A third-trimester patient in labor with a history of a fall presents with bruising but no vaginal bleeding; the Abuse Assessment Screen indicates possible abuse. To which professional should the nurse refer the patient?

• A. The social worker on call
• B. The obstetrician on duty
• C. The patient's family physician
• D. The police department

Answer: (A)

When a patient in labor has indicators of possible abuse, the priority is to ensure safety and connect her with resources that can address both her immediate situation and long-term well-being. A positive Abuse Assessment Screen signals that the patient may need confidential support, risk assessment, and safety planning beyond acute medical care.

The social worker on call is the best fit because hospital social workers are trained to handle disclosures of abuse, assess danger, and coordinate resources such as safe housing options, legal assistance, counseling, and social services. They can create a safety plan for the hospital stay and after discharge, facilitate communication with protective services if needed, and advocate for the patient’s autonomy and confidentiality. This role integrates with the medical team to ensure comprehensive care that includes both health and social support.

Obstetricians provide medical management, but they’re not the primary interface for addressing abuse and arranging social resources. The patient’s family physician may not be readily available in the hospital setting. The police department is for law enforcement and crisis response in imminent danger; while they may be involved in certain situations, the initial and ongoing support for abuse disclosures within the hospital is best handled by the social worker who can coordinate care and resources.