How to write an essay on the role of nursing in child maltreatment (Solved)
Problem description: Advocating for and protecting children is still evolving to reflect the varying societal perceptions of proper child care and the definition of maltreatment. Child maltreatment refers to “physical and sexual abuse, neglect, emotional maltreatment, and exposure to intimate partner violence” (Jack et al., 2021). Child protection services investigate children annually for child abuse and neglect. According to Gonzalez et al. (2021), more than 3.2 million children were reported to have experience child abuse, with 20% of them having evidence of maltreatment. Child maltreatment affects several brain structures and functions and their response to stress. Also, maltreatment in early childhood is associated with long-term adverse physical and psychological health outcomes (Suzuki et al., 2017). The outcomes include impaired physical health, mental health issues such as post-traumatic stress disorder, and depression (Suzuki et al., 2017). Failure to address child maltreatment results in adverse social and occupational outcomes in adulthood and consequently slow socioeconomic development of the country. Therefore, addressing these issues in early childhood promotes healthy development and prevents mental issues in adult life.
Public health nurses have historically addressed children’s health and social needs in diverse settings, including home visits. Several socioeconomic factors within a child’s environment put them at risk of maltreatment. These risk factors include young maternal age, single parenthood, having a nonbiological caregiver, child disability, previously reported to child protection services, and low family income at the community levels (Jack et al., 2021; Gonzalez et al., 2021). At the community level, the risks include social isolation, neighborhood poverty, and social support (Jack et al., 2021; Gonzalez et al., 2021). These factors interact to contribute to the increased likelihood of child maltreatment. Public health nurses have the knowledge and skills to help assess child development, strategically identify risks for child maltreatment in families, and intervene accordingly. This paper discusses child maltreatment and the nursing ethical principles surrounding it.
The impact of nursing ethical principles on child maltreatment
The third provision in the American Nurses Association Code of ethics requires a nurse to “promote, advocate for, and protect the patient’s rights, health, and safety” (ANA, 2022). This ethical principle impacts child maltreatment as it revolves around promoting, advocating for, and protecting the child in question. Health professionals and social workers are tasked with the responsibility of supporting children and their families, investigating any form of maltreatment, and collaborating with other disciplines to overcome barriers to protecting children from maltreatment carefully. First, public health nurses promote children’s health and safety through home visits to assess for and prevent child maltreatment. For higher efficacy, these visits are done during pregnancy to provide adequate time to establish a therapeutic relationship, identify child maltreatment risks, and implement multifaceted nursing practices aimed at sensitive and responsive motherhood (Jack et al., 2021). According to Jack et al. (2021), engaging in supportive services during the early prenatal period helps to reduce the chances of child maltreatment in the first two years of life. Also, home visits utilize primary prevention as a way of addressing child maltreatment. Public health nurses also protect and advocate for children’s health and safety by observing or suspecting maltreatment in their environments and carefully investigating before reporting to the local protection agency and collaborating with other agencies to support the child. After assessing the client’s needs, nurses intervene by supporting and referring the client to other service providers and organizations that address their type of maltreatment and its sustained effects so far.
Ethical conflict
Public health nurses and family nurse practitioners need to establish and maintain a therapeutic relationship with clients to advocate, protect and promote their health and safety. One of their roles is reporting, which is related to the ethical principle of advocacy and protection of the client. Their duty to report can create conflict and ethical tensions, interfering with the nurses’ ability to gain trust when interacting with highly socially or economically disadvantaged families. For example, a child might not report maltreatment if they have a history of one and live in a foster home, especially when they have never had a stable family and have found some stability in their new foster home. They are often afraid of losing what they are already familiar with for a new and strange venture in another home. As a result, they’d rather keep it to themselves and hope to survive through it all.
The legal aspect of the conflict
One of the legal requirements of child protection services is that nurses identify ongoing or suspicion of child maltreatment, perform a background investigation to ascertain the facts, and report to the child protection agency for relevant response. The conflict comes in when nurses are in a position where they are mandated to support these families and at the same time feel like they are policing them. Research evidence suggests that there is high concern that the trusting client-provider relationship built over several years is at risk of irrevocable damage, especially due to the involvement of child protection issues.
As a result, mandatory child protection reporting is a significant challenge among nurse practitioners that they seek to address in practice. Mandatory reporting creates stress for young and single mothers as they do their best to protect the rights of their children. Analyzing these situations reveals that even though reporting (Legal responsibility) is intended to promote a child’s safety, most families are left constantly vulnerable and isolated, especially if no additional support is provided to address their deficits. Also, having trust issues with the public health nurse, families may shun utilizing the supportive services of home visiting programs.
Summary of the application of the ethical principle
The constant global revolution influences the shifting definitions of child support and maltreatment. The discussion above highlights various forms of child maltreatment and their negative consequences on the child. Some of these consequences follow them up to adulthood, where they manifest as mental health issues and socioeconomic unproductivity. These outcomes have detrimental effects not only on individuals and their families but also on the nation. Therefore, it is critical to address child maltreatment with the promptness and seriousness it deserves.
As healthcare professionals, family nurse practitioners are obligated to advocate for, promote and protect the health and safety of their clients, which includes children. They are also legally required to report their findings on home visits to legal agencies. This situation presents a clash and ethical tension in reporting child maltreatment after a family has trusted the practitioner enough to disclose their struggles. It particularly stresses financially unstable families who would do anything to protect their children. Despite the tension, the health professional still has to advocate for the child and execute the most appropriate action to ensure the child’s health and safety- reporting to child protection services.
References
American Nurses Association (ANA). (2022). American Nurses Association Code of Ethics for Nurses. Retrieved from https://nursing.rutgers.edu/wp-content/uploads/2019/06/ANA-Code-of-Ethics-for-Nurses.pdf
Gonzalez, D., McCall, J. D., & Doerr, C. (2021). Child Abuse and Neglect (Nursing).retrieved from https://www.ncbi.nlm.nih.gov/books/NBK568689/
Jack, S. M., Gonzalez, A., Marcellus, L., Tonmyr, L., Varcoe, C., Van Borek, N., Sheehan, D., MacKinnon, K., Campbell, K., Catherine, N., Kurtz Landy, C., MacMillan, H. L., & Waddell, C. (2021). Public Health Nurses’ Professional Practices to Prevent, Recognize, and Respond to Suspected Child Maltreatment in Home Visiting: An Interpretive Descriptive Study. Global qualitative nursing research, 8, 2333393621993450. https://doi.org/10.1177/2333393621993450
Suzuki, K., Paavilainen, E., Helminen, M., Flinck, A., Hiroyama, N., Hirose, T., Okubo, N., & Okamitsu, M. (2017). Identifying and Intervening in Child Maltreatment and Implementing Related National Guidelines by Public Health Nurses in Finland and Japan. Nursing research and practice, 2017, 5936781. https://doi.org/10.1155/2017/5936781
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