What Does “Mandated Reporter” Really Mean?

I just went to the grocery store, where, as usual, I picked the wrong time of day to go (I wake up in the late afternoon and end up running errands when everyone is getting off work). Everyone was cranky, and the store was crowded. I was waiting in the cereal aisle for a logjam to clear so I could get my Banana Nut Crunch and move on with my life when the adult in front of me hauled off and whacked the toddler in her shopping cart, saying, “Shut up! Shut up! Mommy can’t take this right now!” I don’t mean she slapped the kid or gave her a little pop. I mean she really HIT this kid.

I wish I could say I saved the day by educating this parent on appropriate behavior or at least telling her to stop hitting her kid, but in point of fact I just stood there with my jaw hanging open and didn’t do a thing. Neither did anyone else. I stood there gaping, the angry mommy got her Pop-Tarts and moved on, and everyone else pretended they hadn’t seen a blatant example of child abuse and averted their eyes. I am rarely stunned speechless, but I couldn’t believe a parent would do that at all, much less in a crowded public area. More to the point, I wondered, if this mommy couldn’t take the toddler’s behavior and hit her in public, what went on at home where she didn’t have an audience.

We all know the answer to that. The baby didn’t cry or act as if this behavior was particularly unusual, so I bet mommy used her as a punching bag pretty often. And I didn’t do anything. Morality aside (I really wish I had intervened; I did not do the right thing), I started wondering what my obligations are as a nurse in situations like that. I know nurses are obligated reporters in my state and, as far as I know, in all US states, but does that mean we’re obligated to report abuse all the time or only while we’re clocked in? I’m talking legal and professional obligation and not the moral and ethical obligation for which I totally dropped the ball.

The rules are clear at work. If we suspect child or elder abuse or neglect, we have to report it. Period. Full stop. The rules for not-at-work are not at all clear. I looked up information for several states including mine and in no case found differentiation between on-duty and off-duty reporting. In my state, for example, “mandated reporter” is defined as

“Persons licensed to practice the healing arts, dentistry and optometry; persons engaged in postgraduate training programs approved by the state board of healing arts; licensed professional or practical nurses; and chief administrative officers of medical care facilities.”

Nowhere in this document does it specify “while these people are practicing their professional duties.” I found no differentiation in similar documents from other states. I take this to mean nurses are liable if they DON’T report suspected child abuse even off the clock.

This has obvious issues. Practically, I could have done nothing official with the toddler-punching mom unless she volunteered her name and address so that I could offer her a free visit from Child and Protective Services. I suppose I could have called the cops, but she would have been gone by the time they got there. Technically, though, it seems I should have done something simply because I’m a nurse and am obligated to. I think all of us in the aisle should have intervened, actually, but that’s another societal issue.

I am going to follow up on this issue and other related ones (e.g., what if I know a friend is suicidal and don’t say anything?). Nurses should know what we are legally obligated to do.