One of the most remarkable roles of a certified nursing assistant is being a patient advocate, in other words, acting in the patient's best interest and ensuring their safety and well-being. Like a plot twist in a novel, sometimes healthcare facilities such as hospitals become a setting of abuse and other similar cases, requiring a CNA to do what’s necessary and call the proper authorities for help.
Nursing assistants must keep a keen eye and have the guts to the make very important call to report a problem or ask for assistance. Refer to the Q and A section below to know when to contact the right agency.
1. Question - What cases should be reported to the proper authorities?
Answer - CNAs must report to the proper authorities if they suspect or witness the following: abuse or neglect of children, older people, mentally ill or developmentally disabled persons, long-term care facility residents; patients who are suspected victims of human trafficking; and the use of alcohol or illicit drugs by healthcare workers while providing direct care to patients or those driving a vehicle that transports a patient.
2. Question - When should I call the police?
Answer - When there is a criminal act such as rape, physical assault, or battery, or if the unlawful act results in an immediate, life-threatening situation, calling 9-1-1 or law enforcement is mandatory.
3. Question - I have a school-aged patient who confided to me that every time that she acts like a ‘bad girl’ her mother would beat her, make her skip dinner, and keep her in her room for hours. Do I need proof before I report?
Answer - No, you don't need concrete proof before reporting. Contact local Child Protective Services (CPS) as long as you have a strong reason to believe that a young patient is harmed.
Child abuse is inflicting physical, sexual, or mental harm on a patient below 18 years of age. Child neglect is failing to meet the child's needs (food, clothing, shelter, education, or healthcare), abandonment, or the condoning of abusive acts done on the child. When you suspect child abuse, follow institutional policies and state laws regarding reporting procedures.
4. Question - I have reason to believe that my elderly patient is being abused and exploited by her daughter by controlling her finances, like signing checks for her. Which agency should I call?
Answer -Elder financial abuse is the illegal or improper use of an elder’s money. If you have strong reason to believe that any form of elder abuse is happening (such as financial exploitation), inform your institution’s point person and follow agency policies. The process usually involves contacting Adult Protective Services or calling the local elder abuse hotline.
5. Question - I saw a colleague post an unconscious patient's photo online. Is a HIPAA violation reportable?
Answer - Yes. A HIPAA violation is a federal offense where a person or an institution breached the confidentiality of a patient’s health records and information. If a colleague breached the HIPAA rule, report the incident to the supervisor, your organization’s HIPAA compliance or Privacy Officer, who would file the report to the Office of Civil Rights (OCR). If the breach was committed by the institution itself, you may bypass the officer and directly contact the OCR.
6. Question - Which cases of CNA/nurse practices should be reported to the appropriate regulating body?
Answer - Any situation where a fellow CNA or a nurse’s practices or behavior at work is unsafe, incompetent, or unethical, which can put a client at risk for injury.
Examples of these circumstances are: providing care while under the influence of illegal drugs or alcohol, practicing with a fraudulent license, misconduct, performing tasks beyond their scope of practice, falsifying information and documentation, and verbal, physical, mental, or sexual abuse of clients.
For RNs and LPNs, the regulating body to contact is the state board of nursing. For CNAs and other unlicensed personnel, contact the state’s Health and Human Services, Public Health, and in some states, the board of nursing.
CNAs face a dilemma when confronted with situations where there is a need to report to the proper authorities. It is therefore essential to document observations properly and always refer to institutional policies and state laws regarding reporting procedures. Many of these cases require mandatory reporting, and failure to do so may have legal consequences. Above all, remember to prioritize the patient's safety and well-being.
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