When children are in peril, nurses and the Illinois Department of Children and Family Services (DCFS) come to their rescue. From abuse to lice to developmental delays, DCFS nurses are pivotal in properly meeting children’s medical needs.
If a case worker suspects any special healthcare needs, such as malnutrition or delayed development, a nurse in that geographical location of the state will assess the situation.
“Even if [special medical needs] are just suspected, a nurse will look at it,” says Jerrilyn Pearson-Minor, RN, MS, chief of nursing services for DCFS. “Now it’s to the point that any child who comes through the DCFS system who is medically complex or has special healthcare needs [must be assessed by a DCFS nurse].”
If DCFS is contacted regarding the suspicion of abuse or neglect of a child, a child welfare specialist nurse teams up with a case worker to begin the consultation.
The department’s nurses do not provide direct care during consultations. The consultation is based on evaluations and observations that lead to diagnosis and recommendations, such as referring case workers to a facility or professional who can provide direct care.
Nurses are important components to DCFS because they provide continuity of care, says Pearson-Minor, a former nurse educator who began her position at DCFS in April 2007.
In addition to medical information, DCFS nurses assess home and family situations as well as any other specifics about each child. Depending on the situation, nurses may visit the child in the hospital, at his or her home or foster home, or at school, Pearson-Minor says.
“They are very, very involved as much as they can be,” she says. “They make it their business when they do an assessment to always schedule a home visit just to go out and see if their assessment is on target.”
Once a nurse reviews medical records, which are easily accessible to him or her, and completes a consultation, he or she arrives at recommendations for the medical needs of that child.
Amanda Ellis, RN, MS, one of 14 nurses on staff with DCFS, also points out that in situations in which a child isn’t hospitalized, it’s necessary to have a nurse examine the situation to decide what is best for the health and safety of the child.
“It’s advantageous that children have nurses who are consultants to assess what’s needed,” says Ellis, who works out of the department’s Chicago office. “We can make sure needs are specific to that child.”
Nurses follow up on each case to make sure the recommendations are followed — specifically, if a child is discharged from the hospital and needs continuing care, among other scenarios, Ellis says.
However, the degree of follow-up is determined on a case-by-case basis, which can range from a nurse following up on his or her recommendations with a caseworker to a nurse revisiting the child or family, Pearson-Minor says.
“Because of our nursing expertise, we may pick up on something another specialist wouldn’t,” says Antoinette Sanchez, RN, BS, who has been with DCFS since 1993, because nurses bring extra skills to the table.
Besides assessing medical needs, nurses also act as a bridge by linking state, school, hospital, and other agencies involved in each child’s needs, Sanchez says.
“We’re a link to everybody,” Sanchez says. “We sometimes ask that meetings be held to make sure all health needs are met.”
Common situations DCFS nurses experience involve children who have signs and symptoms that they are failing to thrive or not meeting common child development milestones, Sanchez says.
Sanchez says she also receives a number of lice cases. Schools often contact DCFS if a child has missed multiple days because of lice.
“I’ve been working a lot in the Spanish community with lice in children,” says Sanchez, who interprets for other nurses.
When DCFS nurses respond to lice calls, they direct parents to a doctor so they can get shampoos to get rid of the lice, she says. “Then children can go back into the school system,” Sanchez says.
Sometimes situations don’t have successful outcomes, especially if severe abuse or neglect is involved and a child passes away.
When that happens nurses receive support both from the agency and their peers. Pearson-Minor says DCFS offered support when she dealt with patient loss in a case. Colleagues are comfortable talking to each other and providing needed support, as well, Ellis and Sanchez agree.
“Usually we can talk to each other and debrief each other,” Sanchez says. “We’ve developed our own support system as nurses.”
The number of children the nurses assess each week varies depending on the region of the state and other factors, says Pearson-Minor. Nurses are strategically placed in the state where they are needed most, she says.
DCFS nurses have been working with the agency since 1993.
Pearson-Minor says she hopes to fill a few open positions on staff to address the DCFS caseload. Nurses who would thrive in the job need medical and surgical experience as well as solid assessment and observation skills.
In the future, she also hopes to better equip her nurses with laptops, cell phones, and other devices to make them more accessible.
Even though the program has its challenges, Ellis says she enjoys the unique aspects of her job.
“The difference between the hospital setting as opposed to the social DCFS atmosphere is DCFS is a little more holistic,” says Ellis. “We actually go to home settings. We’re able to look at what’s going on there. It’s kind of rewarding to mix the social with the clinical with the health.”