A nurse witnesses another nurse slap a patient. The patient has been very difficult to manage and often very rude, observed screaming obscenities at other patients and staff. What action should the nurse take after witnessing this?

Report it to the Bureau of Adult Protective Services.

Explanation

•Abuse is against the law, and the nurse is a mandated reporter. This means that the nurse is required to report such events directly to the appropriate authorities.  

•The Centers for Medicare and Medicaid Services requires investigation and reporting of witnessed or suspected abuse (including injuries of unknown origin) within 5 days of the incident.

•Abuse includes verbal, sexual, physical, and mental abuse, as well as the abuse of a patient's money or property. Nursing homes and hospitals are also prohibited from isolating a patient or using physical or chemical restraints without just cause.

•In one study of 2000 nursing home residents, 44% reported they had been abused and 95% said they had been neglected or seen another resident neglected.

•Depending on your state, the agency that investigates abuse and neglect may be either the Adult Protective Services or the State Survey Agency.

•It is inappropriate to suggest that the incident might not be reported immediately or "if it happens again." The nurse must realize this is probably not the first time the nurse has abused a patient.

•Calling the patient's family is not the nurse's responsibility, but the supervisor may decide to do so.

•You must not simply inform the charge nurse and ask him or her to report the abuse. As a mandated reporter, the nurse witnessing the abuse or neglect should report the event directly to the state agency.  

•Remember: Your license is on the line, and if it is discovered that you did not report suspected or witnessed abuse, you could be held responsible. Always make the report yourself.

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