Escalating problems surrounding child protection and domestic violence have put nurses at the front line of this fraught situation – but too often they are not being recognised for essential work they already do to ensure the wellbeing of children at risk.
To help guarantee the safety of children and ensure their healthy start to life, Dr Lauren Lines from Flinders University’s Caring Futures Institute is leading a research project that examines how our future health workforce is being educated in child protection – especially prevention and early support for families experiencing adversities. By exploring interprofessional education for nurses, midwives and social workers in this work, supported by a 2022 Flinders Foundation Health Seed Grant, she aims to identify shortcomings that can be addressed before these health workers complete their qualifications.
Dr Lines is perfectly placed to make these observations, having previously worked as a paediatric nurse for almost 10 years – and her PhD thesis (2020) focussed on nurses’ experiences of responding to child abuse and neglect in child focussed settings in Australia. It has provided the impetus for her continued research in this field.
“Working clinically as a nurse, I would come across kids from difficult family situations, but these things we encountered in day-to-day practice were not broadly being recognised and the full context of family situations was not being fully understood,” she says. “I felt that it was important to establish a voice on behalf of these children – to recognise exactly what is needed to ensure their safety – because often they don’t have the opportunity for the complexity of their story to be heard.”
Dr Lines was lead author of a recently published international literature review that examines the current state of nurse training in this difficult area – “Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review”. The review found that international approaches to this problem remain ad-hoc, with practices and methods for training undergraduates not being replicated across the sector.
The research also highlights that nurses and midwives face an uphill battle obtaining acknowledgement or being officially recognised in Australian health care policies or guidelines for work they already do that involves child protection.
Dr Lines wants this to change – to have these unrecognised skills and job requirements currently done by some dedicated and experienced nurses, formally included in university training, so that new nurses going into the health care workforce are prepared for these additional demands, and have the necessary skills, calmness and expertise to have empathetic conversations that maintain therapeutic relationships with families to facilitate early support.
“There is scant recognition of the depth of the work being done – with many of these skills being 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, having that essential child-focus and being able to connect and engage with parents. If clinicians can achieve this, they can then determine what support is required to get the very best for that child. Most importantly, this support should emphasise prevention and early help when families are experiencing challenges – which helps parents feel safe and not judged for seeking help.
“It’s clear that if disadvantaged families trust the person providing care, the clinician can act effectively as a conduit between the different services and provide a much better outcome.”
Strong and cohesive training within supportive and well-resourced services that recognises these additional responsibilities is crucial, says Dr Lines, as nurses and midwives need the confidence and sense of safety necessary to build relationships with parents and ask sensitive questions to intervene early and enable children to thrive in their own families, communities and cultures.
This work follows on from Dr Lines work in the Safeguarding Project, funded by the Flinders Foundation, that explored the nature and scope of Australian nursing and midwifery roles in preventing and responding to child abuse and neglect. Completed two years ago, it outlined improvements in interprofessional education for nurses, midwives and social workers, and informed further development of nursing and midwifery practice in safeguarding, enhancing interdisciplinary communication and promoting better outcomes for children in Australia.
Now, Dr Lines hopes her new research will push the debate further and introduce more structured education that will build the capacity of a multidisciplinary child and family workforce to support children and families experiencing adversity.