Bound by Law

Making the Call on an Endangered Child
by Teddi Fine

When it comes to detecting child abuse in preschool children, nurses are on the front lines. Yet, just over eight percent of reports to child protective services are from nurses.

According to post-doctoral fellow and clinical mental health nurse Shelly S. Eisbach, PhD, RN, most nurses say making the required call is a “no brainer” when a child has obvious signs of abuse. But when the signs are more subtle, the decision becomes more difficult and more critical.

In a descriptive exploration, [“Am I Sure I Want To Go Down This Road? Hesitations in the Reporting of Child Maltreatment by Nurses,” Journal for Specialists in Pediatric Nursing, October 2010], Eisbach and a colleague asked how nurses handle these less definitive cases of child abuse. Do they report it, hesitate, or seek additional information before contacting protective services? Do they engage the families immediately or watch the situation over time?

Based on their interviews with pediatric nurses and nurse practitioners, Eisbach found no one path is always the right one for detecting and reporting child abuse. Sometimes, when a nurse engages a family, they reach out for help; other times, delay can result in heartbreak.

She advised nurses to “follow their knowledge, experience, and ‘gut feeling’ to save a child from harm.” Further, Eisbach called upon everyone “to be as public and outspoken about child maltreatment in this country as we are about animal abuse.”