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In the given scenario, if you come across a patient with a bruise or wound who is not willing to disclose the possible abuse, it is your ethical and professional responsibility to take action to ensure the safety and well-being of the patient. According to the provided information, consent is not required to raise a safeguarding concern. Here are the steps you should take based on the marking criteria and ethical guidelines:


1. Escalate the Concern Regarding Safeguarding (Patient Consent Not Required): Since patient consent is not necessary in cases of possible abuse, you should escalate your concerns immediately. This means reporting the situation to the appropriate authority within your healthcare organization, such as a supervisor, manager, or designated safeguarding officer.

2. Communicate with Compassion and Empathy to the Patient: While the patient’s consent is not required to report the concern, it is important to communicate with compassion and empathy. Approach the patient in a sensitive and understanding manner, expressing your concern for their well-being and safety. Even if they do not want to disclose the abuse, your empathy can make them feel heard and supported.

3. Act Without Delay & Raise Concern: Act promptly without delay. Do not wait for the patient’s consent if you suspect abuse. Time is crucial in such situations, and immediate action can prevent further harm. Raise your concern to the appropriate channels within your healthcare organization, following the established protocols and procedures for reporting safeguarding issues.

4. Be Clear, Honest, and Objective When Raising Concern: When reporting the concern, be clear, honest, and objective in your communication. Provide specific details about the observed injuries, your conversation with the patient (without breaching confidentiality), and any other relevant information. Objectivity is essential to ensure that the report is accurate and helpful in addressing the situation.

5. Make a Clear Written Record of the Concern and the Steps Taken: Document the concern and the steps you have taken in a clear and detailed manner. Maintain a written record of the observed injuries, your conversation with the patient, and the actions you have taken to report the concern. Proper documentation is important for accountability, continuity of care, and legal purposes.

6. Acknowledge the Standards & Values Set Out in the NMC Code: Adhere to the standards and values outlined in the Nursing and Midwifery Council (NMC) Code of Conduct. Uphold the principles of professionalism, integrity, and advocacy for the well-being of the patient. Your actions should align with the ethical guidelines and standards set forth by your professional regulatory body.


I will recognize the necessity of addressing safeguarding concerns even without patient consent, in line with the duty of candour.

I will approach the patient with empathy and compassion, using appropriate language to communicate the situation.

I will identify the urgency due to potential risks to the patient’s safety, I will promptly raise the concern at the earliest suitable moment.

I will report the concern to the manager or local authority, ensuring clarity, honesty, and objectivity in explaining the reasons for my concern according to safeguarding policy.

I will maintain a detailed written record of the issue, including a body map if necessary, documenting the steps taken and noting the date and individuals involved in the reporting process.

I will uphold the standards and values outlined in “The Code,” prioritizing people’s well-being, practicing effectively, preserving safety, and promoting professionalism and trust.


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