Child abuse

Initial Discussion Post:
Most states have laws requiring mandatory reporting for suspicion of child abuse as a
condition of professional licensure. Research the law in which you plan to be licensed as
an RN and consider the information as you respond to this discussion.
Read the following resources:
Muller, L. & Fink-Samnick, E. (2015) Mandatory Reporting: Let’s Clear Up the
Confusion. Professional Case Management, 20(4), 199-203.
Office of Children and Family Services (2014).Summary Guide for Mandated Reports
in New York State. Rensselaer, NY: New York State Office of Children & Family
Services.
Using your readings and the resources above address the following in your initial
response (minimum of 250 words):
Discuss the common ethical and legal implications of mandatory reporting for nurses
regardless of the state in which a Registered Nurse practices.
Do the mandatory reporting laws ensure children will be protected? Explain your
response.
How would the RN overcome the feeling of hesitation to report suspected child abuse?

Child abuse

Common legal and ethical implications of RN mandatory reporting
All registered nurses are mandated to report child abuse. They are expected to learn and
know the standards of good faith reports and the confidentiality specifications. If the
registered nurse will share medical information with other providers, they are expected to
follow HIPAA law and employers procedures (Office of Children and Family Services
(2014).
In some situation, the registered nurses may face ethical dilemma. In this context, they are
bound by their profession’s code of ethics. They have an ethical duty to act within the
professional guidelines, and must ensure that their decisions are not influenced by their
beliefs or values of the accused. Failure to report child abuse must be sued in civil court and
the registered nurse is forced to pay monetary damages for harms associated to failure to
report the child abuse (U.S. Department of Health and Human Services, 2011).
Do the mandatory reporting laws ensure children will be protected? Explain your
response.

Child abuse
Yes and no. Yes because most of the registered nurses fear penalties issued for failing to
report. No because child abuse does not begin or end with mandatory reporting. Child
protection laws are only effective if the registered nurses and citizens work in partnership to
improve the safety of the children in the community (Nurse.com, 2014).
Overcoming the feeling of hesitation to report suspected cases of child abuse
In most cases, the RN will hesitate to report a suspected child abuse if they are not sure if the
information is correct or not. In this case, the RN should make the report in good faith. If the
information reported turns out to be incorrect, there are no liabilities attached to the RN.
However, it is important for one to check and understand their obligations as well as
protections in his or her respective state (Muller and Ellen, 2015).

Child abuse
References
Muller, L.S., and Ellen, F.S. (2015). Legal and regulatory issues. Professional care
management 20 (4); 200-203.
Nurse.com . ( 2014 ). Careers in nursing .
Office of Children and Family Services (2014). Summary Guide for Mandated Reports in
New York State. Rensselaer, NY: New York State Office of Children & Family Services.

U.S. Department of Health and Human Services. (2011). About CAPTA a legislative history .


S elf -P olicing
As professionals, there is a broad range of specifi c
duties and obligations as they relate to the actions
and inactions of our colleagues. “Nebraska nurses
must report themselves to the board of nursing if they

lose their jobs for incompetence; negligence; unethi-
cal or unprofessional conduct; or physical, mental,

or chemical impairment” ( Medscape Nurses, 2008 ,
p. 1). Other states have no legal duty to self-report
in any way at all. New Jersey has one of the strictest
laws requiring mandatory reporting with its Health
Care Professional Responsibility and Reporting
Enhancement Act, aka, the Cullen Act, in the wake
of the conviction of serial killer, Charles Cullen; a
nurse then licensed in New Jersey and Pennsylvania
and was sentenced to 7 life sentences for admitting to

the murders of 22 patients; he is suspected in as many
as 35 deaths.

It has been more than 10 years since the enact-
ment of the law and the consequences have been felt

by many professionals, including nurses, and not
always for the reason the law was legislated. More
often today, behaviors by professionals that once

would have been dealt with by counselling inter-
nally or referral for drug and alcohol treatment are

used as reasons for termination, even of long time

otherwise productive employees. In addition, ter-
mination is accompanied by mandatory reporting

by the employer to the State Professional Licensing

Board. Rather than moving on to another employ-
ment opportunity, the professional is left to answer

questions in the form of an informal investigation or
undergo protracted investigation.
E xamining Y our S tate ’ s L aw
When you review your state’s law, look for:
• A defi nition of reportable events or situations;
• A description of level of suspicion (i.e., must
you have fi rst-hand knowledge, or is “reason
to believe” or “suspicion” enough?);
• Direction about whom to report to;
• Exceptions from duty to report; and
• Consequences of failing to report. ( Medscape
Nurses, 2008 , p. 4)
What does my profession say I should do, even if
there is not legal mandate? Whether we recognize it
or not, we are each accountable for our professional
actions, inactions, and choices. Perhaps it would
be easier to overlook the faults of a colleague. In
the 2015 Code of Ethics for Nurses, there is a clear
acknowledgment that nurses are duty bound to be
alert to Questionable and Impaired Practice. The
interpretive statements make it clear that nurses are
expected to identify and report questionable practices
through established systems. “Nurses must protect

the patient, the public and the profession from poten-
tial harm” ( American Nurses Association, 2015 , p.

13). The Code goes on to say that even when a nurse
believes that he or she may be subject to personal risk
for reporting bad behavior, the duty to further patient
safety remains ( American Nurses Association, 2015 ).
The Code of Ethics of National Association
of Social Workers (NASW) addresses impairment,
incompetence, and unethical conduct of colleagues.

“Social workers who believe that a social work col-
league is incompetent and have not taken adequate

steps to address the incompetence should take action

through appropriate channels established by employ-
ers, agencies, NASW, licensing and regulatory bodies,

and other professional organizations” ( NASW, 2008 ,

Reporting is both an ethical and legal

duty.

Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

PCM-D-15-00016_LR 201 CM-D-15-00016_LR 201 21/05/15 11:50 AM 1/05/15 11:50 AM

Legal & Regulatory Issues

202 Professional Case Management Vol. 20/No. 4
pp. §§2.10, 2.11). Self-policing is at the very core
of a profession. Without the bravery and veracity
of individual practitioners to meet their ethical and
legal duties, the integrity and value of the profession
would be greatly compromised.
F ailure to R eport

The potential consequences for failing to report genu-
ine acts of child, elder, or other abuse that could have

been prevented by such a report varies as much as
the duty. The consequences range from sanctions by
a professional licensing board to criminal culpability.

The majority of states “impose penalties on man-
datory reporters who knowingly or willfully fail to

make a report when they suspect that a child is being
abused or neglected. In Florida, a mandatory reporter
who fails to report as required by law can be charged
with a felony” ( Child Welfare Information Gateway,
2014 , p. 2).
C ase M anagement G uideposts

“The Code of Professional Conduct for Case Man-
agers with Standards, Rules, Procedures and Penal-
ties” leaves no doubt as to a case manager’s profes-
sional duty. From the Preamble to the end, there are

eight references to reporting. “Board-Certifi ed Case

Managers (CCMs) who become aware of unethi-
cal behavior of others are obligated to report such

alleged infractions” ( Commission for Case Manage-
ment Certifi cation, 2015 , p. 2). Case managers are

duty bound to be honest and “report known lapses

of the standards of care to proper agencies” ( Com-
mission for Case Management Certifi cation, 2015 ,

p. 6). This is an express statement of our collective
responsibility to “police” our profession. No doubt,
the fi rst question many are asking is, “What if I’m not
a Board Certifi ed Case Manager (CCM)?” Although

the answer has not been completely tested, a reason-
able attorney and a reasonable jury can deduce that

certifi ed or not, the CCM Code and Standards are
a recognized standard and may very well apply to a
practitioner who is not currently certifi ed. The Code

would be viewed in combination with state statu-
tory and case law, along with the Case Management

Society of America Standards of Practice for Case
Management ( Case Management Society of America,
2010 ).
C ONCLUSION
There is no doubt that as case managers we each strive
to do, not just what is required, but also what is right.
Statutory and industry reporting requirements are
only one element of our complex professional lives.

Ethical obligations are the foundation of all profes-
sional behavior, whether specifi cally required by law

or not. When performing a legal/ethical analysis, we
should fi rst look to existing federal and state laws.
If there is a law that applies, then you know what

your duties and obligations are and there is no guess-
ing involved. If there is no law on point, then move

onto Standards of Practice and Codes of Ethical
Conduct controlling your license and certifi cation, if
applicable. In this time of electronic communications,
no one should feel that they have to fi nd answers on

their own. Collaborate with colleagues, call on pro-
fessional organization and certifying bodies because

when you do, each benefi ts from the knowledge and
experience of the other.

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