Becky Carter: Blue Ridge Regional Hospital: Our Role as Protector of Community Members From Abuse and Neglect

By Becky Carter
Chief Executive Officer/Chief Nursing Officer, Blue Ridge Regional Hospital


When you think of Blue Ridge Regional Hospital (BRRH) – or any hospital for that matter – you might think we spend most of our time caring for people who are ill or recovering from surgery, or helping patients who need emergency care. This is indeed our mission and a large part of what we do, but we are also concerned for your safety when you are not with us.

We are mandated to screen every patient for signs of abuse or neglect. This includes infants, toddlers, children, teens, and domestic partners of any gender identity. It also includes the mentally handicapped, the elderly, and those who have other sorts of conditions that might make them partially dependent on a family member or caregiver for care, such as people with epilepsy, cerebral palsy, or traumatic brain injury.

This care framework is just as much geared toward supporting patient safety as removing fall risks from a hospital room, ensuring the safe administration of medications, and making the correct diagnosis for a patient. The issue of identifying and protecting patients from abuse or neglect came to the fore about 20 years ago, and although hospital polices were developed primarily with children in mind, they expanded to include the elderly, disabled, and other groups.

What does keeping our patients safe from mistreatment and neglect look like at BRRH? We have an official Identification and Management of Suspected Abuse Victims policy that every clinical team member must learn, keep up-to-date on, and employ when they come into contact with any patient, not just if abuse is suspected.

Our policy starts with the belief that every patient has the right to “be free from abuse, neglect, or harassment.” Since our staff is trained on the signs and symptoms of abuse, neglect, and trauma, they are obligated to report any suspected incident to the Department of Social Services and law enforcement. This also means we treat each patient appropriately, educate them about resources that are available to them, and refer them to these resources.

What does practicing this policy in a practical way mean? First, our caregivers directly ask every patient, during a private moment with them, a series of screening questions about their personal safety. One simple inquiry is whether the patient feels safe in their own home. Different strategies are employed depending on whether the patient is a minor or has intellectual disabilities, for example.

There is also a specific departmental and institutional chain of communication outlined to report potential abuse or neglect for caregivers, as well as protocol on how to ensure that it’s correctly noted in a patient’s medical record.

Our responsibilities range from keeping a patient’s identity confidential if they have experienced domestic violence and sensitively interviewing trauma victims to knowing how to properly interview a toddler or protecting a patient with dementia.

All of us at Blue Ridge Regional Hospital take every patient’s physical and mental health and safety seriously. We as caregivers pledge to “look beyond the symptoms” by protecting and advocating for every one of our patients in the ways that they need. When we ask “Is anyone in your home causing you harm?” just know that we ask everyone that question and if you are safe at home, you are among the fortunate ones.

Not only are we committed to your healing, we want you to be cared for in the best ways possible – whether you’re our patient in the hospital or living your life at home and out in the world.

Finally, as it’s October, I also want to recognize Breast Cancer Awareness Month. Please remember that BRRH is here to provide education and consultation to women, as well as advanced mammography services. We celebrate with the survivors in our community and remember fondly those we have lost.


Becky Carter


Rebecca W. Carter, MSN, RN, FACHE, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.

Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE). A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.