By Jodi Pahl
Last fall, a developmentally delayed young woman came into the emergency department of a Bon Secours Mercy Health hospital in Ohio. She was willing to show off her body any time a staffer wanted to assess or treat her. That, plus the presence of an older man who was a “friend,” raised the suspicions of the duty nurse. She took the patient “for an x-ray” (which was not ordered) in a room away from the man. They questioned the young woman, and found that the man was selling her for sex.
This is one of the success stories of Bon Secours Mercy Health’s new initiative to address and combat human trafficking. Working through community-based initiatives, the system addresses the abuse of individuals across the care continuum. It is a complex issue and must be addressed with a multi-faceted approach.
The system has committed itself to training its workers and improving identification of victims with a standardized patient screening protocol. The questions were carefully chosen and vetted from Massachusetts General Hospital, which is recognized as a leader in the development of identifying and assessing Human Trafficking victims. Any positive response is considered a positive screening. The questions are:
- Do you feel that people are controlling you and forcing you to do things you don’t want to?
- Are you scared of or frightened by people in your everyday life or work setting?
If screening is positive, a best practice alert will appear. It reads: “Screening for suspected exploitation, abuse and/or human trafficking is positive. If suspected, local policies and mandatory reporting procedures should be followed. In caring for an abused/exploited patient please use a trauma-informed care approach and partner with local/community advocates/social service providers as appropriate. For information on human trafficking, contact the National Human Trafficking hotline at 888-373-7888.”
The useful flow chart that our staff now uses to identify and help trafficking victims is reprinted below.
Once a potential human trafficking victim has been identified, our protocol provides a step-by-step guide for actions to be taken. We use a trauma-informed care approach to engage people with histories of trauma to recognize the presence of trauma symptoms and acknowledge the role that trauma has played in their lives.
Not all cases end successfully, however. Another patient was a woman in her late 20s, admitted for diabetes complications, but staff and I noticed that between two different male visitors, she was never left alone. The men never stated their relationship to her, didn’t want to be part of a report, and did not seem concerned about her well-being. The patient wouldn’t tell us where she was from, and nothing she reported made sense. That’s when we started following protocol.
After further questioning, the woman left the hospital against medical advice. But the staff implemented quiet time on the unit very strictly in order to get her male visitors off the floor. That gave us the opportunity to give her a number to call for help, concealed in a tube of lipstick. We don’t know whether she used it, but we did what we could. This work will be ongoing for a long time.
Jodi Pahl is chief nursing executive of the Great Lakes Group of Bon Secours Mercy Health.
