Any domestic violence, child abuse, or elder abuse. Should be notated. In the state of New Jersey, the Department of Justice defines domestic violence, or intimate partner violence, as a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. This includes any behaviors that intimidate, manipulate, humiliate, isolate, frighten, terrorize, coerce, threaten, blame, hurt, injure, or wound someone. Domestic violence can happen to anyone regardless of race, age, sexual orientation, religion, or gender. Domestic violence affects people of all socioeconomic backgrounds and education levels. Domestic violence occurs in both opposite-sex and same-sex relationships and can happen to intimate partners who are married, living together, or dating.
All nursing facilities, are required to notate and report first hand, any kind of the injuries, bruises, abuse, neglect, mistreatment and any inappropriate signs showing or proving that the patient has been put in rough circumstances. They have a legal obligation to inform the police also, when they notice or suspect any such situation. Any sprains, fractures, cuts and bruises should not be taken any lightly. The nursing professionals should also carefully administer the fearful behavior a patient my show when talking. Specially when the person accompanying is there and is not giving privacy and trying to dictate all the questions and answers and also some times showing signs of fear and pushing away things o showing signs to pull / push the patient, or cutting through the conversation. Many a times the accomplice will also try to be rough and rude and yell and scream and try to walk out and away with the patient, dragging the patient with him. The first and foremost duty of the health care professional is to make the situation calm and not to show any signs of suspicion. Carefully try to engage them and call for help without endangering the patient’s life or health. Or ask for private check if possible where the patient can be talk without any fear. The health care professionals should insist on accurate and comprehensive notes as it can help to be a good evidence which can be used to protect patient and support the legal proceedings.
It’s a no brainer for a hospital or a nursing facility, that If a patient comes in with a variety of wound patterns that show an abuse context it should take advantage of all the options it has like psychiatrist on call or a social worker on call, before contacting police. It is important that hospitals have policies that are well written and detailed enough so that the staff knows how to handle these cases. Once the staff calls the police the state law takes over ad they will investigate domestic violence and prosecute if appropriate.
Some of the characterictis that would lead a provider to supect abuse or warning signs of abuse are clues that something is happening in the life of the person that should be looked into. Some indicators are obvious signs of abuse. Other indicators are subtle, requiring careful observation. In some situations abuse may not be occurring at all. It is important to think about the person and any health or behavioral issues they have. Some people may get injured more easily due to health reasons or aging. For example, some medications and some health problems like hemophilia (where the blood clots slowly) can cause easy bruising. Some people may engage in self-injurious behaviors that cause injuries that look like abuse. Even if you discover that a person has a health or behavioral issue that might be the cause of the injury, it is still important to investigate to rule out abuse as the cause. It is important to put aside any biases that you might have that care providers would not abuse a person with a disability that they support. As you interact with someone with a developmental disability, you should pay close attention to any changes in how that person looks or acts. A sudden or gradual change in appearance or behavior can be an indicator that abuse or neglect has occurred (or may still be happening.) Some of the signs are
Bruising on the face or trunk, as most accidental elderly bruising occurs on limbs and extremities
Broken bones, sprains, or serious injury, especially without a reported fall
Signs of being restrained, like strap or rope marks
Sudden changes in behavior
Direct reports of physical abuse from the elderly victim
Women who have been assaulted by their partner generally have worse heath than other women. Health issues include chronic problems with digestion, stomach, kidney and bladder function and headaches, poorer pregnancy outcomes and lower birthweight babies.
Recognition by nurses about the extent of these health consequences is central to their commitment to working with women to address the underlying cause of poor health. If nurses think a woman in their care may be experiencing domestic violence, the detail of questioning will depend on how well they know the woman and what indicators they have observed. Nurses should begin with broad questions, such as: ‘How are things at home?’ ‘How are you and your partner relating?’ ‘Is there anything else happening that may be affecting your health?’ Specific questions linked to clinical observations could include. ‘You seem very anxious and nervous. Is everything all right at home?’ ‘When I see injuries like this, I wonder if someone could have hurt you?’ ‘Is there anything else that we haven’t talked about that might be contributing to this condition?’
If you suspect that a child you know is being abused, you can take one or more of the following actions:Look out for signs of child abuse. If you have the feeling that something is going on, you might well be right. You are probably not the only one who has noticed something, but you might be the first person to do something about it. Talk to the child or to the child’s parents. Understand that child abuse is often the result of desperation. You can help just by being there for the family. Or by offering the child a listening ear. In my facility I will report abuse to my supervisor who then get social worker then psych that would report to the compliant officer who will then take it forward to the state.
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