The Eye of the Beholder

Personal perceptions can affect reporting of suspected child abuse

Child Abuse illustration

Nurses are required by law to report any “reasonable suspicion” of abuse or neglect to child protection agencies, yet their perceptions on what discipline is acceptable and what is over the line can be poles apart, even in the same medical setting. Understanding how nurses make these decisions, to report or not, form the basis for the study “Pediatric Nurses’ Differentiations Between Acceptable and Unacceptable Parent Discipline Behaviors” by Grace Ho, PhD, RN, and Deborah Gross, DNSc, RN.

By examining the views of 48 pediatric nurses in an urban medical center, the researchers found consensus on what constituted “most acceptable” and “most unacceptable” discipline behaviors, but there was wide variation in how nurses draw the fine line between harsh discipline and child abuse. For instance, while some nurses stated that any form of hitting is indicative of abuse, to others, mild spanking, such as “hitting the child with an open hand,” is relatively acceptable compared to discipline strategies that can cause the child to be afraid, such as “putting the child in a dark basement.”

“Nurses need to have consistent views on what is considered acceptable and unacceptable parenting behaviors requiring a report for child protective services. The stakes are too high for families of young children, who could risk stigma and potential loss of their children as a result of biased or idiosyncratic assessments of child abuse,” the authors conclude.

Publication: Journal of Pediatric Health Care