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Patient safety is of utmost importance. If abrasions and bruises were noticed in a number
of unusual places on my patient, it would be important for me to determine the cause. In cases
where bruises are found, the clinician should obtain a complete medical history and document all
findings from a thorough physical exam. Nurses are required by law to report situations that may
indicate abuse. Nurses have a unique opportunity to identify abuse before it escalates, but in
order to intervene effectively they must be able to distinguish when a bruise might be more than
just an accidental injury. (Chapple, 2015).
In order to approach the topic with my patient, I would establish a rapport so that they
feel comfortable talking to me. I would ask open-ended questions in a non-judgmental way to
determine how the injuries occurred. If the patient is with a caregiver, speak to the patient alone
so they can speak openly. Note inconsistencies between the injuries and the patient or caregiver’s
explanation about how the injury occurred. It is important to document patient, witness, and
suspected abuser statements verbatim, without offering your opinion. (Earlam, Woods, & Lind,
2018).
Some of the barriers that might prohibit the patient from opening up include not being
cognitively aware. The patients are often in denial. Patients may fear that it will happen again if
they say anything. Many victims of abuse are ashamed or embarrassed. Cultural factors can also
play a role. Sometimes their belief is that situations like this should not be shared outside of the
family. Other victims feel they did something to deserve the abuse. Some patients do not
understand their rights. Others have a poor understanding of what constitutes abuse.
These barriers can be addressed through the assessment process by recognizing the
barriers that are present when you are discussing their situation with them and addressing them
as they arise. For example, neither of you might have enough information about the person's

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Patient safety is of utmost importance. If abrasions and bruises were noticed in a number of unusual places on my patient, it would be important for me to determine the cause. In cases where bruises are found, the clinician should obtain a complete medical history and document all findings from a thorough physical exam. Nurses are required by law to report situations that may indicate abuse. Nurses have a unique opportunity to identify abuse before it escalates, but in order to intervene effectively they must be able to distinguish when a bruise might be more than just an accidental injury. (C ...
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