A nursing career comes with many responsibilities. Nurses are the foundation of our healthcare system: caring for patients, supporting healthcare teams, administering medications, and providing expert care for patients from birth to the end of life. Because nurses come into direct contact with the most vulnerable of our population, they carry added responsibilities. Nurses have to deal with legal, ethical, and human rights issues in addition to patient care.
Nurses are responsible for protecting their patients, which means they are responsible for reporting when someone else is in danger.
What Are Nurses Responsible for Reporting?
Nurses have many reporting responsibilities to protect patients and others from danger, whether from workplace safety issues, physician negligence, or abuse.
Because of their role as frontline healthcare workers and their tendency to care for patients of all ages, nurses may be positioned to protect the most vulnerable patients from abuse or neglect in one form or another.
In most states, nurses are considered mandated reporters and are legally required to report the following types of abuse:
Nurses are Required to Report Child Abuse and Neglect
Every state in the U.S. has mandated reporting laws to protect children from suspected abuse and neglect. In most states, mandated reporters of child abuse are designated by profession, such as healthcare workers, law enforcement, and teachers.
Nurses are commonly named as legally mandated reporters of child abuse; their proximity to patients allows them to spot the signs of abuse and neglect that others might not see.
Nurses in schools, general practitioner’s offices, and emergency rooms, among others, are in a prime position to assess a child’s physical, mental, and emotional health. If a nurse suspects child abuse or neglect is occurring, their report could save a child.
Find out if you are a mandated reporter of child abuse at mandatedreporter.com
Nurses are Required to Report Elder Abuse and Neglect
Elderly and dependent adults are another vulnerable population protected by mandated reporting laws in most states. Up to 5 million elderly and dependent adults are abused yearly, and it’s estimated that only 1 in 24 elder abuse cases is reported to authorities.
Nurses in general practitioners' offices, emergency rooms, surgical centers, and long-term care facilities, among others, may come into contact with elderly and dependent adults being abused or neglected. In some cases, they may see signs of elder self-neglect, which should also be reported to protect these patients.
Nurses May Be Required to Report Intimate Partner Violence
While most U.S. states have mandatory reporting laws in place to protect children, elderly, and dependent adults, there is a lack of legal reporting laws in place to report suspected instances of intimate partner violence.
Nurses and other healthcare workers, however, may have a legal responsibility to report injuries caused by weapons or injuries caused in violation of criminal laws, which may include intentionally inflicted injuries or illegal acts that resulted in serious or grave bodily injury.
At least six states have mandatory reporting requirements that address intimate partner violence, including California, Colorado, Kentucky, New Hampshire, and Rhode Island.
Whether specifically required to report intimate partner violence or only to report illegal injuries, nurses once again find themselves in a position to protect the vulnerable through their reporting requirements.
A Nurse’s Role as a Mandated Reporter
What is a nurse’s role as a mandated reporter? Nurses must have an understanding of different types of abuse. For instance, child abuse can be physical, psychological, sexual, or from intentional or unintentional neglect.
Elder abuse can include physical abuse, psychological abuse, isolation or abandonment, financial abuse or exploitation, sexual, or may include neglect or self-neglect.
Understanding the different types of abuse each vulnerable population is most likely to occur is only part of a nurse’s role as a mandated reporter. Nurses must also know their legal requirements for reporting.
Recognizing Signs of Abuse
Some of the signs or symptoms of physical abuse are easily apparent to a nurse. For example, when a patient presents with bruising on their face or arms or a child has unexplained fractures, lacerations, or wounds. But not all of the signs of abuse are readily visible; some could be mistaken for another cause or completely overlooked.
Education and training about the obvious and subtle signs of abuse can help nurses better identify and help patients who need intervention.
Nursing Legal Requirements for Mandated Reporting
Each state has different requirements for mandatory reporting, including:
When to File a Report
The time frame that a nurse is required to report can vary depending on the alleged victim and crime. An emergency room nurse who suspects physical abuse of a child may have to report immediately, while a nurse working in a long-term care facility who suspects non-physical, financial abuse of a patient may have up to 2 days to file a report.
How to File a Report
Mandated reporting can be done via phone and/ or written report. In some states, specific mandated reporter forms are required in certain situations. A nurse’s duty to report includes knowing if it’s enough to tell their supervisor or pick up the phone to call local law enforcement or if they need to fill out a specific report form to consider their duty complete.
Where to File a Report
Local law enforcement, Child Protective Services, Adult Protective Services, or the Long-Term Care Ombudsman Program—these are all various entities that a nurse may be required to notify if they suspect abuse or neglect. A nurse’s duty includes knowing where to file a report so the appropriate entities can move forward with investigating the issue.
Is Mandated Reporter Training Available for Nurses?
A nurse’s duty to report is complex and often guided by state regulations. A nurse’s duty to report can vary from state to state and even depending on the alleged victim, type of abuse, or location of abuse.
Mandated Reporter Training can help nurses understand their duty and provide them with the information they need to ensure they can file a report at the right time, in the right place, and to the right entity.
Can Nurses Get CE Credits for Taking Mandated Reporter Training?
In some states, nurses can satisfy their continuing education requirements with a mandated reporter training course approved by their state nursing board.
California nurses can satisfy CE requirements with Simple’s Mandated Reporter Training course, created in partnership with the CA Department of Social Services and approved by the Board of Registered Nursing. Simple’s Mandated Reporter Training course can satisfy 4 of the 30 hours required to maintain a nursing license in California.
What Happens if a Nurse Fails to Report?
Failing to report suspected abuse goes beyond a code of ethics issue for nurses. It becomes a legal issue, as well. In states where nurses are mandated reporters of abuse, failing to report may carry criminal and financial penalties. These penalties often become more severe if the abuse results in severe bodily injury or death.
Studies have shown that inadequate education regarding mandated reporting is one of the primary barriers preventing nurses from carrying out their roles. Nurses who felt they didn’t receive adequate education about the identification of and response to abuse considered themselves only moderately prepared to report. Because failure to report can have severe consequences for both the victims of abuse and the professionals required to report, consistent training can help nurses overcome this barrier and feel more confident in their legal duty.
Ethical Considerations for Nurses: Mandated Reporting vs. HIPAA
Nurses may wonder about the ethical considerations surrounding mandated reporting, such as protecting the privacy of their patients. While HIPAA is designed to protect patients’ individual confidentiality, its protections do not extend to mandated reporting. The U.S. Department of Health and Human Services states that HIPAA does not preempt state mandatory reporting laws. When nurses disclose a report of abuse or neglect, they comply with both state reporting laws and the Privacy Rule.
Nurses are uniquely positioned to help protect the most vulnerable of our population against neglect and abuse that ruins lives. Children who experience abuse and maltreatment can experience lifelong harmful effects, and children under the age of four are at the greatest risk of death from intentional maltreatment. While mandatory reporting is a heavy responsibility to carry as a nurse, it is a duty that puts nurses in place to save lives and protect the people who need it the most.