Mandated Reporting and a Softer Heart

Friends. I might have done it. This might be the closest one of my blog posts will ever come to relating parenthood and nursing. I am very excited about this.

A few weeks ago, Olivia took a pretty dramatic tumble down our (carpeted, thank God) basement stairs. To make a long story short, my morning routine was different, I didn’t make sure the door at the top of the stairs was shut, and when I turned my back to make her bottle she took full advantage of the most dangerous thing in the room. (Side note: how does the human race still exist if this is what babies are inclined to do?)

I grabbed her from the bottom of the stairs, and called 911, we were brought into York Hospital as a trauma, and from there we were sent to Penn State Hershey children’s hospital for a pediatric trauma evaluation because on one of her x-rays there was a fractured 1st rib, along with a fractured clavicle. Fun fact: a fractured first rib is indicative of a “high energy” injury. Based on the potential for more underlying injury, we were sent to be evaluated by a pediatric trauma team. The whole time, Olivia was awake, totally unpleased with the poking and prodding, but generally okay. At Hershey, they discovered that the rib wasn’t fractured, but her femur was. Y’all. My heart. I sobbed. (another side note: I RARELY wear make up. I put on mascara that morning because I was going to the DMV to get my picture taken. I looked like some sort of tragedy.)

On our way to Hershey. That neck collar. MY HEART.
Hanging out in her new Rhino brace

Michael had gone home to get us clothes in between hospitals, and I rode in the ambulance with Olivia to Hershey. Once the initial assessment was complete, and we were waiting on results, I was sitting alone with Olivia when a detective and two social workers came in. Per the hospital’s protocol, any child with a fracture under age 1 year needs to be reported to children and youth services. So, without Michael, I sat through questioning by a detective, and then separate questioning from the social workers. I was then informed that I was unable to be alone with Olivia, the people in my life over 18 needed to sign affadavits stating they would supervise me until this case was investigated further. Devastated does not begin to cover my response. Another long story short, we were quickly cleared, and we are back to living a normal (ha!) day to day life.

Alright guys, here it is, the nursing tie in!!

I recently had an elderly patient, let’s call him Adam, who was admitted for complications of an existing disease. As I was asking the questions for his admission, I began to see some red flags. He was a retired truck driver, but when he moved here, his niece would no longer let him drive at all. She used his credit cards, ignored him around the house, and was horribly mean to him. No signs of physical abuse, but he apologized so frequently for “being a bother.” He broke my heart. Fun fact: nurses (along with many other professions) are “mandated reporters” which means that we are obligated to report any suspected abuse. After I was done with sweet Adam’s assessment, I called in my report.

Had I not just experienced my own drama with social services, this may have been much easier for me. But as I processed what Adam had just told me, I felt overwhelming sympathy for the him, but a tiny bit (tiny, y’all, I’m not a monster) of empathy snuck in for what was coming down the line for his niece. Is it possible she was well intentioned when she asked Adam to move in with her, but it became too much? Was Adam perceiving things differently than the niece was trying to portray them? Did the niece need resources as badly as Adam needed to feel more loved and less like a burden? None of these concerns mattered, because my job and obligation was to report suspected financial exploitation and verbal abuse.

Until this moment, I had been so angry with the child safety physician at Hershey for treating me like some kind of criminal. I felt so ashamed and humiliated that I had been there when Olivia had fallen down the stairs, and the investigation they implemented was crushing. And then, while on the phone with a social worker in the early morning hours of a night shift, my heart softened. It doesn’t feel good. Nobody wants to make that call. Nobody wants to get a patient in that’s potentially being neglected or abused. While I had sat in the discomfort that was being “victimized” I had not even considered the horrible reality of that physician’s job. Her sole purpose at that hospital is to look for malicious intent in children’s injuries, and report them. And she does this so that children do not have to be subjected to the cruelties that exist in this world.

I don’t know what the outcome will be for Adam, but I did my part. I felt so torn when I hung up. I had just started chaos for that family, but if it could protect an elderly man from neglect, it’s worth it. But if this niece is doing everything she can to care for Adam, and it was some sort of mix up, then I have just put even more pressure on a woman who is trying her best.

Seeing this from both sides was humbling. I had been so caught up in my own discomfort that it was difficult to see the good that these protocols do for so many children, and how hard of a job that physician does every day. I had a small brush with her reality, and it didn’t feel good. I hope, for Adam and his niece’s sake, that everything is okay at home, and if not maybe social work can provide them with resources to make it a little better. Had I not experienced my own drama with this, I might have had a harder heart, but life came full circle on this, and instead I left that shift with a much broader view of the whole thing.

Being a mom is hard, and being a nurse is hard, but man is it beautiful when things like this line up and I can catch a glimpse of things that are so much bigger than me.


Brace is off, fractures are healed, we’re doing a-okay 


Author: Trying to Keep it Together

Amanda is new graduate BSN, trying to figure out how to balance life as a new mom, a wife, and a nurse.

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