Nurses’ Obligations to Child Abuse Victims

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Within California, the issue of child abuse presents itself as a truly terrible crime.  According to statistical information gathered by the Children’s Bureau of Southern California, there were 170,471 cases of child abuse or neglect reported within only Los Angeles County in 2010 (Children’s Bureau).  Within these reported abuses, the highest age group that is affected by early childhood trauma is those children from 0-3 years old.  This is most likely due to the fact that children within this age group are the most physically dependent upon their parents or care givers and lack the cognitive ability to efficiently communicate their wants, needs, and desires.  For this reason, it is especially important for a nurse to look for signs of abuse within children of this age group.  

For an infant, specific warning signs can be looked for in both the physical and emotional assessments that a nurse can use to determine if abuse is occurring.  For infants, it is not possible for a nurse to get an accurate, or that matter any, sort of verbal confirmation from the child that the abuse is taking place, therefore it is important to identify warning signs that abuse is or may be occurring.  Examining for physical injuries such as cuts, bruises, or other injuries is a good way to look for physical abuse on infants, as their normal lifestyles prevent them from usually receiving injuries of this nature.  If the child appears to be overly fearful or negatively reacts to physical contact with an adult can also be a slight warning sign of some sort of abuse in their past.  This can, however, be misleading as some cultures such as that of eastern Asia put emphasis on refraining from certain types of contact between individuals, such as the touching of the top of the head.  Regardless, if a nurse suspects some sort of abuse or neglect is present, they are legally obligated to report it.  Within California, the reporting mechanism of abuse is to call child services and inform them of the issue.  Nurses are given complete immunity for making these claims but are held in legal responsibility for not reporting abuse when it is present in California (Markus, 1999).

When an infant grows into a toddler, their ability to be mobile begins to manifest itself.  With this newfound mobility comes a new set of dangers for the child, however.  According to the National Institutes of Health, the leading causes of injury and death for children between the ages of 1 to 4 years of age are as follows: “accidents, developmental and genetic conditions such as juvenile Huntington's Disease that were present at birth, and cancer,” (NIH, 2012).  As one can plainly see, a child is much more likely to become injured or even get killed by having an accident at this age.  Some of the environmental factors that can contribute to these accidents are things that many adults take for granted such as sets of stairs, kitchen appliances, electrical outlets, and many other common household items.  

That is why it is essential for parents of toddlers to “child-proof” their homes.  This term refers to attempting to create an environment so that toddlers will not accidentally hurt themselves while playing with a potentially harmful item.  This process can include: placing dangerous tools and appliances on high shelves out of children’s reach, putting covers in electrical outlets, placing gates at the top of stairs, and locking up cabinet doors that have access to cleaning chemicals (CDC, 2012).  Two other important tactics that parents should employ are to not leave their child unsupervised and to make sure that the child understands they are not to go to certain places or interact with certain items ever.  Obviously, it is not feasible to believe that a toddler will listen entirely to a parent when told not to do something or not to go somewhere, however, if the child does understand they will get into trouble from performing a specific action, they may be more likely to avoid attempting it.  The other factor, not leaving a child unsupervised, is also critical to promoting a better healthy environment for a child.  Like telling a child what not to do, it is not entirely feasible to think a parent can keep 100% of their attention to making sure the child is not in immediate danger, however certain risks can be avoided by making sure a child is not left unsupervised in a potentially dangerous situation such as being alone near a water source or a flight of stairs.

References

CDC. (2012, Aug 15). Child development: Toddlers Center for Disease Control and Prevention, Retrieved from http://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/toddlers.html

Children's Bureau. (2012). Abuse statistics. Children's Bureau, Retrieved from http://www.all4kids.org/child-abuse-statistics.html

Markus, K. (1999, April 20). Reporting signs of abuse. Nurse Week, Retrieved from http://www.nurseweek.com/features/99-4/abuse.html

NIH. (2012). Death among children and adolescents. Medline Plus: U.S National Library of Medicine & National Institutes of Health, Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001915.htm