By Sylvia Foley, AJN senior editor

Never to lie . . . by flickrohit, via Flickr

Picture this: “Mimi,” an 18-year-old Brazilian girl who speaks little English, arrives in your ED with injuries sustained in a beating. She’s accompanied by an older man who refuses to leave her side and who intercepts and answers questions directed at Mimi. The ED physicians and nurses treat Mimi’s injuries and release her back to this man’s care. Maybe you feel uneasy, but what can you do? Maybe the man really is her uncle; maybe he’s just being overprotective.

In fact, Mimi is a victim of human trafficking, and the man who brought her to the hospital is both her pimp and her trafficker. And you and your colleagues just missed a chance to intervene on her behalf. Unfortunately, you’re not alone. In “The Role of the Nurse in Combating Human Trafficking,” a February CE feature, author Donna Sabella notes that clinicians who encounter victims of human trafficking often don’t realize it, and many such chances to intervene are lost. Sabella, a nursing professor active in helping such victims, hopes to change this.

What is human trafficking and where does it happen? Human trafficking, broadly defined by the U.S. Department of State as  “activities involved when one person obtains or holds another person in compelled service,” happens worldwide—and the United States is no exception. Sabella offers a concise overview, explaining the various types of human trafficking (sex and labor trafficking are two of the most common) and cites some alarming statistics.  For instance, it’s estimated that between 14,500 and 17,500 foreign nationals and an unknown number of American citizens, both adults and children, are trafficked annually inside the United States.

What can nurses do? As Sabella says, “It’s never too soon to start thinking about how you and your facility will handle a potential trafficking situation.” First, she describes how to recognize signs that someone is being trafficked. Possible indicators might include:

  • The person doesn’t speak English (or speaks some English) and someone else is speaking for her or him.
  • The person doesn’t seem to know where she or he is.
  • The person doesn’t have any identification or travel documents, or someone else is holding the documents.
  • The person has no spending money.
  • The person appears to be under constant control and supervision and is never left alone.
  • There are signs of malnutrition, dehydration, drug use or addiction, poor general health, or poor hygiene.
  • There are signs of physical abuse or neglect.
  • The person appears depressed, frightened, anxious, or otherwise distressed.
  • The person’s story about what she or he is doing in this country or on the job doesn’t make sense.
  • The person lives with an employer or at the place of business and can’t give you an address.
  • Those who brought the person in for treatment are resistant to letting you speak with the person alone.

Sabella goes on to describe ways that nurses and other clinicians can safely intervene (while preserving patient autonomy), and provides an extensive list of resources.  Sabella advises, “If you suspect that someone is a trafficking victim and are unsure how to proceed, call the National Human Trafficking Resource Center hotline at 1-888-3737-888 or visit” In a  related editorial, Shawn Kennedy describes an interaction with a patient many years ago that has haunted her. And don’t miss this exclusive podcast conversation with the author.

Have you encountered a “Mimi”? Will you be able to help next time?

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