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Question

Feels Guilty for Not Reporting Possible Patient Abuse

Hi Nurse Beth!

How and when does one draw the line with mandated reporting? Let me explain; following things by the book is generally what I attempt to do... I've been met with times where I've witnessed unethical behavior and interfered and stopped what was occurring with but didn't report beyond that.  For instance, years ago a Co worker was purposely rough while cleaning a patient's genital area .

I immediately told the Co worker to stop and they did and I apologized to the patient. I've felt guilty for years for this because although the patient is no longer living and the patient didn't have any more dealings with the Co-worker, the fact that I didn't do more horrifies me and makes me feel terrible.

Another instance I didn't witness but was TOLD of an instance that occurred a year after it happened and was self defense but still wondering, "Do I have to report this?" And lastly, present tense a nurse used 4 bed rails for a fall risk patient to stop them from getting up. Is this considered reportable or even considered abuse or just considered a violation?  I know it all sounds anal and I just want to know if everything is black and white, and also if I need to move on from the event years ago that I didn't report or what.  I've never forgiven myself for it and the idea of me breaking the law by having not reported haunts me.

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    Dear Haunted,

    Nurses are mandated reporters which means we have to report suspected abuse. Mandated reporting includes child abuse, elder abuse, neglect, and sexual abuse. 

    Having 4 side rails up is considered a restraint, which requires a provider's order, but is not abuse.

    You did the right thing by stopping the coworker who was purposely rough while cleaning a patient. Instead of beating yourself up, know that many people would not have stood up to the coworker and told them to stop, like you did. That showed moral courage.

    It would have also been good to report that coworker to your manager. Someone who mistreats vulnerable patients should not work with patients.  If this was an RN, the manager may have investigated, disciplined, and reported this person to the BON, If the person was certified, such as a CNA or tech, then it can be reported to their certifying agency.

    Whenever you are disturbed by such behavior, it's because your internal sense of right and wrong is telling you something is wrong.  Follow your chain of command and talk to your manager or charge nurse. You are not alone.

    Finally, let it go. You deserve to treat yourself well and not torture yourself with guilty thoughts. It's in the past, and you cannot change the past. 

    If you're not able to let go, then see a counselor to unpack your feelings and talk about it.

    Best wishes,

    Nurse Beth

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    Love Nurse Beth advice!

    My goodness, rough while cleaning someone's genitals.. that one has me. I can't even think straight now.  People are cruel. 

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    Can the person still be reported or no since it was so long ago ? 

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