Mandated Reporting
You will have occasion to see many different situations. If you have reason to suspect any form of abuse or neglect, you must report it. It isn't up to you to make judgments, or to try to figure out why it's happening. You just have to report it. There is a team of professionals who will take it from there to determine how and why it's happening and what can or must be done.
Everyone worries about retribution for reporting, but not reporting can actually get you into more trouble! The laws protect mandated reporters. The reporter cannot be identified. Sometimes it's obvious, but you have every right to protect yourself and to suggest that any number of others may have seen or suspected something. By reporting suspected neglect or abuse, you help to establish a path for the situation to be improved and hopefully resolved for the patient.
Mandated reporting laws vary from state to state. Be sure to understand what your facility expects you to do. Also be sure that they are in compliance with state laws and not just trying to avoid trouble for themselves. If you have a question about reporting a situation, consult with your supervisor and ask for social services to be consulted.
Perhaps your patient is a stubborn elderly woman who lives alone and refuses to accept any help. She isn't safe at home alone and that's why she fell. Her family is at their wits' end trying to force her to accept some help, but she fights them every step of the way. If social services has to become involved, they may be able to help resolve the situation by “enforcing the rules” that she must accept some help or be placed in a facility. Sometimes, there is really little that can actually be forced on a patient, but an outside official telling her she has to get some help may make a difference. This practice can at least give the family some leverage with her and raise everyone's awareness of the seriousness of the situation. Each time a report has to be made could give the Protective Agencies more power to eventually take action if necessary.
The physician needs to be kept abreast of the situation, and the discharge planner needs to know so that arrangements can be made for follow-up from community resources such as home health and outside Protective Services. Reporting suspicious neglect and abuse is always an uncomfortable thing, but as a health care worker, it is your duty to do so. You are the advocate for the patient. Your job is to protect others and promote wellness. Be sure to understand your state laws and to stay informed.
