A nurse suspects elder abuse in a patient who presents with multiple bruises and appears fearful of their caregiver. What is the nurse's PRIORITY action?

When a nurse suspects elder abuse, the priority action is immediate mandatory reporting to the appropriate authorities, such as Adult Protective Services. Nurses are legally designated mandatory reporters in all U.S. jurisdictions, meaning they are required by law to report suspected abuse regardless of whether it has been confirmed. Acting immediately protects the vulnerable adult from further harm. Waiting for additional evidence before acting is inappropriate and potentially dangerous; the standard is suspicion, not proof. Simply documenting findings and continuing the care plan without reporting fails the legal and ethical duty to protect the patient. Discussing the situation with the caregiver is inappropriate as the primary action because it could alert the alleged abuser, allow for fabrication of an explanation, and further endanger the patient. The nurse must prioritize the safety of the patient above all other considerations. After reporting, the nurse should continue to document objective findings thoroughly — the location, size, color, and pattern of bruises, as well as the patient's verbal statements and behavioral cues such as fearfulness — to support the investigation. Collaboration with the interprofessional team, including social work, is also essential after the initial report has been made.