Go through attached article and use it to answer the questions listed in Qualitative reasoning . 

Please cite at least 2 sources. please no plagiarism. 

R E S E A R C H

Elizabeth Lo
the Universi

Elizabeth B.
Villanova, P

For correspo
the Universi
E-mail: eliza

J Emerg Nu
0099-1767

Copyright ©
All rights re
https://doi.o

■ ■ • ■

NURSES’ PERCEPTIONS OF VICTIMS OF HUMAN
TRAFFICKING IN AN URBAN EMERGENCY
DEPARTMENT: A QUALITATIVE STUDY

Authors: Elizabeth Long, BSN, RN, CEN, Elizabeth B. Dowdell, PhD, RN, FAAN, Philadelphia, PA and Villanova, PA

Contribution to Emergency Nursing Practice

• Emergency nurses are in a key position to identify and
care for victims of human trafficking but do not have
enough education regarding how to identify these
victims and which resources to use for them.

• Differing perceptions of emergency nurses regarding
victims of violence, prostitution, and human trafficking
can potentially affect the care delivered to these patients.

Abstract

Introduction: Human trafficking is estimated to surpass the drug
trade as the leading illegal industry in the world. According to a
recent study, over 87.8% of trafficking survivors came into contact
with a healthcare professional while they were enslaved and were
not identified as a victim of human trafficking. The aims of this
study are to understand the perceptions of emergency nurses about
human trafficking, victims of violence, and prostitution.

Methods

: A qualitative, descriptive study using a semi-structured
interview approach was done with ten registered nurses in a

ng, Member, PA-ENA Chapter, is Clinical Nurse III, Hospital of
ty of Pennsylvania, Philadelphia, PA.

Dowdell is Professor, Villanova University College of Nursing,
A.

ndence, write: Elizabeth Long, BSN, RN, CEN, Hospital of
ty of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104;
beth.long@uphs.upenn.edu.

rs ■.

2017 Emergency Nurses Association. Published by Elsevier Inc.
served.
rg/10.1016/j.jen.2017.11.004

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large, urban Emergency Department in the northeastern U.S.
Interviews were recorded and transcribed; thematic analysis
was performed.

Results

: Six themes emerged from the interviews including,
“human trafficking exists in the patient population” yet no nurse
has screened or treated a victim; human trafficking victims are
perceived to be “young, female, and foreign born”; all of the
emergency nurses reported having worked with or screened a
victim of violence; victims of violence were viewed as patients
who present as “sad and grieving”; prostitutes are seen as
“hard and tough”; and emergency nurses did not have
education on human trafficking victims’ needs or resources.

Discussion

: Emergency nurses should be more aware about
victims of human trafficking. The media portrayal of human
trafficking victims had influenced the nurses’ perceptions of this
population. Victims of violence are perceived to be very
different from prostitutes, but there is a desire for education
about violence as well as information about specific resources
open to victims.

Key words: human trafficking; Emergency Department; victims
of violence; prostitution

H
uman trafficking, also known as modern-day
slavery, is one of the largest illegal industries
globally, generating more than 150 billion US

dollars each year.1 Because of its increasingprevalence, victims
of human trafficking have become a growing public health
concern in the United States.1 It is estimated that there are

more than 21 million adults and children enslaved worldwide,
more than at any time in history.2,3 The Emergency Nurses
Association (ENA) position statement, released in February
2015, emphasized the vital role of emergency nurses in
educating other professionals, the public, and policy makers
about human trafficking.4 Emergency nurses are key persons to
identify victims and direct resources to assist them.

Two categories of human trafficking are forced labor and
sex trafficking.5 Victims of forced labor trafficking can be
found in domestic servitude in places such as restaurants,
carnivals, and migrant farms. Sex trafficking is present in online
escort services, residential or disguised brothels, and prostitu-
tion.6 Globally, more than 4.5 million people have been forced
into sex trafficking, often lured into romantic relationships
with traffickers and then forced into prostitution.7

The literature suggests that traffickers target vulnerable
populations, which frequently include persons living in
poverty, refugees from war or conflict, runaways and

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FIGURE 1

Interview questions.

RESEARCH/Long and Dowdell

homeless youth, victims of domestic violence or sexual
assault, and ethnic minorities. Often, traffickers seek
vulnerable persons from certain ethnic or cultural back-
grounds, imprisoning and exploiting their victims through
the use of force, psychological coercion, and violence.
Traffickers deceive victims with false promises of chances
for prosperous lives and job opportunities or secure, loving
relationships.6 These criminals do not necessarily present to
health care providers as domestic violence abusers might.
Rather, they are often charismatic and manipulative,
feigning concern as romantic partners, family members, or
community leaders.6,8 These key assessments are frequently
overlooked in the early identification of human trafficking
perpetrators and their victims.

In 2015, the National Human Trafficking Resource
Center (NHTRC) received more than 21,947 phone calls,
1,275 emails, and 1,535 online tip reports about human
trafficking in the United States.9 The 2015 NHTRC annual
report found that 74.6% of cases were related to sex
trafficking, and 13.0% of cases were related to labor
trafficking.9 In sex trafficking cases, more than 91.4% of
victims were women, and 34.7% were US citizens or legal
permanent US residents.9 Of all the calls to the NHTRC in
2015, only 1.9% of callers were medical professionals.9 These

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statistics speak to the increasing prevalence of this injustice
and the need for nurses to play a vital role in identifying
victims. Having an awareness of human trafficking will help
nurses acquire the vital skills needed for in-depth screening.10

Victims are challenging to identify. They are men, women,
or children and American citizens or foreign nationals.9,10

They are not likely to self-identify, and therefore it is
important for the emergency nurse to pay attention to
nonverbal body language when screening for abuse or human
trafficking. Victims of violence and victims of human
trafficking present in similar ways; however, victims of
human trafficking are more likely to be isolated, abuse drugs
and have infectious diseases, malnutrition, and complications
from poor medical care.9,10

Research has focused heavily on the physical and
psychological effects of human trafficking. Victims of human
trafficking can suffer from physical, sexual, and psychological
health problems such as sexually transmitted infections, genital
mutilation, urinary difficulties, pregnancy resulting from rape
or prostitution, broken bones, burns, concussions, dental
problems, and infections in addition to post-traumatic stress
disorder, anxiety, and depression.5,6,11–13

Because of the growing incidence of human trafficking
and the related health concerns, institutions and health care

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TABLE 1
Demographic data

Registered
Nurses

Age (years) Gender Certifications Ethnicity Number of Years
Working in the ED

Previous Specialties

1 34 Male TNCC Caucasian 4 None
2 25 Male TNCC Asian 3 Research
3 26 Female TNCC Caucasian 4 Occupational Health
4 41 Male TNCC Caucasian 8 None
5 35 Female TNCC, SANE, CEN Caucasian 4.5 Critical Care
6 57 Female TNCC, CEN Caucasian 38 None
7 38 Female TNCC, CEN Caucasian 16 None
8 40 Female TNCC Caucasian 10 Cath Lab
9 35 Male TNCC, CEN Caucasian 7 None
10 29 Female TNCC African American 6 Telemetry

Long and Dowdell/RESEARCH

providers are now being asked to develop policies and
screening protocols. Emergency departments have been
identified as ports of entry for many victims of human
trafficking into the health care delivery system because of
progressive interpersonal violence policies, experienced staff,
and specially trained nurses such as forensic nurse examiners
(FNEs) or sexual assault nurse examiners (SANEs) who
have expanded roles within the emergency department.
However, there is a gap in the literature documenting how
RNs—specifically, emergency nurses—perceive this topic
and how the policies, or lack thereof, in their hospitals affect
their perceptions of screening policies for victims of human
trafficking. The purpose of this qualitative study is to examine
the perceptions of emergency nurses about human trafficking,
prostitution, and victims of interpersonal violence so that they
can better identify and screen for these victims.

Methods

A descriptive qualitative design was chosen for this study.
Data were collected using semistructured interviews
exploring emergency department nurses’ experiences with
human trafficking, prostitutes, and victims of interpersonal
violence (IPV) to better understand the emergency nurse
perspective. Before the selection of participants, institu-
tional review board (IRB) approval was obtained from the
university at the academic medical center and from the
researchers’ university. Both IRBs determined that oral
consent was adequate for participation in the study.
Subjects were provided with a written description of the
study, risks and benefits of participating, and information
stating that participation in the study was voluntary. Oral

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consent was obtained following the reading of the
information sheet at the time of the interviews and
assurance that their interviews would remain confidential.

Sample and Setting

A purposive sample of emergency nurses were recruited for
this study. Nurses were recruited through flyers and at shift
change meetings over the span of 3 months. Criteria to
participate in the study included being a registered nurse
with a Bachelor of Science in Nursing (BSN) degree who
had worked for at least 2 years in the emergency
department. All emergency nurses worked in the same
emergency department, which was part of a large, academic,
urban emergency department; it is also the region’s level I
trauma center, in the northeastern US. This emergency
department was chosen because of its location in a city
identified with a large human trafficking population, its
progressive IPV policy, and the number of experienced
emergency nurses, which included a SANE on each shift.

Data Collection

Semistructured interviews were selected as the means of
data collection in anticipation of capturing information
specific to experiences with human trafficking. All
interviews were audio-recorded and transcribed verbatim.
Each interview consisted of 12 open-ended questions
(Figure 1) that asked the emergency nurses about their
experiences in caring for victims of human trafficking,

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prostitution, and violence. Sociodemographic data were also
collected identifying participants’ gender, ethnicity, age, years
of experience in the emergency department, nursing specialty
areas in which they worked previously, and their level of
education. Data saturation was reached after 10 emergency
nurses were interviewed.

Content analysis was used to analyze the data. The
interviews were transcribed verbatim by the first author and
read and confirmed by the second author to ensure a
comprehensive examination of the data and credibility during
the process of analysis. Field notes were taken concurrently by
the first author to document nonverbal communication. The
interviews were recorded, transcribed, and thematic analysis
was performed. Data collected from the interviews were
analyzed systematically, which is recommended for qualitative
data.14,15 Transcripts were read and reread by both authors to
ensure a rigorous examination, and field notes were used as
supplementary data in the analysis process. Data were coded
manually, guided by the research questions, and potential
themes and subthemes were identified.14,15 Each transcript
and all field notes were read individually and then together to
identify themes. Trustworthiness was addressed by both
authors in discussions about data credibility and confirm-
ability to identify any bias that might have influenced the
analysis process.

Results

The final sample consisted of 4 male and 6 female
emergency nurses with nursing experience ranging from 3
to 38 years. The sample included 4 nurses who
were certified emergency nurses (CENs) and 1 who was a
SANE (Table 1).

Through the data analysis process, 6 core themes were
identified. This paper reports on each theme by using
quotes from the emergency nurses to illustrate the findings.
Pseudonyms are used to protect participant confidentiality.

THEME 1: HUMAN TRAFFICKING EXISTS IN THE
PATIENT POPULATION, BUT NO SCREENING IS
PERFORMED

Each emergency nurse was asked, “In your practice here in
this emergency department, have you screened and or
worked with a victim of human trafficking?” None of the
nurses interviewed had ever screened, identified, or
knowingly treated a victim of human trafficking. There
was a repetitive level of uncertainty regarding victims of
human trafficking, screening, or identification and their
presence in the patient population of the emergency

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department. Screening for human trafficking is based on
ED experience, and all the nurses stated “never” having
worked with a victim of human trafficking either domestic
or sex trading. There was awareness by the emergency
nurses that human trafficking occurs in their patient
population, but there was a lack of having screened and
knowingly having treated a victim.

• Ashley, when asked if she had screened or treated a victim
of human trafficking, stated, “I have never come across one
that I have definitely known about.”

In answering the question, the emergency nurses
described their perception of how a victim of human
trafficking would be similar to a victim of IPV. The nurses
frequently linked human trafficking presentation in the
emergency department as being similar to patients who
experience IPV. These responses illustrate how emergency
nurses are aware that human trafficking victims would
present similarly to victims of IPV but also shows that there
is uncertainty directly related to a lack of experience with
these types of patients. Because victims of human trafficking
do not self-identify and can present in a variety of ways, it
can be very challenging for the emergency nurse to screen
for them.

THEME 2: HUMAN TRAFFICKING VICTIMS ARE
“YOUNG, FEMALE, AND FOREIGN BORN”

All of the emergency nurses in this study held the belief that
victims of human trafficking must come from different
countries (foreign born) and are young women or girls.

• Ashley said, “…we generally think of them (victims of
human trafficking) as young, or children, but I know in
different areas (of the city) we still see women from Russia,
women from China…I think that when we see them we
feel we will see them with an overbearing man, because
that is the normal presentation of abuse…it’s what I see on
TV.”
• Henry stated, “I imagine they (victims of human
trafficking) would look very traumatized…be scared.”

These quotes highlight the misconception of victims of
human trafficking being similar to that presented in
mainstream media. Ashley’s quote, in which she stated
that the patient would present with an overbearing man, is
more often true with victims of IPV. Victims of human
trafficking can present with charismatic, well-mannered
“boyfriends” or “family friends.” No study participants
mentioned this presentation of a suspected trafficker, and
this speaks to a lack of education on the topic. Also, victims
of human trafficking are similar to victims of IPV, as they

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Long and Dowdell/RESEARCH

are usually not forthcoming with information about their
situations.16

• Carol shared: “I think that it would be a person who is
easily preyed upon…probably a minority in ethnicity: for
example, maybe a foreign person who comes in and isn’t a
citizen of the US and who came in via various means, like
promised something and was never given it. And also a
younger person: for example, a young woman, who was
maybe sold by her family to these terrible people and just
people who don’t have resources who are used by people of
stronger means.”
• Henry also reported that he wasn’t sure if men or boys
would present to the emergency department as victims of
human trafficking “because it’s not really portrayed in the
media.”

These statements speak to how the media can add to
the impression of victims of human trafficking being
exclusively young, foreign women in the sex trade.
Furthermore, these responses show how emergency nurses’
perceptions of human trafficking victims are largely
influenced by the media and reports of human trafficking
in our society.

THEME 3: IDENTIFYING VICTIMS OF VIOLENCE

All the emergency nurses in this study reported that they
consistently screened and worked with victims of IPV. This
positive finding demonstrates how these emergency nurses
are routinely screening all patients for IPV and emerged as a
strong theme related to their current bedside practice.
When compared with their uncertainty related to human
trafficking screening, the study participants were all
comfortable and certain of their skills in screening for
IPV. The innovative ED policy, combined with multiple
in-service education modules, may be considered to be
factors that have increased levels of understanding and
acquisition of skills. These study participants are playing a
significant role in identifying this vulnerable population
that often does not self-identify.16

• Ashley reported, “Oh sure, we always screen for victims of
violence here in the emergency department.”
• Dave said, “Yes, I’ve seen a whole range of things…I see
people who are first time and multiple times being
assaulted…it is not pretty”

The quotes by these emergency nurses reflect their
awareness of the problem as well as adherence to federal law.
Nurses play a critical role in identifying these patients and
providing them with the tools they need to leave an abusive
situation. It is encouraging to see that all patients are being

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screened for IPV. The interactions that nurses have with the
victims of violence can truly make an impact.

THEME 4: VICTIMS OF VIOLENCE VIEWED AS “SAD
AND GRIEVING”

The participants in this study frequently described victims
of IPV as expressing a “sad and grieving” or “defensive”
presentation. They reported that victims of IPV reacted
differently from prostitutes because they believed that
victims of IPV are often in states of shock.

• Clara shared that victims of IPV are “usually very upset at
the time they present; it’s an emotionally charged incident,
and they behave like that in the emergency department.”
• Lucy shared: “The patients themselves come across as
withdrawn with a flat affect…some of them come across as
being aggressive, feeling defensive.”

In these comments, study participants identified
characteristics of the psychological impact that the violence
has had on these victims. There is a sense that these patients
require special consideration when providing care. Partic-
ipants in these interviews perceived these victims to present
in various ways that were similar to the stages of grief. Some
patients appeared defensive, whereas others seemed with-
drawn and “delicate.”

• Mary reported, “Patients who have experienced violence
are pretty anxious when they come into the emergency
department, and they are delicate.”

These comments also reflect the perspective that
victims of IPV present as fragile. There is a sense of
uncertainty about what type of emotion these victims will
share, but, regardless, the nurse must have consideration
when dealing with these patients. Overwhelmingly, study
participants expressed their sympathy and compassion when
caring for these victims. They recognized that they are in a
key position to identify and care for them.

THEME 5: PROSTITUTES ARE SEEN AS “HARD AND
TOUGH”

Because of the close relationship between sex trafficking and
prostitution, the participants in this study were asked about
their experiences in caring for women or men who were
prostitutes. There was no indication from any of the
participants that many prostitutes are also victims of human
trafficking or are being traded for sex. Study participants
reported that prostitutes appear in the emergency depart-
ment as “hard and tough, because they have chosen their life
style.” The description of prostitutes’ presentations served as
a stark contrast to how they perceive victims of IPV.

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FIGURE 2

Questions to report a victim of human trafficking: National Human Trafficking Resource Center 2 (NHTRC).9

RESEARCH/Long and Dowdell

• Henry stated, “They are a little rough around the edges. It’s
hard to figure out if they willingly want to do this (prostitution).”
• Dave said, “Those women (prostitutes) are more aggressive
than regular victims of violence…They are not timid; they
don’t have as many downplayed eyes, they’re like ‘this is
what I do, this is who I am, and this is what I need.’”
The impact of being labeled “hard” or “tough” emerged

as a key difference between how study participants viewed
victims of IPV and prostitution. Participants echoed this
sentiment that prostitutes are often not viewed as victims
because they perceived that prostitutes “have chosen this life
style.” None of the participants in this study expressed a belief
that prostitutes were forced into a life of prostitution or that
there was a link between sex trafficking and prostitution.
These viewpoints about choice of lifestyle, whether correct or
not, might influence the care provided to these patients.

THEME 6: NO HUMAN TRAFFICKING EDUCATION
FOR EMERGENCY NURSES

All the nurses who participated in the study reported
receiving education on caring for victims of IPV and the
available resources while in nursing school or during
continuing education courses. All the study participants
reported not having received any formal education on
human trafficking, and many used their education on how
to identify and care for victims of IPV when asked how they
would identify a victim of human trafficking.

• Dave reported that he thought that resources for human
trafficking victims would include “social work, and we can
call the police at any point, but mostly social work.”
• Carol shared: “I would have no idea what to do, but I
would call social work first and see if they know, and I’m
sure the city has resources (for victims of human
trafficking), but not any that I know of.”

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Most study participants expressed that they would contact
social work, which is standard procedure in this emergency
department when a nurse needs a referral for safe housing,
group housing, or cab vouchers. However, as one participant
pointed out, social work is not available at night, when many of
these victims might present to the emergency department.

• Ashley stated, “There is a big discrepancy between day and
night shift because there is no social work at night…and we
get a lot of patients who are victims of violence at night.”

The study participants did mention that the city probably
had shelters but did not know of ones that were specifically
designated for victims of human trafficking. These comments
about consulting with social work are, in part, based on a belief
that the social worker might know more about how to help a
trafficked victim. Although there was a gap in education
regarding victims of human trafficking, all participants
reported interest in having education on how to care for
victims of violence and provide resources for them. The SANE
specifically expressed how in her nurse practitioner program
she had not received education on this topic and, therefore,
had the same level of education as the staff nurses in this study.
This desire for education demonstrates that emergency nurses
are interested in learning as well as implementing best practices
at the bedside to help this population.

Discussion

The findings of this study emphasize that emergency nurses
are in a key position to identify as well as provide care to
victims of human trafficking and violence. Because nurses
are often the first health care providers to see patients in
emergency departments, it is important that they are given
the tools to better identify and care for these victims.

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Long and Dowdell/RESEARCH

The passage of the Affordable Care Act (ACA) in 2010
mandates that health care providers screen for victims of
violence including all women ages 14 to 46 for IPV.17,18

This mandate, and increased awareness among health care
providers, has allowed nurses to screen for and identify these
victims routinely.19 The screening for victims of IPV was
part of the care delivered by these emergency nurses, which
supports their report of all having cared for victims of IPV.
Most study participants reported that their victims of
domestic violence have been women, and that is reflective of
national statistics, which state that, in IPV cases, 76% of
victims were women compared with 24% of men.18 The
perception of victims of IPV as “sad or angry” is a stark
contrast with the participants’ perceptions of prostitutes as
“tough and hard.” Study participants viewed prostitutes as
unapologetic and hardened about their situation. They also
viewed the prostitutes not as victims, but as women who
“made a choice.” This perception speaks to the media’s
portrayal of prostitutes and pimp culture. Pimps are
glorified in pop culture today, especially in online games
and music.20,21 Because of this, the public has an inaccurate
perception of pimps, and that can affect the way emergency
nurses screen and identify victims of human trafficking.

Another interesting finding is that although the study
participants did not knowingly care for any victims of human
trafficking, they all believed that it occurred in their patient
population. This speaks to the awareness of emergency nurses
that human trafficking occurs but also points to further
education needed for nurses to identify and care for these
victims. A recent study noted that 87.8% of trafficking survivors
came into contact with health care professionals while they were
enslaved and were not identified as victims of human
trafficking.22,23Furthermore, 63.3% of those survivors reported
being seen in emergency departments.22,23 Emergency nurses
are in a prime position to identify these victims, just as they
identify and routinely screen for victims of violence.

Although most human trafficking victims do not
self-identify, it is vital for nurses to ask questions. If patients
say they do not feel safe, there are additional questions that
health care providers can ask to identify whether these
patients are victims of human trafficking (Figure 2).9

Furthermore, study participants perceived human trafficking
victims as young, female, and foreign-born, although 43.8%
of all victims of sex trafficking in the United States are
American citizens, compared with 12.9% of foreign national
victims.24 Also, although women are overwhelmingly victims
of sex trafficking, 50.9% of men trafficked are victims of labor
trafficking in the United States.25

The study participants’ perceptions of these victims
reflect the media’s portrayal of human trafficking victims
coming from other countries and being forced into the sex

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trade. Also, the controlling, overbearing man is what nurses
are taught to look for with victims of violence, but the
literature suggests that this is often not the typical
presentation of human traffickers.6 Human traffickers are
experts at manipulating people and often present as
charismatic, concerned boyfriends, community leaders, or
family members.24

Study participants reported having had in-service
programs, online courses, and courses in nursing school
about victims of violence. They reported providing many
resources for victims of IPV that are offered in the
emergency department, such as women’s shelters, the
Special Victims Unit, and even lipsticks with a crisis hotline
number inside. However, the SANE participant in this
study reported that although they do offer these resources,
they are often difficult to use. The SANE participant
reported having difficulty calling shelters across the city to
find a spot for victims of violence because the shelters were
filled. This speaks to the prevalence of violence against
women in this urban setting and across the country, where 1
in 3 women and 1 in 4 men experience some form of IPV in
their lifetimes.19

The participants in this study expressed that they had
never had any education or in-service programs on victims
of human trafficking in professional practice or education.
This gap in education affects patient care, particularly on
night shifts when social workers are not available in this
particular emergency department. The nurses, especially
charge nurses and clinical resource coordinators, are left
with the task of coordinating resources for these patients.
Without a strong foundation in knowledge of these
resources, the health care team is not providing optimal
care for this unique patient population. Victims of human
trafficking have different psychological and physical needs
from victims of violence, so these specific shelters are
important resources that should be made available to
victims of human trafficking.5,6,11–13 A positive finding
from this study is that most study participants did have
education or in-service programs on how to care for victims
of violence in the emergency department. The participants
in this study were adamant on the importance of screening
for victims of violence. Overall, study participants expressed
a desire to become more aware of the specific needs and
resources for victims of human trafficking.

Limitations

There were some limitations in this study, which included
the small sample of nurses interviewed, the range of ages and
nursing experience, specific emergency department, and

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gender. Furthermore, having 4 male and 6 female
participants could have affected how victims of violence
and prostitutes are perceived through a gender-specific lens.
Also having only 1 SANE participate in the study affected
the results because the other participants did not have the
same depth and breadth of educational content to care for
victims of sexual assault and violence. Finally, another
limitation to the study was that the emergency department
did not have a policy on human trafficking regarding
screening or caring for victims. This did not allow the
researchers to determine how hospital policy affected
nursing practice in the emergency department.

Implications for Emergency Nurses

This research suggests that although violence is a significant
part of a nursing assessment, there is a group of victims who
are being excluded. The context of today’s busy emergency
department often encourages nurses to conduct generalized
screening for violence with minimal to no education provided
to develop the skills necessary to identify patients who are
victims of human trafficking. It is important for emergency
nurses to be empowered with the tools and assessment skills to
identify as well as provide care to these vulnerable patients.
Within the health care system, emergency nurses are at the
forefront of patient care and are often some of the first people
with whom patients interact in the emergency department.
Emergency nurses are in key positions to use current research
and guidelines to advocate for a federal mandate to screen for
these patients. Also, emergency nurses can use their education
on the topic to develop hospital-wide policies on screening
and encourage their colleagues in other specialties to be aware
and screen for this high-risk patient population.

Conclusions

Emergency nurses are in key positions to identify and
provide care to victims of human trafficking, violence, and
prostitution. This study shows how each of these patient
populations is perceived differently by emergency nurses.
Finally, this study speaks to the fact that emergency nurses
want to become more aware and have additional education
on resources specific to victims of human trafficking.

Acknowledgments

This work was supported by a summer grant from the Davis
Family Undergraduate Student Research Fund, Villanova
University College of Nursing. The authors would like to
thank the emergency department nurses who participated as

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well as the nurse manager. The authors would also like to
thank the Davis Family and Dean M. Louise Fitzpatrick
from the College of Nursing.

REFERENCES
1. International Labour Organization. Profits and Poverty: The Economics of

Forced Labour, Geneva, Switzerland: International Labour Office; 2014.

2. Skinner EB. A Crime So Monstrous: Face to Face With Modern-Day
Slavery, New York, NY: Free Press; 2008.

3. US Department of State, Office to Monitor and Combat Trafficking in
Persons. Trafficking in Persons Report 2015. Washington, DC http://
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• Nurses’ Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study

Methods
Sample and Setting
Data Collection
Results
Theme 1: Human trafficking exists in the patient population, but no screening is performed
Theme 2: Human trafficking victims are “young, female, and foreign born”
Theme 3: Identifying victims of violence
Theme 4: Victims of violence viewed as “sad and grieving”
Theme 5: Prostitutes are seen as “hard and tough”
Theme 6: No human trafficking education for emergency nurses
Discussion
Limitations
Implications for Emergency Nurses
Conclusions
Acknowledgments
References

Qualitative Research Article Critique

 
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