Why aren't nurses mandatory reporters of ALL abuse?

[Double-Helix]

Everyone that is a nurse knows that we are mandatory reporters of suspected child and elder abuse, but I've always wondered why we aren't mandatory reporters of domestic abuse as well.

Victims of domestic violence (men or women) are a very vulnerable population. They may be just as scared and powerless as a child or elderly person. I understand that an adult in this situation is legally considered competant to make his or her own choice, but an elderly person who is being abused might not have any cognitive deficits either. As a nurse, we report suspected abuse in the elderly because they cannot advocate for themselves. Victims of domestic abuse cannot always advocate for themselves either. The victim might not have access to money, might be isolated from friends and family, might believe the abuse is his/her fault, or might fear for the safety of his/her children or family. They truely may not be able to ask for help.

So please help me understand why, when a child or elder is being abused, nurses report it to the authorities, but when a victim of domestic abuse comes into the ER, we do not.

[nurseprnRN, BSN, RN]

speaking from personal and professional experience, the reason most women leave their abusers is because either the abuser is a threat to the children or because they don't want the children to observe their mothers being treated in that way.

i have often found that women will take care of their children better than themselves; it's only after they are away from the abuser that they realize that leaving wasn't such a bad idea for themselves, either. appeal to their sense of caring for their children; that can help the whole family.

[Altra, BSN, RN]

At my facility we report all suspected abuse. It's a part of our admission stuff. We ask the person and mark their answer and then in a separate field we mark if we suspect any abuse and what type. It automatically fires a social worker consult.

This is not the same as legally-mandated reporting to law enforcement or governmental agency authorized to legally do something about the abuse. It's important to recognize the difference.

[~Mi Vida Loca~RN, ASN, RN]

My point was that at my facility every single person admitted is asked about abuse and if they feel safe and such. Not just elderly and children, not just people that show up bruised and battered. Everyone is asked.

IMO Emotional abuse is far worse then physical abuse (unless of course the physical abuse results in life threatening injuries. Sadly though, emotional abuse seems to be ignored. I know it's harder to prove and all that, but I think that it's far more damaging to the victim.

[belgarion]

In many of the posts the assumption seems to be that only women can be victims of domestic abuse. As a matter of fact, one poster said specifically that they ask women if they feel safe at home or is anyone hurting them. Isn't that a little on the sexist side?

We have a regular "customer" in our ER who is regularly used as a punching bag by his male partner. He refuses to press charges and to be honest the cops treat it like a joke. I have also seen several guys who were laid out cold by their wives or girlfriends. Do ya'll not consider this as abuse?

[Esme12, ASN, BSN, RN]

In many of the posts the assumption seems to be that only women can be victims of domestic abuse. As a matter of fact, one poster said specifically that they ask women if they feel safe at home or is anyone hurting them. Isn't that a little on the sexist side?

We have a regular "customer" in our ER who is regularly used as a punching bag by his male partner. He refuses to press charges and to be honest the cops treat it like a joke. I have also seen several guys who were laid out cold by their wives or girlfriends. Do ya'll not consider this as abuse?

ABSOLUTELY!!!!!!!!!

As women we use the vernacular she.......but ANYONE who is brutalized and bullied deserves protection. Abuse by partners in the Gay community is a huge problem and one that is hugely under-rated and reported. Thank you for astute observation!!!!

[rn/writer, RN]

I talked about asking women if they feel safe, but mostly because I work postpartum and don't have male patients (except for the teeny-tiny ones in the cribs).

But as a SANE (Sexual Assault Nurse Examiner) nurse, I have to agree. Males can be victimized as well. Sometimes by a male partner. Sometimes by a female partner, which puts a tremendous burden on the victim. Men seem to be less shackled by the dependency that women feel as they are often the breadwinner. On the other hand, men who are physically or emotionally abused wrestle with extreme feelings of embarrassment and shame. This rockets up exponentially if the abuser is female.

Men who admit to being hit by their female partners become the targets of unbelievable amounts of teasing and harassment. They're looked upon as wimps and milqetoasts who don't have the balls to keep the little woman in line. In reality, some of them quietly endure because they care for the abuser and don't know what else to do.

But, as with adult women, we have to respect their autonomy. We can offer help and plant seeds, but we can't force anything on them.

Thank you, belgarion, for raising this important point.