Childs Abuse And Nursing Essay Research Paper

Childs Abuse And Nursing Essay, Research Paper

CHILD ABUSE AND NURSING

Nurses who regularly see children in their practice are currently treating victims of child abuse, including sexual abuse and neglect, whether they know it or not.

The causes of child abuse and neglect are complex and varied, and occur in all types of families and settings. Nurses must always remain alert to the possibility that abuse may be occurring in any family, regardless of their socioeconomic status.

Nationally, in 1993, averages of 42.9 children per 1,000 were reported to authorities as victims of alleged abuse or neglect. A 1995 Gallop Poll of 1,000 parents yielded the estimate that 3 million U.S. children were victims of physical abuse by their parents, or about 44 per 1,000 children (The future of children, 1998).

Child characteristics may include, the child was prematurely born, the child has disabilities, either mentally or physically, the child exhibits certain behaviors of infancy and childhood, such as persistent crying, the child is chronically ill, and the child has already been victimized. Family characteristics may include, there is other violence in the home, substances, including alcohol, are abused by the parents or caretakers, the parents of caretakers lack necessary maturity, skills or knowledge to care for the child, parental expectations are inconsistent with the child?s developmental abilities, the caretaker is socially isolated, the family is experiencing high levels of stress from events such as loss of a job, increased financial burdens, serious illness, death in the family, separation or divorce, adult members of the family have themselves been abused as children (Ohio State Medical Association, 1992).

Definitions of the major forms of maltreatment are as follows: Physical Abuse- An act of commission by a caregiver that results or is likely to result in physical harm, including death of a child. Examples of physical abuse acts include kicking, biting, shaking, stabbing, or punching of a child. Sexual Abuse- An act of commission, including intrusion or penetration, molestation with genital contact, or other forms of sexual acts in which children are used to provide sexual gratification for the perpetrator. This type of abuse also includes acts such as sexual exploitation and child pornography. Neglect- An act of omission by a parent or caretaker that involves refusal or delay in providing health care, failure to provide basic needs such as food, shelter, clothing, affection, and attention, inadequate supervision or abandonment. Emotional Abuse- An act of commission or omission that includes rejecting, isolating, terrorizing, ignoring, or corrupting a child. Examples are confinement, verbal abuse, withholding sleep, food, or shelter, exposing a child to domestic violence, and other inattentions that result in harm or potential harm to a child (The future of children, 1998).

Under section 2151.421 of the Ohio Revised Code, nurses, as well as many other health professionals, are required to report incidents of suspected abuse or neglect of a child to the Public Children Services Agency, the County Department of Human Services exercising the children services function, or to a municipal or county peace officer. Failure to report can result in a fourth-degree misdemeanor punishable by 30 days in jail or a $250 fine. If found guilty of a fourth-degree misdemeanor, the nurse may lose their nursing license.

The report can be made by telephone or in person, although the requesting agency may request a written report.

The nurse should report any child under 18 years of age, or any physically or mentally handicapped child under 21, who you have the reason to believe has suffered any wound, injury, disability, or condition of such nature as to indicate abuse or neglect. It is important to note that you need only suspect that abuse or neglect is occurring; physical proof or other forms of validation are not required. It is up to the children service agency to further investigate whether abuse or neglect has occurred.

In obtaining data in suspected abuse or neglect, the nurse must conduct a thorough health assessment including a history and physical exam as well as a developmental assessment. The nurse should assess the child?s immediate medical needs, obtain the past medical and social history of the child and family members, assess the credibility of the history being provided in light of any pre-existing medical conditions, determine the level of risk to the child if he/she returns home. The following physical findings may be indicative of physical abuse: Bruises and welts, which form regular or symmetrical patterns, will resemble the shape of the article used to inflict the injury. Burns- cigarette, immersions burns, or patterned burns resembling an electrical appliance. Lacerations or abrasions- rope burns, palate, mouth, and external genitalia. Fractures- skull, ribs, or long bones. Abdominal Injuries- Bruises, hematomas, intestinal perforations, ruptured liver or spleen, ruptured blood vessels, kidney or bladder injury, pancreatic injury. Central Nervous System Injuries- Subdural hematoma, retinal hemorrhage, subarachnoid hemorrhage, cerebral infarction secondary to cerebral edema. Other injuries or signs- Munchausen syndrome by proxy, symptoms of suffocation, or chemical abuse.

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