What can nurses do?

Prevention  

(WHO, 2010)

Preventing child maltreatment requires a multidimensional approach. Effective programs should target parents and teach positive parenting skills. These include: visits by nurses to parents and children in their homes to provide support, education, and information; parent education, usually delivered in groups, to improve child-rearing skills, increase knowledge of child development, and encourage positive child management strategies; and multi-component interventions, which typically include support and education of parents, pre-school education, and child care.

What Nurses can do?
(Newton et al., 2010; Manning & Stickley, 2009; CNO, 2006)

According to CNO Therapeutic Nurse-Client Relationship Practice Standard, nurses have the responsibility to ensure that abuse is prevented or stopped and reported (CNO, 2006). Nursing professionals are mandated by law to report suspicions of child maltreatment to child welfare authorities without delay and may be fined and reprimanded by College for failing to report.

For children and youth who present to the hospital for accidents related to neglect or inflicted injuries, nurses may be their first contact and have the opportunity for initiating protective services.  Nurses are therefore required to rely on their clinical skills and judgment to identify signs and symptoms consistent with abuse (Newton et al., 2010).

Moreover, mental health nurses are ideally placed to offer help, care and support to those individuals who experience mental health problems by acknowledging and listening to their life events, including experiences of childhood abuse (Manning & Stickley, 2009).

It is very important for nurses to understand how early adversities can affect later health, both physical and mental.

Psychiatric nursing care that focuses on strengthening parent-child relationships, end­ing violence between parents, and helping parents improve their functional status by treat­ing mental illness and addiction is the best approach to prevent­ing childhood adversities. Psy­chiatric nurses should be aware that health in adulthood begins with mental health in childhood (McGuinness, 2010).

Nursing interventions 

·         Thorough assessment (history, self care practices, health screening practices)

·         Listening and being a witness to their life is therapeutic and convey accepatance of the whole person

·         Safety of the clients

·         Proper documentation which has legal considerations

·         Maintaining therapeutic relationship

·         Maintain holistic focus to practice

·         Health teaching

·         Anticipating chronicity

References

1. College of Nurses of Ontario. (2006). Practice Standard: Therapeutic Nurse-Client Relationship. Toronto: Author. 
2. Manning, C., & Stickley, T. (2009). Childhood abuse and psychosis; a critical review of the literature.Journal of Research in Nursing, 14(6), 531-547. doi:10.1177/1744987109347045.
3. McGuinness, T. (2010). Childhood adversities and adult health. Journal of Psychosocial Nursing & Mental Health Services, 48(8), 15-6. doi:10.3928/02793695-20100701-04.
4. Newton, A., Zou, B., Hamm, M., Curran, J., Gupta, S., Dumonceaux, C., et al. (2010). Improving child protection in the emergency department: a systematic review of professional interventions for health care providers. Academic Emergency Medicine, 17(2), 117-125. doi:10.1111/j.1553-2712.2009.00640.x.
5. World Health Organization. (2010). Child Maltreatment. Fact Sheets. Retrieved December 12, 2010, from http://www.who.int/topics/child_abuse/en.