Nurses are Mandated Reporters – Not a Judge or Jury

Kathy Quan RN BSN PHN

Kathy Quan RN BSN PHN

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’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. 

6 thoughts on “Nurses are Mandated Reporters – Not a Judge or Jury”

  • Judy Passaglia says:

    If an RN is functioning in a volunteer position and learns of a situation that would be reportable if he/she were working in their professional capacity, does this reporting mandate still apply? Please advise ASAP.

  • Sick and Suffering says:

    There is no one in this country that tells the truth in the medical society, the abusive manners the doctors speak to all their patients using their power as weapons picking and choosing who they help is so rampant in this industry. Woman and children suffer the most and what really is interesting to me is how woman treat woman, this “I don’t care anymore” culture is destroying so many lives and it’s really sad as we are taught to trust so much and patients are clueless their doctors are leaving them sick and crippled when a simple surgery or a medication they refuse are used like God pick and choose. We all as human beings who have worked, paid our taxes and just happen to fall on health issues deserve so much better and sadly doctors used to care, but they just don’t anymore and the egos are out of control and killing patients. I wish people would report things, I wish people weren’t silenced and made to fear loss of their jobs, I wish we were caring again, but that wish will never come true in my life time or anyone else’s. Instead they will shovel you to expensive money driven psychiatrist and psychologist and maybe the dead can think themselves alive after the negligence to properly care for them is realized after too many of us end up dying. What we have now is a dangerous joke that needs to change fast. From someone harmed by this who does care!

  • Diane says:

    I am a nurse. My step daughter has relapsed and I have concerns for her kids due to her drug use. I want to wait to report to see if I can help her get help but my friend insists I must report. Am I a mandated reporter outside my job?

  • L. Sibley says:

    I am a AZ nurse who was denied my mandated rights to report workplace violence, blood , assaults of myself and a vulnerable adult. My patient on the floor who also sustained injuries died days later.
    OSHA/ ADOSH refused on 2 documented calls , which I have legal documents to provide to take any incident reporting, which are reporting felonies to the State of Arizona. 23 minutes total for 2 days where no historical documentation was taken.
    This is criminal activity by State employees covering up assaults and injuries.
    I would be prosecuted, but these employees are told to cover up crimes. Frightening that this state covers up abuse of Nurses. I also have documents to provide my diagnosis of PTSD from this assault and attempted patient rape.
    There was a 79 year old female who was forcibly rape 14 months ago in this facility.
    There are no alarms, silent alarms, keys to escape or staff to adequately staff this geriatric psychiatric ward. It is an endangerment to anyone who is in this facility.
    The AZ Workman’s attorneys know this illegal activity is being covered up.

  • ????? ????? says:

    I found this article very interesting, thanks for sharing

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