As a registered professional nurse, I feel the only approach to the case is to report the injury to Department of Family and Child’s Services (DFACS) for their investigation. When a report is made, DFACS will complete an investigation and make the ultimate decision if abuse or neglect was the cause of the injury. Each nurse has a duty to report all suspicious injuries to DFACS, regardless of her feelings on abuse or neglect. This is true even when the physician knows the family or does not suspect abuse. The nurse is responsible for her own actions. In order to provide the best quality of care for this patient, I would take the statement from the parent about how the patient was injured, and then talk to the physician to gather the physical finding, which may include x-ray reports after this information is gathered, I would report the case to the local DFACS. Anytime there is a suspicious injury regardless of the plausibility of the story, or if the physician knows the patient and does not suspect the parent, the DFACS case must be reported. The nurse in this situation has a duty to report this injury and let child services decide if the patient is in danger.
I would perform a complete examination of the patient and communicate with the physician, in addition to noting any other signs of abuse, along with paying close attention for indicators of abuse. Indicators of abuse can warn healthcare providers to pay closer attention to situations that may indicate abuse or neglect and sometimes there are not indicators even though the child may be abused (Henderson,
References: Buppert, C. & Klein, T. (2008). Dilemmas in Mandatory Reporting for Nurses. Medscape. P. 4- 16. Henderson, K. L. (2013). Mandated reporting of child abuse: Considerations and guidelines for mental health counselors. Journal of Mental Health Counseling, 35(4), 296-309. Padera, Connie. (2009). Nursing, Child Abuse, and the Law. 7(37). P. 122-126. When you suspect child abuse or neglect: A general guide. Retrieved from https://www.oag. state.tx.us/victims/childabuse.shtml