If a nurse suspects abuse or neglect, they should first report it to a physician, nurse practitioner, or physician assistant. Notifying a supervisor may also be required, depending on the workplace. If the victim is with a suspected abuser, the exam should take place without that person in the room. Nurses should provide a calm, comforting environment and approach the patient with care and concern. A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well. Thorough documentation and description of exam findings, as well as patient statements, non-verbal behavior, and behavior/statements of the suspected abuser should also be included.

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The nurse should notify law enforcement as soon as possible, while the victim is still in the care area. However, this depends on the victim and type of abuse. Adults who are alert and oriented and capable of their decision-making can choose not to report on their own and opt to leave. Depending on the state, nurses may be required to report suspicious injuries to law enforcement whether or not the patient consents or wishes to press charges.

Depending on the type of abuse, the nurse is required to call Adult Protective Services or Child Protective Services and follow it up with a written report. Contacting additional resources, such as social services, may also be a requirement (depending on the organization).

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While not required by law, nurses should also offer to connect victims of abuse to counseling services. Many times, victims fall into a cycle of abuse which is difficult to escape. Offering mental help to cope with abuse can help break the cycle.

Nurses should be familiar with their state's mandated reporter laws. Employers are typically clear with outlining requirements for their workers, but nurses have a responsibility to know what to do in case they care for a victim of abuse.

Amanda Bucceri Androus, RN, BSN
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