Leadership | Legal / Ethical | Nursing Practices

Understanding the Nurse’s Role involving Mandatory Reporting

  • Nurses are mandated reporters of patient abuse and neglect. 
  • Some of the signs of abuse and neglect are dehydration, poor hygiene, and unusual behavior. 
  • Law enforcement keeps both the patient and the nurse safe after a report has been made.  

Amy White

RN-MSN – Chief Nursing Officer

November 08, 2022
Simmons University

Mandated Reporters

Nurses have a unique and important responsibility when working with patients and suspecting any type of abuse or neglect.   

As a nurse caring for these individuals, it is imperative that the nurse reports any suspected abuse or neglect to assist the patient experiencing the event to get the necessary help as soon as possible.  Hence why nurses are designated as mandated reporters.

 It is difficult for many nurses, as they do not fully understand the responsibility of being a mandated reporter. Nor do they know all of the actions that need to be utilized.   

Typically, this is an area that may have been discussed briefly in either nursing school or as an employee at a place of employment.  

However, it is not practiced or utilized daily.  

Mandatory reporting needs to be fully explained and understood by nurses.  Knowing how to accurately identify abuse and neglect, and how to care for patients who have experienced this unfortunate treatment must also be known.  


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Identifying Patients With Abuse and Neglect

Some of the common signs of physical abuse among patients can be easily identified while others cannot.   

The most common ones that nurses may recognize are: 

  • Bed injuries 
  • Dehydration 
  • Fractures or head injuries 
  • Infections 
  • Malnutrition 
  • Rapid weight loss/gain 
  • Reluctance to speak in staff’s presence 
  • Unexplained injuries – bruises, wounds, lacerations, etc. 
  • Unsanitary personal hygiene 
  • Unusual  behavior patterns 
  • Desiring to be isolated from others  
  • History of frequent illnessess that do not seem to have been treated by a physician 


Many of the above symptoms of abuse and neglect are readily visible, while others are not.  If a nurse is not taught how to properly identify these, it can easily become overlooked or mistaken for something else.  

 Educating nurses in both visible and subtle symptoms is absolutely necessary in order to  identify patients possibly experiencing abuse and neglect.  

Effective Ways for Nurses Report Findings

If a nurse suspects abuse or neglect, she should report it to a physician, nurse practitioner, or physician assistant.  It may also be necessary to notify the supervisor of the nurse’s workplace.   

If the patient is present with the suspected abuser, the nurse will need to do an exam without them in the room.  When the nurse reports any findings, it is imperative that she only report the facts and does not include any personal opinions and judgements.  

The nurse must report these findings to a civil law authority and must enforce confidentiality as this protects the individual involved. It also ensures that any information collected is not jeopardized and unable to be used in legal matters.  

Ethical Considerations for Mandated Reporters

Many nurses worry that if they make a notification, that they have made a breach of professional ethics.  Making a notification is not generally considered to be a breach of professional ethics or standards of conduct.  Reporting is a legal and moral obligation.  

If a nurse serving as a mandated reporter fails to report abuse or neglect, there can be significant consequences. This includes fines, penalties, and disciplinary action. The abuse or neglect of the individual may continue, and the needed help may not be given. 

The nurse serves as the patient’s advocate and by not reporting abuse or neglect, the nurse may be unintentionally working against the patient and creating more danger for the patient. 

mandated reporters Florida

Effective and Safe Screening Practices

Each state has differing approaches and safe screening practices that helps to determine the priority of each case and helps to identify those that require immediate response.  There are certain instances abuse and neglect that may be life threatening and must be stopped immediately.   

The nurse may experience a fear of retaliation if the abuser or neglectful individual finds out that they were reported.  However, each state has agencies involved with law enforcement that are ready to receive these reports and to ensure the safety of both the nurse and the patient. 

Typically, a screening report is submitted and based on certain criteria of acceptance, the report will be screened to ensure validity.  A nurse shouldn’t fear reporting a case due to negative repercussions. 

All cases of abuse and neglect must be reported to save those who are experiencing these terrible acts.  

The Bottom Line

Nurses serve as mandatory reporters and must not hesitate to report any case due to fear of retaliation, feeling unsafe, or concern for their reputation.  The number one consideration must be for the patient.  

The nurse is ultimately serving as the patient’s advocate when reporting abuse or neglect.  

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