I Think My Patient Is Being Trafficked

Roxanne Nelson, RN, BSN

Disclosures

September 24, 2019

He noted that identification is the "easy" part. "We performed 14 screenings and nine were positive, and six of the nine patients have accepted some assistance," said Paulus. "But although that seems like a high success rate, it often takes multiple tries to get people out of this situation permanently. It's a little bit tricky to say how safe they are—only one of the six was a complete success." In that instance, the case involved a woman with an 11-month-old baby who was being trafficked by the child's father.

If local resources are limited, clinicians can try to arrange a private setting for the patient to call a national hotline, including:

  • National Domestic Violence Hotline, 1-800-799-SAFE (7233);

  • National Sexual Assault Hotline, 1-800-656-HOPE (4673); and

  • National Human Trafficking Hotline, 1-888-373-7888.

Resistance and Refusal

Many patients will refuse to disclose anything or deny that they are being exploited. Or, even if they admit that they are being victimized, they may refuse assistance.

Gibbs pointed out that this may be the most difficult step for the clinician. "We need to respect their wishes, although we do need to follow through on mandated reporting," she said. "But importantly, we are taking the focus off of disclosure and rescue, and instead we want to empower them to escape on their own terms."

Still, there are mandatory reporting laws which will vary by state. If the patient in question is a minor, then all 50 states require child abuse to be reported. It's more complicated for an adult, but most states do mandate that injuries caused by weapons or injuries caused in violation of criminal law, suspected abuse, or domestic violence be reported.

Whenever possible, clinicians should try to arrange a follow-up appointment in order to continue to build rapport with the patient as well as monitor health and safety. The hope is that even if the trafficking survivor doesn't seek help on a first visit, they may open up at a later visit. Another tactic is to give the patient a 24-hour hotline number and write it down discreetly on a prescription or a health card or indicate that the number is for some type of related service, such as the phone number for an urgent care clinic.

Ensminger explained that even if patients decline help, clinicians should not feel that they've failed.

"We have to do this work in faith; we are planting seeds, and the patient may come back when ready," she said. "We planted the seeds and showed compassion, and even if you don't get a bloom right away, you're a stepping stone. The important thing is for the patient to know that this is a safe place if they want to come back."

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