How a nurse feels about reporting child abuse

DoeRN · Nov 16, 2008

It has to be reported. I have never had to do it because I don't work in peds and am a new grad. But I think that most would be thinking about the best interest for the children.

LovebugLPN · Nov 16, 2008

I can tell you what mine is. I worked with a child who was in school. He told some wild stories that are quite horrific and disturbing about things that were going on at home. He came to me and told me. The school told us they were handling it. I wanted to trust them and hated the idea of reporting it because this child had quite an imagination. I have reported other cases but this one I did not. I felt that if the school said they were handling it I should back away. I hope I made the right decision.

Neveranurseagain, RN · Nov 16, 2008

It has never bother me to report suspected child abuse. It is not our job to figure out if it really is child abuse or not. Nurses report it so it can be further investigated by someone with more training and time than us. The only time a suspected child abuse case bothered me was one that I didn't report almost 20 years ago....I felt it was not child abuse but wondered days, weeks and years later if it really was.

allnurses Guide · Nov 16, 2008

It doesn't bother me to report either.

It does bother me that a child is being abused.

That is a odd question. I guess it is meant to show that SOME nurses are ambivalent about reporting . . . .which is a bad thing.

So maybe the instructor wants to discuss this.

The first thing we were asked to do in nursing school was identify our biases. So we could make sure we didn't do anything unprofessional regarding that.

It is a good idea . . .. I'm biased against illegal drug users but I know it and can put that aside and give good patient care and still be my patient's advocate.

As I'm typing I'm realizing this question may not be so odd after all. :)

steph

BrnEyedGirl, BSN, MSN, RN, APRN · Nov 16, 2008

I work ER so this issue comes up more frequently than I'd like. I think what "bothers me most" is what if I'm wrong?

Some cases are very obvious and I have no problem reporting them and doing everything in my power to get that child away from whom ever is hurting him/her. Many cases aren't so cut and dry.

I must admit I'm not a big fan of Division of Family Services. I've seen kids taken away that shouldn't have been and others left in horrible situations even after multiple hotlines. As a Mom myself I can't imagine the harm done to a child who has spent even a week in foster care while DFS investigates and then finds nothing wrong.

VivaRN · Nov 16, 2008

I work ER so this issue comes up more frequently than I'd like. I think what "bothers me most" is what if I'm wrong?
Some cases are very obvious and I have no problem reporting them and doing everything in my power to get that child away from whom ever is hurting him/her. Many cases aren't so cut and dry.

I agree with this. I started my career in the Burn Unit and when I was a relatively new nurse had a child present with some odd burns and an explanation that could be plausible... but what if? The social workers asked me, "is it abuse?". I've known the patient and family for less than an hour. Still, I am one to err on the side of reporting. Let social services do their own assessment and take it from there.

I also agree that some cases are very obvious and somewhat painful to remember. Nothing in school prepared me for that. It's good your class is talking about it.

insatiable · Nov 16, 2008

I saw a thread on here relating to child abuse so I thought Id give some information on the process of reporting child abuse.

-As mandated reporters we are required by law to report suspicions of child abuse or neglect on any child under the age of 18 or a physically or mentally handicapped child under the age of 21. Its important to note that you need to only suspect or have reason to believe abuse is occurring; physical proof or other forms of validation are not required. It is the responsibility of the children services agency, through investigation, to determine if abuse or neglect is actually occurring.

-A report of suspected child abuse or neglect is confidential. Your identity will not be released to anyone without your written consent.

-Upon report, children services will begin investigation within 24hrs to determine validity of the allegation, unless the child is in immediate harm for severe physical abuse or the parents are mentally unstable then the child may be removed immediatly. Investigation includes a visit to the childs home to interview the parents and the child. Contact may also be made to anyone else that may provide more information, such as teachers, docters, etc. As a mandated reporter you are also entitled to know the status of the case. Children services has 30-45 days to investigate reports, after this time frame you are able to call (this is only available to mandated reporters) to see if the case was closed or is being pursued.

-Through investigation, one of three determinations will be made on the report:

1.Report unsubstantiated-no evidence of abuse or neglect

2.Report indicated-isolated indicators of abuse or neglect but lacks confirmation

3.Report substantiated-admission of abuse or neglect or any other confirmation deemed valid

*Children services may or may not stay involved or make refferals for support services on ANY of these three findings depending on the level of risk. That means even a report that is unsubstantiated but is high risk may have a case continued for monitoring or assistance.

-The agency then makes decisions on how to serve the family, which could be any of the following:

1.No court involvement required, in home services provided and child stays in the home-most cases dont require court involvement. Most families do not neglect or injure a child with willful intent, and want help to correct circumstances which caused the occurence. It is important to remember that trauma caused by removing the child from thier home may often be as damaging as the act of abuse itself. For this reason, a child will not be removed from the home unless there is a serious threat to their health. Services will be provided to the family and child as a unit. Some examples of this may be in home family counseling (which is what I do), parenting classes, drug/alcohol counseling, job training, public assitance, domestic violence services, medical care, etc.

2.Court involvement required-If family refuses services or child is in a potentially harmful situation, court involvement will be initiated. Charges may be filed against perpetrator if appropriate.

3.Court orders placement of child-if child is in immediate danger, court will order removal of child from home to ensure safety.

4.Court orders services for family and child remains in the home-the court may place family under protective services supervision. Child can stay in home as long as family participates in appropriate community services (family counseling, parenting classes, etc).

-As long as the child isnt in immediate danger, children services prefers the child to stay in the home and work with the family as a unit. So although it may appear that nothing is being after a report of abuse because the children are not removed from the home, often times the family is still being supervised by professionals to monitor the situation (children services may still have a case open and supervising or maybe children services closed their case but made referrals for supportive services to the family such as counseling etc which they continue to participate in after the closure of the case).

-Treatment/Outcomes

1.Case planning-set goals and time lines to completing those goals

2.Children services or court determines services successful-through provision of appropriate supportive services family able to prevent occurrence of abuse or neglect (90% of people involved can be treated successfully).

Children services or court need modified-maybe due to unexpected crisis etc

3.Children services or court determines services are unsuccessful-if it becomes apparent during case planning that parents are unwilling or unable to accomplish goals, the court will terminate parental rights.

I work with children services (CS) on a regular basis due to the fact that our organization recieves most of the refferals for supportive services for families involved with CS. In my town, CS is actually working on getting out information to the community (especially mandated reporters such as police officers, teachers, nurses, doctors, etc) to help better understand how the process works, clear any misconceptions, etc. So this blurb is some of that information. Just thought Id share.

Thornbird · Nov 16, 2008

I have made several reports of child abuse. The thing that bothers me most is that so often it is found "unsubstantiated" and no services are provided for the future safety of the child(ren). Other times I have seen them go out of their way to track down a child who has left the state but is in danger.

To LovebugLPN: Mandated means we have to make our own report even if someone else has said they were also. Child Protective Services needs all the info they can get and what you have to say may be different than what another profession may find relevent.

Editorial Team / Admin · Nov 16, 2008

Threads merged.

caliotter3 · Nov 16, 2008

One thing that bothered me about reporting suspected abuse was finding out afterward that absolutely nothing was done. However, it is not my job to insure that appropriate action is taken, only to report my grounded suspicions. I know I would feel badly if I did not report.

crzynrsn08 · Nov 16, 2008

I just wanted to send a thank you to all who have helped me with this question, I really appreciate your time. Hope all are having a great day!!!!!

Thanks:yeah: