Will your patient be safe after the ED visit?
Will your patient be safe after the ED visit?
Once a patient with violence-related traumatic injuries is stable and about to be discharged, you have to consider something equally important: Will he or she be safe after leaving your ED?
"If the victim is known to the assailant, he or she may not be willing to take action to prevent further assaults by getting the police involved," says Thomas Tryon, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia.
This may be the case, for instance, if a child was assaulted by a classmate, or for victims of domestic violence, child abuse, or elder abuse. "A senior might be hesitant to complain about a care provider when it might mean dislocation from familiar surroundings," he says.
While gunshot and knife wounds must be reported to law enforcement, it's easier to give alternate explanations for blunt trauma injuries. In the case of intimate partner violence, the injuries might clearly indicate abuse, but the patient might not be ready to report this to the authorities, says Tryon.
"Forcing the issue by reporting without the patient's consent may put him or her in a far more dangerous position with their assailant," warns Tryon. "Philadelphia has had a number of homicides where the victim was killed by the person who she obtained a restraining order against."
Offering possible avenues of assistance might be all you can do, says Tryon, noting that reporting suspicion of intimate partner violence is not mandated in all states. "Be cautious in assuming you know the full story or what is best for a patient," says Tryon. "Well-intentioned intervention does not always result in the expected outcome."
Once a patient with violence-related traumatic injuries is stable and about to be discharged, you have to consider something equally important: Will he or she be safe after leaving your ED?Subscribe Now for Access
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