A nurse is discussing advancing interprofessional communication on the unit. Which of the following should the nurse identify as a barrier to this advancement?

Choice A reason: If client is uninsured the ED can decline to render services is not an information that the nurse should include in the teaching. This is a false statement that contradicts the purpose and the provision of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who requests it, regardless of their insurance status or ability to pay.
Choice B reason: The ED has the right to refuse to provide client services is not an information that the nurse should include in the teaching. This is a false statement that violates the principle and the requirement of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department has a duty to provide stabilizing treatment to any individual who has an emergency medical condition or is in active labor, unless an appropriate transfer is arranged.

Choice C reason: The ED can transfer medically unstable clients to other facilities is not an information that the nurse should include in the teaching. This is a false statement that breaches the rule and the regulation of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must not transfer an individual who has an emergency medical condition or is in active labor, unless the transfer is requested by the individual or their representative, or the transfer meets certain criteria, such as the benefits outweigh the risks, the receiving facility has agreed to accept the transfer, and the transfer is effected by qualified personnel and equipment.
Choice D reason: Clients must receive a medical screening evaluation (MSE) is an information that the nurse should include in the teaching. This is a true statement that reflects the essence and the standard of EMTALA. According to EMTALA, any hospital that participates in Medicare and has an emergency department must provide an appropriate medical screening examination to anyone who comes to the emergency department and requests examination or treatment for a medical condition, to determine whether or not an emergency medical condition exists

Choice A reason: Obtaining a detailed history is the first action that the nurse should take. History can help the nurse determine the cause, frequency, and severity of the bruises, as well as the child's relationship with the abuser and the risk of further harm. History can also help the nurse assess the child's physical and emotional state, and provide evidence for reporting the abuse later.
Choice B reason: Reporting the suspected abuse to the authorities is not the first action that the nurse should take. The nurse should report the abuse only after obtaining a history and confirming the suspicion. Reporting the abuse prematurely can jeopardize the child's safety and the nurse's credibility. The nurse should also follow the legal and ethical guidelines for reporting abuse in their jurisdiction.
Choice C reason: Requesting a social services referral is not the first action that the nurse should take. The nurse should request a social services referral only after reporting the abuse and ensuring the child's protection. A social services referral can help the child access resources and support, such as counseling, legal aid, foster care, etc. The nurse should also collaborate with the social worker and other members of the interdisciplinary team to provide holistic care for the child.
Choice D reason: Telling the child what will happen to her when the abuse is reported is not the first action that the nurse should take. The nurse should tell the child what will happen to her only after obtaining a history and reporting the abuse. The nurse should also use age-appropriate language and reassure the child that the abuse is not her fault and that she is not alone. The nurse should avoid making promises that they cannot keep, such as saying that the abuser will never hurt her again.