The Reporting Obligations Of Nurses

Every state and the major U.S. territories have statutes or regulations that mandate certain professionals or employees of certain institutions report suspected child abuse to government authorities. These statutes generally include social workers, healthcare professionals, and school personnel.  Whether listed expressly or not, nurses practicing in a non-clinical setting are universally included as mandatory reporters.  As a nurse, particularly one practicing in a non-clinical setting such as a school, what should you do when you’re faced with suspected child abuse?  What should you do when your boss wants to maintain the status quo and keep quiet?

The duty to report typically arises when you have a reason to believe or suspect that a child is abused or neglected.  Abuse or neglect includes physical and mental harm, and in most states, it includes the risk of physical or mental harm.  Actual knowledge of abuse or neglect is not required to trigger your reporting obligations, and failure to report can bring civil and even criminal penalties.  

Your reporting obligations vary from state to state, but generally, you have a duty to report any suspected abuse to state authorities and/or to your chain of command.  Most states have a specific reporting protocol which falls into one of three schemes:  a report to the head of the institution (or designee) informing them that authorities should be notified, at which point the institution should make a report to authorities; a report to the head of the institution followed by a report to authorities; or a report to authorities followed by a report to the head of the institution.  

About 15 states have provisions which expressly prohibit employers from taking steps to prevent or discourage an employee form reporting child abuse or neglect.  For example, the California Penal Code provides:  

no supervisor or administrator may impede or inhibit the reporting duties, and no person making a report shall be subject to any sanction for making the report.  However, internal procedures to facilitate reporting and apprise supervisors and administrators of reports may be established…

Similarly, in Connecticut, employers are prohibited from retaliating against an employee who makes a good faith report, or who testifies or is about to testify in a proceeding involving 

However, even if your state does not have express protections for reporting child abuse, there are likely other laws which can be applied to protect your career.  An example of how this works can be found in the 2012 case Villarin v. Rabbi Haskel Lookstein School. Villarin was a nurse at a private elementary school.  One day a student visited her office with a prominent injury on his left cheek and told her that his father struck him.  Villarin contacted the father who admitted to hitting the student to punish him.  Villarin consulted with the headmaster who discouraged her from reporting the abuse, even after she explained her obligation to do so under state law.  Villarin disregarded her employer’s unlawful order and contacted the state authorities.  She was terminated a short while later because she was not a “team player.”  

In addition to statutory protections, many states also recognize a concept called common law wrongful discharge in violation of public policy.  In the states that recognize wrongful discharge, they usually protect employees who refuse to engage in unlawful activity or who report suspected unlawful behavior to authorities.  

What should you do? Here’s some practical advice:

• Know that your obligation to report child abuse attaches when you when you have a reason to believe or suspect that a child is abused or neglected. 

• Understand the reporting scheme for your jurisdiction.  Most follow one of three reporting schemes.  In some jurisdictions, reporting to your institution may be enough. 

• If your chain of command discourages you from reporting abuse to authorities, talk to an attorney.  You’re likely protected if you go outside of your school, but get some legal advice before you make a move that can impact the rest of your career.  

David Scher and R. Scott Oswald are principals of The Employment Law Group, P.C., a law firm that represents plaintiffs alleging wrongdoing by their employers.