Working Together and Fighting Back: Complexities of Addressing Child Abuse and Neglect

Aim/Purpose
The aim of this study was to explore the perceptions and experiences of nurses working with children around how they keep children safe from abuse and neglect.
Background/Context
Nurses who work with children, including maternal, child and family health (MCFH) nurses, encounter diverse families such as those facing multiple challenges to providing a safe and caring environment for their children. Little is known about the daily practices of how these nurses address child abuse and neglect to promote optimal outcomes for children.
Methods/Approach
This study was informed by a social constructionist approach. Data was gathered through in-depth, semi-structured interviews with nurses who work with children in Australia (n=21). Data was analysed inductively supported by NVivo software.
Findings
Participants were nurses who worked with children in MCFH (n=10), paediatric (n=7), combined MCFH and paediatrics (n=2) and other community settings (n=2). The key findings showed that keeping children safe from abuse and neglect required a range of complex skills. Nurses worked together with families and colleagues to manage
their own values and beliefs, maintain positive therapeutic relationships and communicate their concerns with child protection services. This occurred within the context of systems and hierarchies that at times restricted nurses’ capacity to enact change for children, meaning nurses had to ‘fight back’ as advocates for children.
Discussion/Conclusions
Keeping children safe from abuse and neglect is a complex area of practice for MCFH nurses. It requires the application of advanced decision-making, relational, critical reflective and advocacy skills to ensure children are protected from harm. This means MCFH nurses need to be supported to develop, maintain and improve their practice to promote the best possible outcomes for children experiencing abuse and neglect.