help, suspect abuse

Nurses General Nursing

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Specializes in cardiac.

Hi all, I am a nursing student by day and a child care worker by night. This question is related to the child care, but I thought some of you may have delt with a similar situation and could offer some advice. Here's the situation: I work at an elementary school grades Pre-K through 6. One of the younger children ( age 5) has been a cause for concern for myself and my co-workers. He often has bathroom issues, which I know can be a sign of sexual abuse. He very rarely has an injury, but when he does the story constantly changes when ever he tells it and it differs from what his mom says. His mom is almost always the one that picks him up (occasionally his dad) and his parents do seem to care about him. He has mentioned to me a couple of times about how his parents scream a lot at home at each other. The other day, we were making "scary" masks and he said something along the lines of "it would only be scary if it looked like a paddle." I tried to get him to open up a little bit more about it, but he clammed up immediately. My main problem with all of this is that everything can be explained. For instance he had a stomach bug (and his mom said he was taken to the doctor) when he was having daily bowel incontinence. (urinary incontinence has been a problem 3-4 times as well. however, he is young.) His mom said the cut on his face happened at school (although he said otherwise and the cut looked like it had been healing for a day or two- it was monday, it looked like it had to happen over the weekend) The same day as the cut on his face he had a few other bruises which he said happened from a fall down the stairs. Later that day he fell down the stairs right in front of me -maybe he is just a clutz. Not even looking at any of these occurences, I just have had a gut feeling (which is rarely if ever wrong) that something is going on and one of my co-workers feels the same. I don't want to turn someone in on gut feelings and i dont want to turn someone in who is innocent and cause problems that they dont need. At the same time, i just can't let go of the feeling that something, if only a rare occurence, is going on at their house. I guess I just feel that even though things can be explained, medically or otherwise, i just feel that there is too much explaining that needs to be done. Am i just lloking for something to be wrong? I'm sorry that this is such a long post, but i just needed some inputon this, and at the very least how to get rid of the guilt gut i feel if nothing is really going on and i cause problems. Thank you all.

I think you have reason to be concerned. You've stated the facts, and if you have suspicions, you're sort of obligated to act aren't you?

On a side note, when my son was 5, my ex-husband and I were on the verge of divorcing. Before the decision was made to split up, we were fighting a lot! And my son started with some bowel incontinence at the same time, which magically went away as soon as his dad moved out and our house was peaceful. (my ex is an active alcoholic)

So what I'm saying is, if you suspect abuse definetly report it.. the worst thing that will happen is that it will be unfounded- better to be safe than sorry.

Report it and let the investigators do their job! Seriously. If nothing is wrong, then it will pass...

Do you have a supervisor? It may be helpful to talk with your supervisor about this. What is the daycare's policy on who is the designated reporter?

I wouldn't ignore that something is going on, but in many daycares there is a policy, and it may be the director who is designated to make those calls.

Do you have a supervisor? It may be helpful to talk with your supervisor about this. What is the daycare's policy on who is the designated reporter?

I wouldn't ignore that something is going on, but in many daycares there is a policy, and it may be the director who is designated to make those calls.

Even if the director is required to make the call... anyone can call the hot line #.

I'd trust your gut, report what you know.... and let social services do their job....

someday the kid may thank you for it.

Specializes in Medical Oncology, Med-Surg, L & D.

Hi Turquoise! I would say REPORT it. You MUST REPORT any known or suspected abuse. No one can interfere with your report (even your employer). If you report the abuse (or suspected abuse), You will receive Immunity and confidentiality. Investigators will find out what's going on. That's the only way to get away from guilt. :icon_hug: Goodluck

Hi Turquoise! I would say REPORT it. You MUST REPORT any known or suspected abuse. No one can interfere with your report (even your employer). If you report the abuse (or suspected abuse), You will receive Immunity and confidentiality. Investigators will find out what's going on. That's the only way to get away from guilt. :icon_hug: Goodluck

We just covered this a few weeks ago in school. You can be in big trouble if you suspect abuse and don't report it--and, from what you've said, you already suspect abuse (that means that you are suspicious or concerned that there MIGHT be abuse). We were told it is up to the investigators to determine if there is a problem, not yours. In addition to the fact that it could possibly get you kicked out of school, how would you feel if something extremely serious happened to this child and you didn't report it?

NurseFirst

Specializes in MS Home Health.

Knowing the legalities of reporting, did you call yet?

On the flip side my son had hip abnormalities and spent time in ER for stitches ALOT.

renerian

When you have concerns, contact those who can check it out.

Once a co-worker mentioned her and her daughter's concerns about her daughter's friends because they were claiming there was no food in the home, and the daughter said she couldn't see any food around. I suggested they call, but they wouldn't because they didn't want to be perceived as interfering. So I called to describe what I had been told. I was worried about the children with no food, and I hadn't even met them. I figured it was better that SOMEONE call on behalf of the children. I'm just reinforcing that it's better to call when you have concerns.

You are right to hesitate when you don't see fairly clear signs.

My kids could exhibit some of the same behaviors and probably say some of the same things but are not abused. However, I am a messy housekeeper. So if some snoopy person called something in on us, it could cause us some unnecessary trouble.

You can never account for those agencies. Sometimes they work the way they should and sometimes not. Unfortunately, I think we have all heard the stories about children that were actually supposed to be monitored by children's services and the child died in the abusive home despite "intervention" and "monitoring". Then there are the ones that have been yanked unjustly.

Those agencies don't always get it right. Now, if there was clear abuse, then you would have to notify and hope they did the right thing. But, it sounds like your case is not too clear cut.

I differ from many ppl in that I don't welcome the interference of the government.

I think the poster who called on a case she never even saw went too far.

I congratulate you on your attentiveness and concern........and also the obvious amount of thought you have put in to the matter.

Ultimately, you will have to follow your best judgement. But, it would be so scary to be turned in to those agencies unjustly.

Specializes in OB, lactation.

You should go with your instinct, especially if you have coworkers who share you concern. Although, my own older son could have fit most of the things you said at one time or another... (he had the bathroom problems occassionally even last year in 1st grade, always bumps and bruises,etc...though they are congruent with the "normal" description below, usually shins).

If it helps, I would think about what kind of bruises/injuries he has - many times you can discern whether they are typical child play bruises or in atypical locations and patterns:

"Use common sense in trying to figure out if a child is being abused. For example, normal, active children get some bruises and bumps from everyday playing. These bruises are mostly over bony areas such as knees, elbows, and shins. But, if you see a child with injuries on other parts of the body, such as the stomach, cheeks, ears, buttocks, mouth, or thighs, you should think twice. Black eyes, human bite marks, and round burns the size of a cigarette, don't come from everyday play."

More that may be helpful:

http://www.aap.org/advocacy/childhealthmonth/abuse2.htm

http://www.keepkidshealthy.com/welcome/commonproblems/child_abuse.html

http://nccanch.acf.hhs.gov/pubs/factsheets/signs.cfm

Specializes in cardiac.

thank you all for your comments and recommendations. It has been reported to the proper people and hopefully, the right thing will be done (whether that right thing is absolutely nothing, or removal from the situation.) Thanks again.

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