Child Abuse: Thoughts From a School Nurse

April is National Child Abuse Prevention Month (NCAPM). This Article is intended to raise awareness and stop the cycle of child abuse. Do you know the signs of abuse in children?

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Child Abuse: Thoughts From a School Nurse

April is National Child Abuse Prevention Month (NCAPM). It was established in 1983 to raise awareness and to help prevent abuse among our littlest. I must admit ... I grew up and lived in rural West Tennessee most of my life, and until I worked within the school system, I was unaware of the frequent occurrence of child abuse and neglect. My hat is off to you, Teachers. Frequently, they are the whistle-blowers. They know their students. They recognize when they have an "off" day, or something doesn't add up. Teachers are often trusted by students and are sources of comfort. They will often confide in them first.

Before working in the schools, I worked MedSurg at my local hospital. I have witnessed elderly abuse and neglect. I have seen the devastation of drug and substance abuse on families and individuals. These are heartbreaking situations. When I began working as a school nurse, the stress-free environment and not carrying home the worry of how my patients were until my next shift appealed to me. No longer did I have to worry, " Did I do everything? Did I do enough? Should I have ... ?”

This naïve bliss lasted about a month. When I had a young girl that wanted to come to see me multiple times a day, first, maybe her head would hurt, then a paper cut, and later, she may have a stomachache. Multiple visits throughout the day for multiple ailments became the norm. She was trying to develop a connection and, maybe for the first time, felt cared for. One day she trusted me enough to say it. She told me about the abuse she had received at the hands of her mom's boyfriend. Such a heavy weight to bear for such a tiny person. That's the case for so many of our little ones. Tiny humans, tiny hearts, little souls walking around carrying adult-size burdens.

So, in honor of the littlest among us who stay brave and wake up and endure and survive, we raise awareness. Every child deserves a safe home.

How Can You Help?

In Tennessee, everyone is required by state law to report knowledge or suspicions of child abuse or neglect. Tennessee state laws protect persons who report suspicions of abuse or neglect in good faith. The reporters always have the right to remain anonymous. The Tennessee child abuse hotline is 1-877-237-0004.

What are Common Signs of Abuse In Children?

  • Poor hygiene
  • Being dressed inappropriately for the weather
  • Failure to thrive, poor weight gain, malnutrition
  • 6-20% of abused children will have burns: cigarette, rope, immersion (hot water), or shape of the hot object
  • Unexplained bruising, fractures, abrasions
  • Bedwetting, nightmares, trouble sleeping

Research shows that children suffering from the stress of abuse and neglect are more likely to struggle in their behavioral, physical, and cognitive abilities. The most devastating fact about child abuse is that it often becomes generational. That is why raising awareness and stopping the cycle of abuse are so important.

What is the Good News?

The National Institute of Health (NIH) reports declining sexual and physical abuse. Self-reported school data has shown a 28 % reduction in sexual abuse and a 20% reduction in physical abuse. This is attributed to the prevention programs in schools and the criminal justice system becoming more involved in child abuse and domestic violence. Centers in West TN, like the Exchange Club Carl Perkins Center of Lauderdale County, make a difference daily in their community. Organizations like these strive to give each child hope for a bright future.

Consider joining in the efforts against child abuse by volunteering at your local child abuse prevention organization.

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Fin82

About Fin82

Leah Pugh, RN, BSN, has 12 years of experience in School Nursing, MedSurg, and as a Novice freelancer.

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Specializes in Psych, Addictions, SOL (Student of Life).

I work in Child and adolescent psych and am often surprised how, in spite of being mandated reporters, few nurses will initiate a child abuse report. The rule in our facilty is the first person who hear's it and has a "reasonable suspicion" that abuse may have occurred must initiate said report. 

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Specializes in NICU, PICU, Transport, L&D, Hospice.

My wife once reported a case  when one of the neighborhood kids showed up to walk to school with my kids with a slap reddened face, split lip and blood trickling from his ear. She sent him on to school and told him to go to the office for his lip and called a son as they left.  She hoped that there would also be a call from the school. The mother came angrily to our door not long after that. My wife calmly told her that nurses and teachers were mandatory reporters for any evidence of child abuse. So, if she didn't want to get reported again she should probably stop hurting her kid in obvious ways.  

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Specializes in School Nurse, MedSurg exp, Nauvice freelancer.

Smart thinking on your wife's behalf. Good for her! Yes, we are required by law to report suspicions of abuse. Sometimes, we are the only advocate these children have.

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Specializes in School Nurse, MedSurg exp, Nauvice freelancer.
hppygr8ful said:

I work in Child and adolescent psych and am often surprised how, in spite of being mandated reporters, few nurses will initiate a child abuse report. The rule in our facilty is the first person who hear's it and has a "reasonable suspicion" that abuse may have occurred must initiate said report. 

I have never worked with peds outside of the school setting, but we have training on how to communicate with students we suspect are being abused and are expected to report immediately. Hopefully, spreading awareness and giving instructions on how and when to report will encourage others to advocate for these children!

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Specializes in Vents, Telemetry, Home Care, Home infusion.

In PA, nurses are also mandated reporters of child abuse with BON requiring 2 hr. CE course  prior to renewal biannual nursing license.

Thanks for being child advocates, often supplying the only emotional support a child receives + needs to thrive into adulthood. .

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