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Child Abuse: Nurse Identification of At-Risk Children   

Sandi Evans, RN  Paediatric Link Nurse, Intensive Care Unit, Christchurch Hospital  Nurse Lecturer in Health Assessment of Children,  Christchurch Polytechnic Institute of Technology 

Evans, S. (2003). Child abuse: Nurse identification  of at-risk children. Nursing Praxis in New Zealand,  19(3), 22-28. 

Abstract   

“Child abuse is a problem for children, for families and for society as a whole, as  the abused child may have life-long emotional and behavioural problems”  (Murray, Baker & Lewin, 2000, p. 47). The nurse, often the first health care  professional to see the abused child, must be alert to the physical, emotional  and behavioural signs of abuse and know how to intervene.  Risk assessment should be standard practice for Registered Nurses offering  paediatric health care. There is a triad of factors that serve as predictors of  increased risk of abuse. To further aid New Zealand health care professionals  where child and/or partner abuse is suspected, identification and response  strategies are outlined in the Family Violence Intervention Guidelines (Ministry  of Health, 2002).  Nurses have an opportunity to assess children for abuse through the nursing  observation, physical examination and history taking. The nurse’s actions to  promote the hauora/wellbeing of each child in her/his practice may be the  crucial determinant in the identification of and intervention for the abused child.   

Key Words: Child, abuse, family, nurse   

Introduction   

New Zealand has “…levels of child  maltreatment deaths that are four  to six times higher than the average  for the leading (Organisation for  Economic Co-operation and  Development) countries” (UNICEF,  2003, p. 2). Maltreatment is the  “Physical, sexual or psychological  abuse or neglect of a child by any  person” (Ministry of Health, 2001b,  p. 9). The same document continues  with assertions that “Physical abuse  includes acts of violence that may  result in pain, injury, impairment or  disease… (and) …may include  under/over medication”, and  “Psychological/emotional abuse  includes any behaviour that causes  anguish or fear…and…exposing the  child to the…abuse of another  person”.  Legislative policy in New Zealand is  reflecting the changing social and  cultural mores, as evidenced by the  Care of Children Bill (2003). This  bill recognises the diversity of family  Evans, S. (2003). Child abuse: Nurse identification  of at-risk children. Nursing Praxis in New Zealand,  19(3), 22-28.  Nursing Praxis in New Zealand Vol. 19 No. 3 2003 Page 23  arrangements in Aotearoa, and also  emphasises parental “responsibilities  to provide daily care,  whereas the previous terminology  was parental “rights”.   

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