Beaten Children

  1. I just need to VENT. I'm new to psych nursing and so far I love it...but I have a question for you experienced psych nurses.
    I'm on the children's unit, and they come in for all manner of behaviour problems. At first glance you would think they were just little terrors. But when you get a full history and these little ones tell you stuff like "That mark is where Mommy's boyfriend whipped me", or "She made me drink a bottle of hot sauce" ...I mean...how do you get thruit day in and day out, hearing what people have done to these kids???
    It's like witnessing these children's futures unravel before your eyes, and being powerless to stop it. The day they go back home it starts all over again, and that's when we get (and I HATE this term) 'frequent fliers'. Sure, a few here and there get prosecuted...but mostly it just seems like after some months, the abusers get custody again. Please, someone tell me how to cope with this. I feel helpless.
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    About Meerkat

    Joined: May '05; Posts: 501; Likes: 6
    Forensic/Acute Psych Nurse

    13 Comments

  3. by   Euskadi1946
    Meerkat it's a horrible pock mark on our society these abused children. In most places Child Protective Services and DCFS pulls these kids out of their homes and place them in temporary foster care!!! But then the DCFS case workers have to contend with the really stupid judges who orders those poor kids back with their abusive parents. These kids really do need advocates who will fight for their rights!!!! How do you deal with it? I don't have the answer to that but you do the best you can for these kids while they are in your care!!!
    Last edit by Euskadi1946 on Dec 5, '05
  4. by   elkpark
    Even when CPS finally pulls kids out of a home, it's not necessarily an improvement. Plenty of kids get beaten, sexually abused, and neglected in some (not all!) foster homes. That's one of the reasons CPS workers are often reluctant to take kids -- they know they don't necessarily have a better place to put them ...

    I've been in child psych nursing, as a staff nurse and then as a CS, for 15 years now. It is definitely not for the faint of heart -- what I have always told students and others who ask is, "the highs are higher, but the lows are lower" than adult psych nursing. What you are describing is certainly one of the "lows" or "dark sides" of child psych. Abused children are always going to be a sizeable percentage of the population in treatment (outpatient as well as inpatient), and they (and the situations in which they're trapped) stir up a lot of emotions in the staff caring for them.

    IMO, a big piece of being successful in either adult or child psych is finding your own, unique balance of objectivity and subjectivity -- if you're too detached, you don't do the clients any good, and if you're too emotionally involved, you don't do them any good, either. The balance is a little different for everyone (and some people never manage it).

    I don't have any "quick fix" answer for you that will make everything fine. I hope that you are getting support from your administration and more experienced co-workers, and have an opportunity to process and debrief these emotionally draining work issues. Do you have an opportunity for structured clinical supervision at work (an opportunity to process on a regular basis with a designated, experienced colleague (someone other than your boss), to get feedback and guidance)? If not, you might want to ask about whether that could be set up. Clinical supervision (esp. for people new to psych) used to be a regular part of the structure of psych units, but it seems to have fallen by the wayside in more recent years -- I think that's a big mistake.

    Best wishes.
  5. by   Thunderwolf
    Excellent post, elkpark...as always.
  6. by   mercyteapot
    It is a real problem. Foster families aren't paid anywhere near enough, and there aren't enough caseworkers assigned to be sure that the money is going towards the care of the child. Unless the system decides to invest at both points of the system- raising the reimbursement rate so that more people will take in foster kids, and assign caseworkers a reasonable load to ensure that they are actually able to make their visits, we are going to stuck with a system so desperate for foster parents that they allow some really questionable people to do it, and then don't provide the supervision needed to protect these kids. And don't even get me started about the "justice" system that puts a higher value on family reunification and parental rights than it does on the safety of children. But that isn't really what you asked, is it? Can't give you an answer... I lasted exactly three months in your position...
  7. by   UM Review RN
    Meerkat, I know it must be difficult, but I hope you find the strength to continue.

    You see, you're probably offering some of these children a taste of NORMALCY in an abusive, chaotic life.

    For some, it will make the difference in who they become and why.

    Go ahead.

    Ask me how I can answer this with such assurance.

    :icon_hug:
  8. by   Meerkat
    Quote from Angie O'Plasty, RN
    Meerkat, I know it must be difficult, but I hope you find the strength to continue.

    You see, you're probably offering some of these children a taste of NORMALCY in an abusive, chaotic life.

    For some, it will make the difference in who they become and why.

    Go ahead.

    Ask me how I can answer this with such assurance.

    :icon_hug:
    Oh Angie, I have no thoughts of leaving the job. I really like it...it's just that I'm finding myself challenged not to get teary eyed when the children tell me the things that have happened to them.
    I myself was in foster care, from a home of abuse and neglect, so in some ways I relate to the children. But for some of them, what they have been through is so much worse than what I experienced...that I find I have a strange mix of emotion...sadness for them and...something like guilt??? (I don't know where the guilty feeling comes from). I am the only nurse on the unit right now, so it's hard to find an outlet for my feelings as they crop up. I guess I just need to find a way to express them.
    The docs and techs on the floor....I don't know if it is just because they are 'seasoned' or what, but I don't sense the same kind of reaction from them when they hear these awful histories.
    So go ahead, please tell me.
  9. by   traumaRUs
    I am so sorry for the heartache you see. Thanks for caring.
  10. by   UM Review RN
    Quote from Meerkat
    Oh Angie, I have no thoughts of leaving the job. I really like it...it's just that I'm finding myself challenged not to get teary eyed when the children tell me the things that have happened to them.
    I myself was in foster care, from a home of abuse and neglect, so in some ways I relate to the children. But for some of them, what they have been through is so much worse than what I experienced...that I find I have a strange mix of emotion...sadness for them and...something like guilt??? (I don't know where the guilty feeling comes from). I am the only nurse on the unit right now, so it's hard to find an outlet for my feelings as they crop up. I guess I just need to find a way to express them.
    The docs and techs on the floor....I don't know if it is just because they are 'seasoned' or what, but I don't sense the same kind of reaction from them when they hear these awful histories.
    So go ahead, please tell me.
    Quote from Angie O'Plasty, RN
    You see, you're probably offering some of these children a taste of NORMALCY in an abusive, chaotic life.
    And some of those children will be so determined to find that "normalcy" and hang on to it. They may even follow your lead and become nurses.

    You'll probably never know how much of a role model you are to some of these youngsters. You really are changing lives, you know.
  11. by   Meerkat
    Thank you Angie

    As it turns out, I had to do another abuse report today. A visitor yanked her grandchild by the hood of her coat backwards, choking her for a moment and then the child who is one year old, fell backwards. The grandmother threatened to 'rip her tongue out by the root' if she didn't be quiet.

    Then I had to discharge the patient (a minor)...right back with the family. DCF was already involved with the parents suspected abuse, but not the grandmother. I truly felt that the children were at BEST neglected, but they both had marks and bruises on them, so I think it is worse than that. I conveyed my concerns to the charge nurse, the doctor and another RN. I don't understand why I had to send my patient home with those people! My patient, who was 4, has already been sexually abused, according to DCF, and it is not even clear if the abuser is in the house or not. The children could have been in imminent danger...why did I have to send them home?
  12. by   NPAlby
    You mentioned the feeling of guilt. It made me think of survivors guilt. I have a touch (okay probably more than a touch)of it. It contributed to the making of my co-dependent self. It's something I'm working on. I haven't worked with children but I'm sure part of your reaction is very, very normal considering you are still new to this field and the population you're working with. But don't neglect your own past and how it may still be affecting you. I would suggest talking to someone either a professional or someone at work, like a mentor. I don't mean to sound like a junior psychiatrist or a wannabe psych NP (although I do intend to start grad school in the fall). It just caught my attention when you used that word.
    And like some posters have already said, know that you are doing these kids good. They might have to go back to a nightmare but b/c of you maybe they now know there is something different, something better. Hope is an amazing gift.
  13. by   Meerkat
    Quote from RNalby
    You mentioned the feeling of guilt. It made me think of survivors guilt. I have a touch (okay probably more than a touch)of it. It contributed to the making of my co-dependent self. It's something I'm working on. I haven't worked with children but I'm sure part of your reaction is very, very normal considering you are still new to this field and the population you're working with. But don't neglect your own past and how it may still be affecting you. I would suggest talking to someone either a professional or someone at work, like a mentor. I don't mean to sound like a junior psychiatrist or a wannabe psych NP (although I do intend to start grad school in the fall). It just caught my attention when you used that word.
    And like some posters have already said, know that you are doing these kids good. They might have to go back to a nightmare but b/c of you maybe they now know there is something different, something better. Hope is an amazing gift.
    Hmmm interesting...I think I needed your reminder. I probably need to get back into therapy, if only to talk about the things I am seeing now. You seem very astute. Thank you so much.
  14. by   GooeyRN
    There are so many sad situations in child psych. It is truly saddening when one of the kids comes up to you and tells you that they DON'T want to go home w/ their parents, out of fear. Some of the situations would really upset me. I would usually vent to coworkers about it and it helped me feel a little better. I still wonder what happened with a lot of the kids.

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