How do nurses and midwives safeguard children in Australia?


What level of commitment are Australian healthcare workers able to demonstrate when dealing with children at risk of or experiencing abuse and neglect? The nature and scope of Australian nurses’ and midwives’ safeguarding practices in child-focused settings is being examined as part of important Flinders Caring Futures Institute research led by Dr Lauren Lines.

With a background in paediatric nursing in hospital settings, Dr Lines says she was exposed to sometimes severe cases of child abuse and neglect as well as at-risk children from families experiencing adversity.

“These families experience adversity due to a range of factors and often face unnecessary stigma that discourages them from reaching out for help. There’s certainly a role for nurses and midwives to recognise that in the healthcare setting, so we can show empathy to families and encourage them to seek support.”

However, with so many competing priorities in a busy healthcare setting, it can be difficult to deliver help where it is needed. Nurses and midwives also face an uphill battle for acknowledgement of the work they do.

“Many of the skills they use are commonly referred to as ‘soft skills’, so they are often undervalued,” Dr Lines explains. “It is about communication, empathy, listening and caring which are critical to building rapport. If clinicians can achieve that, they can then determine what support is required.

“It’s clear that if disadvantaged families trust the person providing the care, the clinician can act as a conduit between the different services.”

Dr Lauren Lines

However, nurses’ and midwives’ roles in safeguarding have not been evaluated in Australia or overseas, nor are there standards or guidelines in place. Funded by a Flinders Foundation Health Seed Grant, Dr Lines set out to explore the nature and scope of safeguarding practices nurses and midwives currently render in healthcare settings. She spoke to clinicians who work in a range of settings, including hospitals, schools and child and family health, to inform her research.

“Participating nurses and midwives demonstrated they are committed to safeguarding children,” Dr Lines says. “It’s clear they are very dedicated to doing this and see it as a core part of their role. But it also highlighted there are immense challenges they face when trying to do this work.

“It’s a challenge of a health system based on the biomedical model of health and disease and addressing physical issues, but not set up to address complex social issues that can contribute to physical conditions – and often make them worse.”

Benefits of clearly articulating nursing and midwifery roles through standards of practice could include enhanced interdisciplinary collaboration and evidence for appropriate professional education, support and resourcing.

“Ultimately, with a unified understanding of nursing and midwifery roles, nurses and midwives would be able to leverage their shared expertise to confidently advocate for children at risk of abuse and neglect,” Dr Lines says.

While emphasising the fact mandatory reporting will still be necessary in some cases, Dr Lines sees opportunity for nurses and midwives to be better resourced to enhance the identification of potential problems.

“If we could do that with a public health approach, that addresses core social factors rather than ignoring them, we could prevent kids getting to the point where they are abused or neglected.”

Future research will examine how different systems ‘talk to one another’ and exactly who nurses are likely to contact or refer to when they identify a child at risk.

“By looking at how all the different services work together, we will be investigating where children are falling through the cracks,” Dr Lines says.

Dr Lines’ co-investigators for the project are Professor Julian Grant, Professor Alison Hutton and research assistant Tracy Kakyo.

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