Human trafficking is an illegal activity that poses numerous risks to the well-being of vulnerable populations. Despite the significant allocation of resources, the issue cannot be resolved without the contribution of all involved parties. Healthcare providers are among the stakeholders that often encounter potential victims in a professional setting. The current paper highlights the state laws relevant for the healthcare organizations, outlines the possible standard operating procedure and educational program for a given facility, and illustrates the encounter using a hypothetical scenario.
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State Laws Related to Human Trafficking
Human trafficking is defined by Florida law as modern-day slavery manifested in the form of exploitative labor, transportation, and harboring of individuals extracted through force, coercion, or fraud (Reid, Baglivio, Piquero, Greenwald, & Epps, 2017). As such, human trafficking is illegal in the state, which is asserted through legislative means at the federal and state levels as well as in several healthcare-specific regulations and policies. The main law about the issue at the federal level is Trafficking Victims Protection Act 2000, according to which two categories of trafficking can be identified – sex trafficking, which is a commercial sex act induced by coercion or force with a person that is younger than 18 years, and labor trafficking, induced by several unfair practices such as debt bondage, slavery, and other forms of involuntary servitude. At a state level, trafficking is defined and regulated by the Florida law’s chapter 787, where the specific practices are defined, and the responsibilities of the involved parties are determined.
Importantly, community involvement is an important aspect of addressing the issue. In this regard, healthcare providers are among the groups that come in contact with victims of human trafficking more often than the majority of the population. For this reason, several aspects of state law specifically address the capacity of these organizations in terms of staff education. For instance, the recent addition to Florida Statute 464.013 introduces several requirements for the education of nursing professionals. According to these requirements, the courses should include the description of specific types of human trafficking, the factors that increase the risk of becoming a victim, the knowledge on the organizations and services providing shelter, food, and assistance to which the victims can be referred, tools for assessment and indication of the possibility of encountering a trafficking victim, and ways of communicating the trafficking-related information to suspected victims and patients (Ahn et al., 2013). The courses also include numerous referral options and contacts of federal agencies and hotlines dealing with the issue (Ahn et al., 2013). As can be seen, the identified law covers both the education and reporting procedures relevant to healthcare professionals.
Standard Operating Procedure
The facility where I work does not have a well-defined standard operating procedure for the situation where the suspected victims of human trafficking are encountered. However several commonly accepted practices and tactics are expected to be employed by nurses in such a scenario. First, the suspected victim is to be assessed using a streamlined framework that includes points such as the lack of identification, the inability of a patient to relate to a specific location, absence or shortage of money, inability to answer certain questions without consulting with an associate, emotional discomfort during responses, the refusal of an associate to be separated from the patient, and nervousness near law enforcement officers. Once a reasonable amount of these factors are confirmed, the healthcare professional needs to seek the opportunity to speak to the patient outside of the reach of their associate who is a suspected controller.
The conversation is focused on the degree of potential victim’s control over the terms of employment and/or living conditions, the possibility of contacting family members, and the possible gaps in their quality of life. Once the issues are reported, it is then necessary to provide the victim with the relevant contacts of the organizations offering support and assistance to the victims. After this, the representatives of law enforcement must be contacted as soon as possible and briefed on the situation. In the case when the healthcare professional can’t separate the potential victim from the controller, the interview phase is skipped and the law enforcement representative is notified immediately and provided with the results of the nurse’s observations and any available information that may be relevant. For the proposed policy to be initiated, the collaboration with the facility’s administration is necessary. Therefore, it would be reasonable to approach nursing administrators.
Currently, my facility does not have a specific program oriented towards the identification and screening of human trafficking victims. Thus, I consider the guidelines issued by the latest addition to Florida Statute the most viable direction in which the program should be developed. As such, the program should include the following components. First, the issue of human trafficking needs to be outlined and its elements defined so that its detrimental effects are understood. Next, a brief introduction of the situation on trafficking in Florida needs to be presented, including statistics and the effects of currently existing responses. Second, the socioeconomic and cultural background of the phenomenon should be identified, which would be helpful in the process of assessment of potential victims. Specifically, the factors that are known to increase the risk of becoming a victim of sex trafficking need to be covered, and the most probable health and social consequences for the victims should be highlighted.
Third, the most important features of victims must be outlined. This section can be improved with the addition of interactive exercises such as simulations and test administration to actualize the acquired knowledge. Fourth, the areas of assistance currently provided to the victims must be covered. The most important of these areas include shelter, food, clothing, rescue, and psychological assistance. Simultaneously, the nurses can be introduced to local and state organizations that specialize in these services and their contacts should be supplied for referrals. Finally, the legal aspects of the issue should be covered concisely as a part of the program to ensure the basic understanding. At this point, the collaboration with law enforcement can be outlined and respective contacts issued to the nursing staff. To initiate such a policy, it would be necessary to approach nursing administrators as well as nursing educators. The former will provide organizational assistance whereas the latter will aid or guide the course development process.
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I could not recall any encounter in my practice or a report from someone I knew that could be considered contact with a victim of human trafficking. However, if I come in contact with someone whom I would suspect to be one, I would look for several signs. First, I expect the patient to have no identification documents. It is also possible that the patient appears to be foreign, although this is not a requirement. Upon inquiry, such a patient will most likely avoid specifying his residence or exhibit uncertainty while doing it. He may also provide partial, inconsistent, or confusing descriptions of the conditions of his employment and arrival at the location.
Most probably, the patient will be accompanied by an associate whom he will consult before responding to some questions or who will provide the answers on behalf of the patient. Other indications may be present of the control exerted by an associate over the patient. At the same time, the patient may display signs of emotional and psychological discomfort and submission. Also, the associate will be reluctant to part with the patient within reasonable circumstances and will seek alternative solutions for such situations. Also, the associate may appear uneasy upon encountering security or law enforcement officers (Hodge, 2014). In such a situation, I will act by the standard operating procedure suggested above. I will try to separate the potential victim from the associate, ask several clarifying questions, provide him with the information on relevant organizations, contact law enforcement representatives, and brief them on the situation.
Human trafficking is a major issue that requires a coordinated effort at the federal, state, and local levels to be resolved. Healthcare providers are among the stakeholders who are especially likely to encounter their victims. This fact has prompted the legislators to introduce certain requirements for healthcare professionals into the state laws covering the educational programs. However, to achieve the desired capacity, the said programs need to be initiated regardless of the state laws at the organizational level. Also, it would be beneficial to introduce a standard operating procedure to ensure consistency of the actions of the nursing staff. With these enhancements in place, it would be reasonable to expect improvements in the long run.
Ahn, R., Alpert, E. J., Purcell, G., Konstantopoulos, W. M., McGahan, A., Cafferty, E.,… Burke, T. F. (2013). Human trafficking: Review of educational resources for health professionals. American Journal of Preventive Medicine, 44(3), 283-289.
Hodge, D. R. (2014). Assisting victims of human trafficking: Strategies to facilitate identification, exit from trafficking, and the restoration of wellness. Social Work, 59(2), 111-118.
Reid, J. A., Baglivio, M. T., Piquero, A. R., Greenwald, M. A., & Epps, N. (2017). Human trafficking of minors and childhood adversity in Florida. American Journal of Public Health, 107(2), 306-312.