Forensic Nursing Chronicles

Screening for abuse is a very important element of the nursing assessment.  While screening for abuse should be included in every nursing assessment abuse is seen more frequently within certain patient populations; such as the very young and the very old.  Those patients who are very young or very young are more vulnerable to abuse by their caretakers.  This screening can sometimes be difficult to perform.  There needs to be attention to detail during the interview for any inconsistencies with information given and findings during the assessment.

The nurse assessment of the skin and musculoskeletal systems hold great importance when screening for abuse.  It is during these advanced assessments there may be evidence of abuse may be found.  Any suspicious bruising, welts, or marks that are found should be taken into consideration when screening for abuse.

When a nurse is functioning in the field of forensics their assessments and screenings for abuse may be called into use during a proceeding in court; the nurse may have to testify to their assessment findings.  Forensic nurses will also have to rely on their experience in advanced assessment to accurately screen possible victims for abuse.

Forensic nurse or any other area of nursing this screening for abuse is a vital part of the nursing assessment.  A nurse is responsible for advocating for the patient to their best ability.  Especially in circumstances when the caretaker of the patient is overpowering and does not cooperate with the patient being assessed without them present.

Original Post

September 28, 2009

Title: Screening for abuse, comment

I think that all nurses and doctors should receive additional training in screening for abuse depending on their specialty area. Patients will present differently depending on whom they are being interviewed by. Many times in the situation of children they are with their abuser when they present and it is difficult to separate the two. The abuser does not want you to have words alone with their child. I worked many years as a school nurse and suspected many cases of abuse that were reported to the appropriate authorities only to find that the child was disbelieved and then years later found to be telling the truth. Adults are very savvy at making a child look like a liar but seldom do these children have the capabilities to make up the horrendous story I heard. Unfortunately the investigators seem to want to believe the abuser. These children were also ones with poor grades (not sleeping at night due to the abuse), behavioral issues (they just wanted someone to listen) and many times documented storytellers (the only way to get attention) so it was very easy for the abuser to discredit them. If we are all trained to look for something other than physical marks we may start to diminish abuse against our children. Part of the assessment should not include where the parents reside in society. Several times the investigators simply found out what the parents did for a living and that in itself ended the investigation.

Original Post:
September 8, 2009
Title: Screening for abuse
Thank you for this important message. It is absolutely imperative that ALL providers know the signs and symptoms of physical, emotional and sexual abuse. Furthermore, it is absolutely necessary that ALL providers screen every patient at EVERY patient encounter for abuse. Providers should incorporate screening for abuse into their health assessment. It is very easy to do. Providers can accomplish this important task by 1. Printing the screening question on the pre-assessment paperwork, 2. Asking the patient during the assessment, “Do you feel safe at home?” 3. Knowing the s/sx and incorporating screening into every pt encounter. So very important.

Original Post
September 2, 2009
Title: Abuse
Child and elder abuse continue to be very under reported making it imperative that doctors and nurses have education on signs of abuse. Nursing home abuse is also very under reported since nursing home pts. are lacking in visitors and seen as demented. Nurses also need to know who to contact should abuse be suspected.

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