Domestic violence or abuse may be physical, emotional or sexual. A nurse may reasonably suspect physical domestic
Domestic violence or abuse may be physical, emotional or sexual. A nurse may reasonably suspect physical domestic violence, child abuse or elder abuse when a child, an elder or an adult patient presents with lacerations, piercings, bruises, other bodily marks or fractures that occurred on very unusual areas of the body like chest, eyes, laps, buttocks or back. Such abuse may also manifest as fractures, cigarette burns or bite marks which do not correspond with the circumstances under which such fractures, cigarette burns or bite marks were alleged to have occurred. (El-Radhi, 2015). Additionally, this student believes that the repeated occurrence of an injury to the same patient may lead a nurse to reasonably suspect that the patient is being physically abused.
A nurse may suspect sexual abuse or violence because of inexplicable behavioral changes in a child, elderly person or any other patient. Such behavioral changes may include but are not limited to aggression and taciturnity. The patient may also manifest with a sexually transmitted disease, lacerations or bruises in the genital area, vaginal or anal bleeding, pain or pubic lice. (El-Radhi, 2015)
Emotional abuse is by far the most difficult for nurses to identify due to the non-physicality of the wounds. The child, patient or elderly person may be emotionally detached from an individual with whom ordinarily they should have a close relationship. They may also be unusually quiet or in the case of a child, show signs of growth retardation. (El-Radhi, 2015). This student believes that in all cases, it is important to pay close attention to minor details like the explanation for the unusual behavior of the child, patient or elderly person. There may also be an unusual delay between the occurrence of the injury and presentation in a healthcare setting. Furthermore, the offending family member may be very defensive, edgy or inexplicably verbally combative and antagonistic.
This student works for a hospital in Dallas, Texas. The hospital has a standard procedure for reporting suspected abuse. Such procedure was developed in furtherance of state law which makes it a felony to conceal elder or child abuse. Consequently, anyone who reasonably suspects elder or child abuse is mandated by law to report to the Texas Department of Family and Protective Services within 24 hours. (Texas Family Code, section 261: 109) Reporting may be by phone, online, in writing or in person. Anyone who reports child or elder abuse in good faith in the state of Texas is immune from criminal prosecution or retribution. This student’s employer’s policy was therefore developed in compliance with the afore-mentioned statute. Any employee who reasonably suspects the abuse of a child or elderly person must report such abuse to his or her supervisor within three hours. The supervisor is required to investigate the alleged abuse within six hours and report his or her findings to management. Management is required to report substantiated suspicions of abuse to law enforcement authorities within 24 hours. This student’s employer strictly enforces this procedure and rightly so.
Many cases of abuse in families across the world are hidden from public view. (Singh, 2014). To combat this problem headlong, nurses and other healthcare professionals are duty-bound to report suspected cases of patient abuse. Identifying the signs and symptoms of abuse is very important. All healthcare workers ought to take this obligation very seriously because a patient’s life may actually depend on it.
References
El-Radhi, A. S. (2015). Safeguarding the welfare of children: what is the nurse’s role? British Journal of Nursing, 24(15), 769-773.
Singh, R. S. (2014). Elderly abuse and neglect: the challenges ahead. Indian Journal of Health & Wellbeing, 5(4), 510-513.
Texas Family Code (2005) Section 261: 109.
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