Challenges for nurses reporting suspected child abuse cases

More effective collaboration between nurses and child protection services is needed to promote change for children affected by child abuse in Australia, a Flinders University research study has found.

Nurses are the largest group of health care professionals and by law in Australia they must report suspected cases of child abuse to child protection services who will then investigate and determine whether to intervene.

However, a research study by Flinders Caring Futures Institute researcher Dr Lauren Lines found that at times nurses felt their concerns weren’t taken seriously by authorities and they felt powerless to evoke change for children.

Nurses also experienced tension between openly discussing their intentions to report with families involved and hoping to reduce negative reactions and maintain engagement.

“Our study showed that nurses often felt disappointed, discouraged and disenfranchised from their experiences in reporting suspected child abuse to the authorities,” says Dr Lines, whose research is part of the wider Safeguarding Project to investigate how nurses and midwives contribute to keeping vulnerable children safe.

“We found that nurses believed they weren’t always taken seriously and had little control over the outcomes after reporting an incident to child protection services.

“This perception was despite all participants being very experienced – some up to 40 years of experience – and often also having much experience in responding to potential cases of child abuse.”

The study, Constructing a compelling case: Nurses’ experiences of communicating abuse and neglect published recently in journal Child Abuse Review, interviewed 21 nurses working with children in Australia.

In Australia, child protection services are typically social workers with different backgrounds and skills to those of nurses.

The report outlined one participant’s experience with a situation that was perceived as serious by nurses and wasn’t automatically interpreted that way by authorities.

“’Saying ‘I’m worried baby’s not gaining enough weight’, that’s probably not enough. You need to actually say ’and if baby doesn’t start gaining weight the vital organs are going to be compromised’,” the participant said.

The participants also outlined examples of suspected child abuse cases that ended with disappointing or devastating consequences.

“When nurses feel their expertise is not taken seriously, it can undermine their confidence and reduce their motivation to advocate for vulnerable children,” Dr Lines says.

Consequently, the study found more effective collaboration was needed between nurses and child protection services to allow for better communication and coordination of responses.

Dr Lines says nurses must be skilled in clearly outlining their concerns to the authorities when they believe children are at risk of harm. However, systems change is also needed.

“Poor interagency communication is a challenge faced by child protection systems internationally, and past failures have led to tragic consequences for children,” she says.

“Some promising interventions include developing a culture of collaboration and shared language for all disciplines and agencies working with children.”

Dr Lines is working with Professor Julian Grant from Charles Sturt University and Professor Alison Hutton from the University of Newcastle.

Lines, L. E., Hutton, A., and Grant, J. M. (2021) Constructing a Compelling Case: Nurses’ Experiences of Communicating Abuse and Neglect. Child Abuse Rev., 30: 332– 346.

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