You have been tasked with orienting new registered nurses in the emergency department in your hospital about how to manage child abuse and neglect cases. The orientation should cover child abuse and neglect definitions, prevention, detection, intervention and treatment, reporting, and interdisciplinary resources.
–Ensure your orientation covers the definition, prevention, detection, intervention and treatment, reporting, and interdisciplinary resources.
1. Define abuse.
• Federal definition of child abuse and neglect
• California’s definition of child abuse and neglect
2. Discuss prevention.
• Analyze the nurse’s role in each level of prevention:
• List the risk factors of abuse including environmental indicators and disparities in care.
3. Explain detection.
• Illustrate the signs and symptoms of child abuse and neglect.
4. Address intervention, treatment, and reporting.
• Define California’s requirements for reporting child abuse and neglect:
o Who can report?
o Who is mandated (legally required) to report?
o Where (to whom) is information reported?
• Identify resources for appropriate referral.
o Provide examples of treatment resources available in your area for children affected by abuse and their caregivers.
o Find collaborative resources for abuse and neglect intervention and treatment.
o List interdisciplinary support services for children affected by abuse.
5. Summarize the differences between child abuse and neglect prevention, detection, intervention, treatment, and reporting, and spousal, elder abuse and/or violence prevention, detection, intervention, treatment, and reporting.
• Are the reporting requirements the same?
• Are all types of abuse and neglect defined the same way?
• How does treatment differ?
• What different resources available for varying types of abuse?
• How do signs and symptoms change with age?
• How does the role of the community nurse change at each level of prevention depending on the type of abuse?
Managing Child Abuse and Neglect Cases: Definition, Prevention, Detection, Intervention and Treatment, Reporting, and Interdisciplinary Resources
Signs and symptoms for abuse. 7
Child abuse and neglect is an issue that registered nurses as well as other health practitioners have to deal with every so often in the healthcare industry (Aff et al., 2015). When it comes to such cases, great care has to be taken in order to correctly identify the children that are victims of the same as well as the required intervention and treatment. In the emergency department, such cases are delicate. This essay will look into the proper way of managing child abuse and neglect cases taking into account the definition, prevention, intervention and reporting of the same within the context of the state of California.
According to the Federal Child Abuse Prevention and Treatment Act (CAPTA), child abuse/neglect is the act or failure by the parent or caretaker leads to the exploitation, serious physical or emotional harm, sexual abuse and/or death of a child. CAPTA extends this definition to cover any act or failure by the parent or caretaker that creates imminent risk of serious harm to the child. According to the California Child Abuse and Neglect Reporting Act (CANRA), child abuse/neglect is sexual assault, exploitation, the death and/or physical injury inflicted on a child that is not purely accidental.
Nurses have a role to play when it comes to the primary, secondary and tertiary prevention of child abuse and neglect (Aarons &Palinkas, 2007). At the primary level, it is imperative that nurses initiate a public awareness program that will help inform the community on how and where such cases are to be reported as well as to educate the parents on their responsibilities. In cases where a family has certain risk factors, the nurses ought to contact family resource centers and parent support groups as well as home visiting programs to ensure that the at-risk children do not suffer from neglect or abuse. Some of the risk factors include low parental age, family income, disability and substance abuse. On a tertiary level, the nurses are required to respond appropriately to reported cases of child neglect and abuse by contacting the relevant authorities.
While it may be impossible to detect cases of child abuse or neglect, there are certain signs and symptoms that all nurses and interested parties should pay attention to. Physical signs include unexplained injuries, untreated medical or dental problems, and difficulties in walking or sitting. Behavioral and emotional indications, on the other hand, include screaming, shouting or yelling, low self-esteem, loss of appetite, and self-hate (Cook et al., 2017). There are very many signs and symptoms that victims of such cases may exhibit. It is therefore the responsibility of the nurses to pay close attention to all the children brought to the emergency room.
As mentioned before, it may be hard to detect signs of abuse or neglect. Therefore, in such cases where the child has been abused in one way or the other or neglected, the only cause of action left is intervention. Intervention in such cases falls under the tertiary category of prevention. Interventional measures are designed to avoid future cases of abuse or neglect as well as to remedy any harm caused. Reporting the cases to the child protection agencies available in the state is one of the most essential ways of intervening. In California, these agencies often double as interdisciplinary support services for children affected by abuse.
Child abuse or neglect may result in physical, emotional or psychological trauma. Therefore, before treating the victims, nurses have to determine the kind of trauma or combination of trauma that the child is undergoing. Any physical injuries should be treated accordingly. Emotional and psychological trauma can be treated through therapies that focus on post-traumatic stress, anxiety and depression. All in all, while a child may not present signs of emotional or psychological trauma, it is important for the healthcare providers to recommend counselling.
Different states have different procedures for reporting child abuse and neglect. In California, the laws are clear about who is mandated by the law to report such cases as well as the bodies that deal with child abuse and neglect. Once one suspects a case of child abuse or neglect, they are required to report that to the local authorities. In CANRA laws, certain groups of people are legally mandated to report cases of child abuse or neglect. They include the clergy members, educators, medical professionals, child care providers, school/district employees, athletic coaches, administrators, and law enforcement. The reports are to be made either to the police department, county welfare department or the probation department. Elaborate guidelines on reporting requirements are contained in California Penal Code Section 11165.7.
To report a case of child abuse/neglect, an employee is mandated to inform an appropriate child welfare agency in the county. The employee cannot satisfy this legal obligation by merely reporting the incident to a school or a supervisor. The report must be addressed to a law enforcement agency, who may include a Sheriff’s/Police Department, a County Welfare Department, or a County Probation Department. Under the California Penal Code Section 11166[c], a person who fails to report such a case can be convicted of a misdemeanor and punished by a $1,000 fine or six-month jail sentence.
Reporting requirements for any form of abuse or neglect are the same in the state of California. The nurses and health practitioners are charged with the responsibility of reporting instances of ill-treatment and neglect to the relevant authorities. However, it only applies in cases of professional capacity. This means that nurses and health practitioners are supposed to report incidences of abuse or neglect if they come across them in their line of duty (Pietrantonio et al., 2013). In instances where a nurse or a health practitioner treats a victim of bodily injuries suspected to be as a result of abuse or neglect, the right course of action involves immediately reporting to the authorities.
Abuse and neglect
There are subtle differences in the way different types of abuse and neglect are defined. Abuse is mistreating a person in a way that is likely to cause either physical injury or emotional trauma and sometimes both. It is usually intentional and with the aim of consciously inflicting harm upon the other party. Abuse can be either emotional or physical. In most instances, physical abuse occurs in situations where there is physical assault such as hitting or slapping a child. On the other hand, emotional abuse occurs as a result of psychological torture.
Neglect, on the other hand, is any conscious decision made by a person that omits taking care of a child as constituted by cultural and constitutional laws. Neglect means that the person responsible for the welfare of the child fails to provide the basic needs adequately such as food, shelter, clothing, and healthcare, and emotional support. The similarity between abuse and neglect is that both cause harm to the child that may result to serious trauma or even death.
Treatment for a child that has undergone abuse or neglect should be conducted in an environment that prevents any more harm. The kind of treatment for victims of child abuse and neglect differs from the regular treatment offered in ordinary hospitals. Treatment for child abuse involves the recovery of the victim both physically and emotionally. The victim should be separated from the person suspected to cause abuse for a quick recovery. The victim should attend therapy sessions afterward to overcome the trauma.
Resources for abuse
There are several resources provided by the government and other nongovernmental parties that provide services to treat and prevent the varying types of abuse. The choice of these resources is informed of interventions such as social services where victims are offered therapeutic services meant to support them emotionally (Finkelhor&Lannen 2015). These social services may include providing the victims various forms of health care such as medical services and mental health services (Herrenkohl et al., 2013).
Signs and symptoms for abuse
Children exhibit different signs and symptoms of abuse as they advance in age. Young children are particularly affected most psychologically by abuse and neglect. They are at a risk of experiencing mental illnesses such as depression, and their cognitive functions may be inhibited. Teenagers who are victims of abuse may act out and be involved in cases of substance abuse as well as violence in school.
Role of community nurses
Community nurses in California play a major role in preventing any form of child abuse because they are at the grassroots level (Lines, Hutton& Grant,2017). Through visits to families, they can detect forms of abuse in the early stages and therefore help the victim get help before the effects of abuse take root. Theyare mandated to report cases of abuse to the relevant authorities as a form of mitigation.
To sum up, child abuse and neglect cause severe damage to the physical and mental well-being of a child. Nurses and health practitioners should play their role to minimize any form of abuse. At the same time, the government and other nongovernmental entities should continue extendinginterventions to aid victims of abuse. Those found culpable of committing these crimes should be tried in a court of law.
Aarons, G. A. &Palinkas, L. A. (2007). Implementation of Evidence-based Practice in Child Welfare: Service Provider Perspectives Administration and Policy in Mental Health and Mental Health Services Research, Volume 34, Issue 4, pp 411–419
Aff, T. O., Taillieu, T., Cheung, K., Katz, L. Y., Tonmyr, L., &Sareen, J. (2015). Substantiated reports of child maltreatmentfrom the Canadian incidence study of reported child abuse and neglect 2008: Examining child and household characteristics and child functional impairment. The Canadian Journal of Psychiatry, 60(7), 315-323.
Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., …&Mallah, K. (2017). Complex trauma in children and adolescents. Psychiatric annals, 35(5), 390-398.
Finkelhor, D., &Lannen, P. (2015). Dilemmas for international mobilization around child abuse and neglect. Child abuse & neglect, 50, 1-8.
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Lines, L. E., Hutton, A. E., & Grant, J. (2017). Integrative review: nurses’ roles and experiences in keeping children safe. Journal of advanced nursing, 73(2), 302-322.
Pietrantonio, A. M., Wright, E., Gibson, K. N., Alldred, T., Jacobson, D., &Niec, A. (2013). Mandatory reporting of child abuse and neglect: Crafting a positive process for health professionals and caregivers. Child abuse & neglect, 37(2), 102-109.