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The frontline of child protection

New standards have been developed to better prepare nurses and midwives on child protection, reports Annie May.

A nurse for more than eight years, Kate* would struggle to put a number to the lives she has helped save or make better. But despite this, she still can’t forget the one patient she didn’t help.

It was during her first few years in the profession, working in a small, close-knit northern NSW community. The patient was a 6-year-old boy and Kate suspected he was being abused.

There were no physical signs, but in the limited education she had received on identifying child abuse, she felt it was her duty to report her suspicions.

Going to management and senior nurses, Kate didn’t get the support she expected.

“It was a community where everyone knew each other. My manager knew the boy’s family and told me I was wrong and to drop it,” she says.

“I then spoke to a few senior nurses I worked with, and while more understanding of the situation, said without physical proof I shouldn’t take the matter further. They also told me it could my make life difficult as things never remained a secret for long in this town.”

Against her better judgement, Kate dropped the matter. Moving interstate not long after, Kate doesn’t know what happened to the boy, but still worries that her failure to act could have left a child at risk.

“Maybe I was wrong. But maybe I wasn’t. I should have found out for sure.”

Nurses and midwives often have first contact with abused and neglected children, yet according to the Australian Bureau of Statistics nurses do not make the top five list of people who identify.

Limited education on recognising signs and symptoms of abuse has been found to be a major barrier to reporting, and while most Australian nursing degrees provide some content on child abuse and neglect, it is not a requirement. In the past it has also been limited.

Addressing this issue, a project at the University of Technology, Sydney, led by Dr Carolyn Briggs of the UTS Centre for Midwifery Child and Family Health, has developed a set of curriculum standards on child protection to integrate into nursing and midwifery courses.

“This is part of a national strategy to provide nurses and midwives with the skills, knowledge and support they need to confidently and effectively respond to situations where children may be vulnerable to abuse and neglect,” Briggs says.

Beyond mandatory reporting requirements, there is little information about what health professionals can do to prevent and respond to such abuse.

“While governments provide legal and policy frameworks and service delivery guidelines there is often minimal information in the government reports about how health professionals should be educated to act.”

As the course coordinator of the graduate certificate in child and family health nursing at UTS, Briggs says she appreciated the need to support nurses and midwives in their child protection role.

“Every nurse and midwife has a responsibility to be an advocate for children. Dealing with child protection issues can be a very confronting experience for clinicians, so they really want to have clear information on what to do.”

Several studies have found nurses frequently had trouble child maltreatment unless there were prominent physical signs. The curriculum standards are centred on core values that relate to child-centred issues, family and environmental issues and cultural and professional issues.

They are intended to: guide curriculum designers towards a primary health care approach for child protection content, indicate the teaching and learning principles and expected outcomes, provide benchmarks for nursing and midwifery programs on child protection content and teaching, and point to suitable resources for educators to enhance learning and teaching.

The Centre for Midwifery Child and Family Health (CMCFH) is also producing a package of learning material that will be distributed free to all Australian schools of nursing and midwifery later this year.

It will contain video clips and other resources to promote interactive learning about initiatives to reduce social isolation and support parents to nurture and protect their children.

Increasing education in this field is essential, says Kate. “Every nurses needs to be as knowledgeable on child protection as possible. Hopefully similar projects will be developed for working nurses.”

*Name has been changed

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