Nurse sees bruises, suspects child abuse
I ran across an online article from a newspaper in Alaska that told a true story about a school nurse and a 7-year-old student in her school.
According to the article, a nurse at the Alaska school observed a student with redness and bruising on her neck. After removing the makeup from the student’s neck, the nurse discovered the marks and applied a cold pack to her neck (“Police: School Nurse’s Diligence Leads To Child Abuse Charges Against Necedah Man”). The 7-year-old did not complain of any pain or injury.
The nurse reported her findings to the police who investigated the incident. Apparently, a 40-year-old man became upset with the young girl when he discovered the girl in his room. He “grabbed her neck with one hand and used another across her bottom to carry her back to her bed.”
A relative living with the young girl told the student to tell people she was injured when she struck a tree and fell off her bike over the weekend. The young girl’s mother applied makeup to cover the injury. The mother said she was sleeping when the incident happened and applied the makeup because she was concerned her daughter would be taken away from her due to child abuse. She told the investigator the man who was living in the house would not be allowed back into her home.
The alleged offender was interviewed and told authorities the girl came into his room around midnight and he “kicked her out of bed” because he had to be at work early the next morning. He denied grabbing her by the neck and carrying her to her room. He said the red marks on the girl’s neck were from her holding her hands tight against her neck when she returned to her room and he checked on her by pulling the covers off of the girl. The man was charged with physical abuse of a 7-year-old child and a court date was set.
I don’t know what happened at the court date and it is unclear what really transpired in this reported situation. However, one thing is very clear: If nothing else, the school nurse was instrumental in getting human services involved in this child’s living situation and possibly preventing future abuse.
Follow reporting statutes on child abuse
As you know, nurse licensees are mandated to report a reasonable suspicion of child abuse to their state agency that investigates alleged child abuse. It is sometimes difficult to know if actual abuse is occurring, so the reporting statutes define reporting what is a reasonable suspicion of maltreatment and protect a nurse who in good faith makes a report to the agency.
… one thing is very clear: If nothing else, the school nurse was instrumental in getting human services involved in this child’s living situation and possibly preventing future abuse.”
The reporting statutes also state there is no breach of confidentiality of the nurse-patient relationship when a reporting occurs. There is no requirement that the parents of a minor student who is 17 or under be informed before a reporting occurs. Such a requirement would defeat the purpose of the intervening in a suspected abusive or neglectful situation.
When considering a report, you must follow your school protocol that governs reporting child abuse or neglect and to make the report “in good faith.” By the way, “good faith” is presumed and any person challenging it must prove it did not exist when the reporting was made.
Currently, 48 states, the District of Columbia, American Samoa, Guam, the North Mariana Islands, Puerto Rico and the Virgin Islands designate which professionals are required to report child maltreatment. States that mandate nurses to report child abuse or neglect include Illinois, Pennsylvania, Alaska, Connecticut, Arizona and Arkansas.
There is no doubt that school nurses play a crucial role in assessing whether child abuse, neglect or maltreatment is taking place or has taken place.
State boards of nursing can discipline nurse licensees if a report is not made by a nurse when it should have been and also can discipline nurse supervisors who prevent a nurse from filing a required report.
If you are a school nurse, know that in many ways you may be the only person who is concerned enough about a student’s maltreatment to do something about it. Whether the maltreatment is neglect, physical abuse, emotional abuse, sexual abuse or access to drugs or alcohol, you can save a student from continued harm that will affect his or her life forever.
The National Association of School Nurses Position Statement (2014), “Child Maltreatment, Care of Victims of: The School Nurse’s Role,” is worth a thorough read.
Courses Related to ‘Child Health’
CE185-60: Child Abuse (1 contact hr)
This continuing education module updates healthcare providers on the recognizing, reporting and treating victims of child abuse. You’ll also learn four risk factors each for becoming a perpetrator and a victim of child abuse.
60050: Keeping Adolescents on a Healthy Track (4 contact hrs)
The goal of this course is to help nurses working with adolescents understand their normal growth and development. This course will review a developmental approach to increase resiliency and improve the health outcomes of adolescents.
CE617: Sports-Related Concussions (1 contact hr)
This program informs healthcare providers about the incidence, symptoms, diagnosis and treatment of sports-related concussions and the potential for serious long-term outcomes, such as dementia.
Nancy Brent’s posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.