Shannon Bartlett If You Are Completing An Admission On A Mat

Shannon Bartlettif You Are Completing An Admission On A Patient Who Yo

If you are completing an admission on a patient who you suspect is being abused, it is important to approach it in the right way. You don't want to jump to conclusions and become biased on the situation. As a nurse, we must remember to use therapeutic communication to allow the patient to feel they are in a safe, non-judgmental environment. We must ask the questions regarding abuse in a natural way to make the patient feel comfortable sharing this information (Jensen, 2019). In our hospital, we are mandated to ask certain questions regarding abuse, including if the patient feels safe at home and within the community. If the patient says no, we then have to dig deeper as to why they are feeling this way.

If a nurse acts surprised that a patient does not feel safe, it may make the patient uncomfortable sharing information. It is essential before asking these questions to ensure the patient is alone, especially if abuse is suspected (Jensen, 2019). The nurse must not assume who the abuser is; if someone refuses to leave the patient's side, that should be considered a red flag (Jensen, 2019). Abusers often refuse to leave because that would give the patient an opportunity to disclose the abuse. During assessment, observed multiple unusual bruises and abrasions.

If anyone is present with the patient, I would ask them to leave the room to ask personal questions and conduct an assessment. I would approach the patient with basic questions at first to earn their trust and avoid frightening them with direct questions about the bruises and abrasions. Once comfortable, I would ask about the origin of the bruises and abrasions, how they happened, and if such marks are usual for their body. If abuse is suspected, I would establish trust by explaining that I am there to help and that their safety and comfort are my priorities.

Creating a safe and comfortable environment facilitates openness. Questions should be clear and direct, so the patient understands exactly what is being asked. In Rhode Island, mandated reporters are required to report abuse of children, elders, and developmentally delayed individuals (DCYF, 2020; RI.GOV, 2019). Additionally, certain injuries like extensive burns, gunshot wounds, or airway burns are reportable in cases of suspicion (Durborow et al., 2010). Although reports are mandatory only for specific populations, suspected abuse in middle-aged adults should not be ignored, and appropriate resources should be offered regardless.

Despite the legal requirements, nurses should still aim to support all victims of abuse, offering resources like social workers or local advocacy centers such as Day One or the Women’s Center of Rhode Island. Recognizing abuse can be challenging due to its sensitive nature, and patients may feel shame or fear. Therefore, nurse interventions must emphasize empathy, confidentiality, and a non-judgmental attitude, creating an environment where the patient feels safe to disclose sensitive information. Such efforts are crucial in early identification and intervention, which can significantly impact the patient's safety and well-being.

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In healthcare settings, nurses play a pivotal role in identifying and addressing abuse among patients. Recognizing signs of abuse during admission processes requires both clinical vigilance and sensitive communication skills. When suspecting abuse, nurses must approach the situation with empathy, ensuring the patient feels safe and unjudged, which encourages open disclosure (Jensen, 2019). Using therapeutic communication techniques is essential, including establishing rapport, maintaining confidentiality, and asking questions in a non-threatening, natural manner. This approach fosters trust and facilitates the patient’s willingness to share difficult information about their safety and well-being.

Legal and institutional mandates reinforce the importance of screening for abuse. In Rhode Island, mandated reporting applies to child, elder, and developmentally delayed individuals, requiring healthcare providers to report suspicions or evidence of abuse (DCYF, 2020; RI.GOV, 2019). For suspected abuse cases, particularly in vulnerable populations like children and elders, reporting is obligatory. Conversely, suspected abuse in middle-aged or adult populations may not require mandatory reporting but still demands appropriate intervention. Nurses must be equipped with knowledge about the local laws and institutional policies to ensure they act ethically and legally while safeguarding the patient (Durborow et al., 2010).

Assessment of physical signs such as bruises, abrasions, burns, or other injuries remains a key component. During admission, noticing multiple unusual bruises or abrasions necessitates further inquiry. Nurses should initiate these discussions gently, beginning with open-ended questions about the patient's overall health and home life to build trust. For example, asking, “Can you tell me how these bruises happened?” or “Have you noticed any marks on your body before?” helps the patient feel less defensive. Once trust is established, questions can delve deeper into safety concerns and potential abuse circumstances.

Addressing the safety of the patient involves ensuring privacy, especially if abuse is suspected. If someone is with the patient, the nurse should request that they leave to facilitate confidential discussion. It’s critical to avoid assumptions about the identity of the abuser and to watch for red flags such as the refusal of a companion to leave or overly controlling behavior. Recognizing the signs of abuse and creating a supportive environment encourages further disclosure and allows the healthcare team to connect the patient with necessary resources (Jensen, 2019).

Resource provision is an essential element of care. In Rhode Island, hospitals typically have posted hotline information, and social services are available to assist with safety planning, shelter options, and counseling. Providing patients with information about local support centers, such as Day One or the Women’s Center of Rhode Island, empowers them to seek help voluntarily. Moreover, healthcare professionals should be familiar with local laws concerning abuse and have ongoing education regarding domestic violence and neglect to improve detection and intervention skills (Power, 2004).

In conclusion, nurses are essential in early identification and intervention for abuse. Establishing a safe, trusting environment, utilizing sensitive communication techniques, understanding legal reporting requirements, and connecting patients with appropriate resources are critical components of caring for abuse victims. By fostering an empathetic and non-judgmental atmosphere, nurses can more effectively support patients through difficult disclosures and contribute to their safety and recovery.

References

• DCYF. (2020). Reporting child abuse and/or neglect. Rhode Island Department of Children, Youth & Families. https://dcyf.ri.gov
• Durborow, N., Lizdas, K., O’Flaherty, A., & Marjavi, A. (2010). Compendium of state statutes & policies on domestic violence & health care. Family Violence Prevention Fund.
• Jensen, S. (2019). Nursing health assessment: A best practice approach. Wolters Kluwer.
• Power, C. (2004). Domestic Violence: What Can Nurses Do?
• RI.GOV. (2019). Protect: Rhode Island Office of Healthy Aging. https://ri.gov/healthyaging