills trust” (Covey, 2006). When a nurse is accountable and advocates for another, trust is built.
Accountability as noted in my book is not something that is imposed upon us. It is something we do for ourselves. It is something we accept. Others can only motivate us to be accountable, they cannot make us accountable. What does doing the right thing mean when it comes to understanding our responsibilities and our accountability in relation to the laws that govern abuse? It means that the law motivates us as nurses to accept our responsibility and accountability in our professional roles. It means that as nurses it is up to each and every one of us to understand our Federal and State laws, the standards that govern our practice and abide by them.
So what are our responsibilities in regard to assuring our patients are safe and free from abusive situations? The answer is to report suspected abuse! It does not matter if you have proof. The mere fact that you have assessed the potential and you are acting in good faith is reason enough. According to the U. S. Department of Justice “The federal government and states, the District of Columbia, and some territories all have statutes to protect older adults from physical abuse, neglect, financial exploitation, psychological abuse, sexual abuse, and abandonment” (https://www.justice.gov/elderjustice/elder-justice-statutes-0). This is also true for child abuse as noted in “Duty to Report Suspected Child Abuse under 42 U.S.C sec. 13031” (https://www.justice.gov/sites/default/files/olc/opinions/2012/05/31/aag-reporting-abuse.pdf). It is a necessity for you to also research your State’s Statutes for your mandatory reporting requirements and instruction on how and where to report.
As nurses it is our responsibility to become involved. Not acting out of a fear or a lack of desire to ruffle feathers is not an excuse for not reporting suspected abuse. Rationalizing our assessments and our suspicions is also not an excuse. Allowing ourselves to succumb to the request of a supervisor or administrator who suggests that we do not report is also not an excuse. As nurses, we do not judge. We report the facts and findings of our assessment. This is our responsibility as a professional nurse and a mandatory reporter. If you are in a situation where your responsibilities to report abuse are blocked, talk to a nurse attorney or an attorney about your concerns. If you would like education and assistance with policies and procedures to reduce your legal risk talk with a legal nurse consultant. As nurses we are all professionally responsible to uphold this duty.
I hope you enjoyed this week’s Talk Tuesday and you can find at least one take away to apply to your practice today. Please take time before you leave to enter your email and follow my blog. I would also love for you to visit my web-site https://upvisionconsulting.com/. In addition to working with attorney’s and medical professionals I speak on various topics including my book in venues both inside and outside of the legal and healthcare arena.
If you wish to purchase a copy of my book please visit https://upvisionconsulting.com/publications
The Legal Nurse
Covey, S.M. & Merrill, R.R. (2006). The speed of trust: The one thing that changes everything. New York, NY: Free Press
Gerrie, J.L. (2016). We are gatekeepers: A self-reflective leadership challenge for nurses at all levels. Kingston Springs, TN: Westview