Nurses are mandated reporters but what does that mean? For nurses being a mandated reporter means that it is a nurse’s responsibility to report any suspicions of child or adult abuse or neglect. If the story just doesn’t fit, the nurse needs to be suspicious. If the child or adult suggest they have been abused, the nurse needs to report.
Get the facts
As in any given nursing situation, it’s important to assess the full situation. Gather the facts, take photos as allowed, obtain and document comments or direct quotes from the patient, parents, siblings, spouse, caregivers, etc. Ask questions and ask to speak to the patient alone. Then report the information to the local department of social services. This is usually child protective services or adult protective services. If danger is imminent, the police should be notified.
Mandated reporting is not anonymous
Mandated reporting is not done anonymously, but there are circumstances where the identification of the reporter is not readily available to the perpetrator or even to the victim. Sometimes it’s obvious or easy to figure out, but the reporter can often successfully deny it if confronted by the patient or perpetrator. The reporter needs to be identified to the social services department in case further information or testimony is necessary to carry out the investigation.
Each state has specific guidelines and information for mandated reporters as to what is deemed abuse or neglect and how and where to report. All 50 states and Washington DC have mandated reporting laws. Nurses need to be familiar with the rules for reporting in their state. Failure to report in a timely manner can carry heavy fines and penalties. It can also result in further harm or even death to the patient.
Several states have mandatory continuing education requirements to ensure nurses are informed and have the skills necessary to recognize and safely handle unique situations presented in cases of child and adult abuse. Pennsylvania, for instance, has very specific mandatory ceu requirements. And New York nurses must contact NursingCE.com’s customer support to receive the New York state completion certificate after completing the ceu course on Child Maltreatment.
One of the first points to note is that there are 4 specific categories that mandated reporting usually falls into:
- Injuries caused by weapons
- Injuries caused by violation of criminal law, as a result of an act of violence through non-violent-accidental means
- Those states which specifically address domestic violence
- States that have no general mandatory reporting laws.
Another important fact to remember is that HIPAA does not preclude mandated reporting although a patient/nurse relationship may be reason to reflect and possibly delay or avoid reporting. This could prove to cause even more harm in the long run. And possibly result in fines for not reporting.
Just report the facts
The most important point that any mandated reporter has to remember is that the reporter is not responsible to prove anything nor to decide the guilt or innocence. The reporter is not the judge or jury. The reporter’s role is to advocate for the child or adult being abused or neglected and work to improve the situation and prevent further harm.
The sole responsibility is to report a suspicion and provide the facts. The appropriate county public services department will investigate and if necessary, seek to bring charges against the perpetrator if the evidence shows there may have been criminal action or intent.
Nurses need to be informed and have an understanding of what child abuse consists of and how to recognize the signs. Most states have at least four major types of child maltreatment which include:
- Physical abuse – abuse that does not happen as a result of an accident
- Emotional abuse – behavior that minimizes a child’s self-worth; i.e. humiliates, threatens or intimidates
- Neglect – failure of the parent/caregiver to meet physical, emotional, financial medical, educational needs
- Sexual abuse – as defined by Child Abuse Prevention and Treatment (CAPTA) “Employment, use, persuasions, inducement, enticement, or coercion of any child to engage in any sexually explicit conduct for the purpose of producing any visual depiction of such conduct; or rape, and in the case of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other forms of sexual exploitation of children or incest with children.”
In some states, additional forms of abuse are identified such as parental substance abuse and abandonment. State statutes can vary. Information is available from Child Welfare.
All of the above can also apply to adult and elder abuse situations. Abuse is most prevalent in situations where violenceis common in the environment. Nurses need to recognize that they are not immune from abusive situations and their own feelings from experiences can be driven to the surface in these situations. Recognizing that their own emotions are the result of prior or even concurrent abuse situations is an important factor in improving outcomes for patients. In some instances, the nurse may need to recuse.
It’s vital to remember that the nurse needs to follow the nurse’s code of ethics and remain non-judgmental in treatment of patients. Providing education and community resources is one of the best ways of advocating for the patient while helping to improve the situation for all involved.