Depending on where you work as a nurse, you may find yourself on the front lines of caring for adults and children who have been the victims of abuse. Nurses who practice in primary care, respite care for older adults, the school system, and the emergency department are especially likely to be the first responders in abuse situations. It's important for nurses to know their legal and clinical responsibilities when working with these victims.
As a registered nurse, you are categorized as a mandated reporter. This means when you sign your nursing license application or your request for application renewal, you agree to report abuse following the guidelines set up by your state. This includes reporting abuse of children or dependent adults, when as a nurse working in your official capacity, you suspect or believe a patient has been abused. The guidelines for reporting abuse in your state are available through your state board of nursing. Additional information about what is or is not considered reportable should also be available through the legal department where you work. Often talking with a direct supervisor is the first step in obtaining this information.
While nurses are not required by law under the mandated reporter provision to report suspected domestic violence, as a nurse you have a great responsibility and opportunity to help victims of domestic violence. One of the first steps in helping victims of domestic violence is assisting patients to open up about potential abuse. Make sure your facility has brochures and flyers about domestic violence services prominently placed in public areas where patients will see them.
Developing Assessment Skills
All nursing schools include information about how to detect child and domestic abuse within the curriculum, but the practice of detection can be much more difficult. Most inpatient and outpatient facilities now require questions about personal safety and domestic violence screening questions as part of the intake process. As a nurse, it's important to ask these questions with intent, so ensure the patient has enough time to answer. Some practitioners even wear buttons or badges that say, "It's okay to talk with me about domestic violence." Only ask questions about domestic violence when the patient's partner is out of the room.
It can be frustrating when a nurse reports child abuse to the proper authorities, only to have the child returned to the home, or when an adult patient returns to a violent situation, especially after being injured badly enough to need medical attention. As a nurse, it's important not to become discouraged when your interventions don't immediately correct a situation. The systems surrounding family-based violence are complicated. You may need to continually re-assess your at-risk patients to ensure their safety.
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