General Abuse reporting question

PsychNurseWannaBe, BSN, RN · Apr 11, 2008

Mandatory reporting is for children and in some states elder abuse. In my state, if you are not a child or an elder... you have the right to stay in an abusive relationship. Therefore, I can only call and get that person help provided that they consent for me to do so. If the patient says no...than I am not to call. They have a right to privacy. It does get stickier if there are children in the home.

Check your state guidelines and company policies

justme1972 · Apr 11, 2008

I agree with Psych nurse. I don't think that falls under mandatory reporting because she is an adult if she wants to stay in an abusive relationship, that is her choice.

However, I would have asked about her living situation..if she was living with the boyfriend (especially if he was at the hospital), that could possibly be an imprisonment-type situation and I would have called the police and just let them take it from there. That may have been one of the few times she may be alone.

In many states if the officer sees evidence of domestic abuse, they are REQUIRED to arrest the person who did the crime. She may not have admitted it when the police got there, but the police most likely would have taken your word for it.

I would have asked if she had children....to me, that is reportable b/c if he is abusing her I can only imagine would he would do to the children.

If she is living alone, you can't fix that.

anc33 · Apr 11, 2008

You can report it and then it is up to the police whether they want to visit the home. However, if the woman does not wish to press charges or denies there is anything wrong in the home, then nothing will happen. Cases involving the abuse (physical, financial, etc) of children, the disabled or elderly requires mandatory reporting in most states.

elkpark · Apr 11, 2008

You can report it and then it is up to the police whether they want to visit the home. However, if the woman does not wish to press charges or denies there is anything wrong in the home, then nothing will happen. Cases involving the abuse (physical, financial, etc) of children, the disabled or elderly requires mandatory reporting in most states.

Report what??? If she's not in a protected group (children, elderly, disabled) and doesn't wish to press charges, you're simply violating her privacy (and, potentially, putting her in greater physical danger (from the BF) than she already is -- don't forget that part!)

I'm no legal expert and just speculating here, but I'm guessing that reporting against her wishes could easily be considered a HIPAA violation (disclosing info about her being in the ED without her consent) and/or leave you open to the possibility of a lawsuit. Do you really want to go there?

Your hospital has social workers who are better prepared, professionally, to deal with this kind of situation than most RNs; you can always ask Social Work to see the client and let them decide what should be done (if anything).

If there are children in the home, it could make sense to report the potential/suspected abuse of the children -- but, remember, in that case, you report to CPS, not the police.

anc33 · Apr 11, 2008

Oh I am well aware of that. My point was that nothing will be done if the person does not wish to file charges. That is why we do not have mandatory reporting across the board. Although, I would consult with the social worker on the floor as there may be children and/or other groups in the home who are also being abused.

justme1972 · Apr 12, 2008

Report what??? If she's not in a protected group (children, elderly, disabled) and doesn't wish to press charges, you're simply violating her privacy (and, potentially, putting her in greater physical danger (from the BF) than she already is -- don't forget that part!)
I'm no legal expert and just speculating here, but I'm guessing that reporting against her wishes could easily be considered a HIPAA violation (disclosing info about her being in the ED without her consent) and/or leave you open to the possibility of a lawsuit. Do you really want to go there?
Your hospital has social workers who are better prepared, professionally, to deal with this kind of situation than most RNs; you can always ask Social Work to see the client and let them decide what should be done (if anything).
If there are children in the home, it could make sense to report the potential/suspected abuse of the children -- but, remember, in that case, you report to CPS, not the police.

This is not entirely true.

I do know whenever, at least in my state, when there is someone that comes in with ANY alcohol related injury (whether they said it was a car accident or not), any car accident injury, any major injuries that could have been caused by another (such as a shotgun wound, stab wound, etc), the hospital is required to report this to the police b/c a crime may have taken place and needs to be investigated.

The woman could also lie about not having children, and that also needs to be investigated...and a crime has taken place because domestic violence is a crime....but HOW FAR you have to go (bruises vs stab wounds) in the injury before reporting it, would be a very good question.

At minimum, if she has children, then that needs to be reported, whether the children are the patient or not.

justme1972 · Apr 12, 2008

Oh I am well aware of that. My point was that nothing will be done if the person does not wish to file charges. That is why we do not have mandatory reporting across the board. Although, I would consult with the social worker on the floor as there may be children and/or other groups in the home who are also being abused.

Sorry for the double post....I would stop by the police department and as them a general question on this.

As I posted before, her testimony is not required in all states for a police officer to make an arrest in the case of domestic violence, the officer viewing the bruises and her making a statement that her boyfriend caused them, in some states...a police officer is MANDATED to make an arrest....and it doesn't matter if she wants to press charges or not.

You need to find out if you live in one of those states.

elkpark · Apr 12, 2008

The woman could also lie about not having children, and that also needs to be investigated...and a crime has taken place because domestic violence is a crime....but HOW FAR you have to go (bruises vs stab wounds) in the injury before reporting it, would be a very good question.
At minimum, if she has children, then that needs to be reported, whether the children are the patient or not ...
As I posted before, her testimony is not required in all states for a police officer to make an arrest in the case of domestic violence, the officer viewing the bruises and her making a statement that her boyfriend caused them, in some states...a police officer is MANDATED to make an arrest....and it doesn't matter if she wants to press charges or not.

You're going to investigate whether or not she's lying about having children???? How, exactly, are you going to do that?

She came into the ED with a fever and some bruises. If you drag the police in and she tells the police, no, he doesn't hit me and I never said that, that nurse is lying (which is most probably what she's going to do), then it's your word against hers. If the police officer does proceed to try to make an arrest (which is hard to imagine), it's going to be on the basis of your statement -- do you want to testify in court about this? (I'm sure the abusive BF will luuuuv that -- better start watching your back ... :icon_roll) And, again, I'm no legal expert, but I do know there are serious limitations on hearsay evidence (which is what your saying that she told you the BF beat her is), so the case may well never make it to court anyway (which, IMHO, would be the best outcome for you).

In my experience (and this is also what the experts in the field of domestic abuse recommend), the best thing you can do for adults in this situation is to make sure they are aware of the shelters & services available to them in the community, and don't rock the boat beyond that. As someone else pointed out here, whether we like it or not, competent adults in our society have a right to choose to stay in an abusive relationship, and, again, well-meaning people who meddle in the situation are often simply putting the woman in greater physical danger.

Let the social worker deal with it ...

vashtee, RN · Apr 12, 2008

As I posted before, her testimony is not required in all states for a police officer to make an arrest in the case of domestic violence, the officer viewing the bruises and her making a statement that her boyfriend caused them, in some states...a police officer is MANDATED to make an arrest....and it doesn't matter if she wants to press charges or not.

Yes, this is the way it is in California, so far as I know...

justme1972 · Apr 12, 2008

You're going to investigate whether or not she's lying about having children???? How, exactly, are you going to do that?
She came into the ED with a fever and some bruises. ..

I never said that I was going to investigate whether or not she has children, that is up to the proper authorities.

She also didn't come in with SOME bruises, she came in with multiple bruises in "various stages of healing", which indicates multiple beatings over different periods of time.

Nurses and other healthcare professionals (paramedics, etc) are considered equal to police officers for their testimony in court in regards to being impartial...to say that a nurse is lying just to be lying is like saying that a police officer is lying just to be lying.

Hearsay is if you repeat what someone said, that someone ELSE said.

Repeating what you heard directly is not hearsay.

Nurses, just like police officers, "don't have a dog in the race". You would expect the court/judge/jury to believe that a nurse just called randomly on some poor woman and the nurse's imagination got away from her and she just started making up things left and right---do you REALLY think a jury is going to think that a nurse just made up things and lying just to be lying?

To me, I could CARE LESS whether a charge was made or not...that isn't the point...the point is assessing your client further to find out if she is an imprisonment situation (which to me, IS mandated reporting) or if she has children (children that could possibly be victims of abuse).

When a woman says, "My boyfriend did this to me", you don't say, "Well, that's nice dear!" and let it go! You assess further!

I think the major problem with our society is too many people want to leave everything up to 'someone else' and stick their head in the sand and have the mentality of, "Oh, well, I can't be bothered!".

If I were the type of person that only took the path of the least resistance and didn't worry about other people or their lives, then nursing is definately the wrong career choice.

chenoaspirit, ASN, RN · Apr 13, 2008

How about a social services consult so they could come see her and talk with her. Maybe they could find out more and offer help. Maybe the patient is scared to tell. Many who are abused are threatened further abuse if they tell anyone. I would feel bad if I read in the newspaper a week later that the patient died at the hands of her boyfriend/husband and I had suspeced and done nothing. Even if nothing is done, I at least tried to be her advocate. I dont know what is technically the protected group of people "children, elderly, or disabled", but I choose to try to protect all. My mother was a victim of abuse and I grew up witnessing it. If I could help someone escape that, I would do what I could. I do understand it is her privacy, but it should at least be addressed so she knows there is help out there for her...if she wants it. If not, then at least we tried.