Child Protection

NRS311 – Life Stage Considerations: Child, Adolescent & Family Health
Assessment Task Two: Child Protection Case Study
Introduction
Young people and children are the most vulnerable groups in society. As a Registered nurse in NSW, I can identify, consult others, and respond to situations where a young person or a child is at risk of harm. Some of the common reasons that predispose young people and children to risk include family and domestic violence, sexual, emotional, and physical neglect. In Fiona's case, the important risk of harm is neglect (NSW Government, 2018b). Fiona burnt part of her feet on the heater three days ago. Susanna, on noticing, cleaned the wound using tap water. She applied papaw ointment and covered it with an adhesive bandage. In this case, the most significant risk is neglect. Under the circumstances, a question suffices to ask where the mother was when Fiona, a three-year-old, got burnt.
Summary of MRG Answers
The Main Concern: Clothing /hygiene. You are a healthcare expert. A child or young person has been diagnosed and found to have sustained a serious condition caused by poor hygiene and clothing. The parent of the case is not willing or simply unable to provide a solution to the problem.
Currently, it is the mother who takes care of Fiona. Fiona's father is serving a jail term. Susanna's mother-in-law could have helped, but all her time is tied up with work. The worry I have is the excellent care that Fiona needs may not be forthcoming. Susanna, Fiona's mother, cannot provide such care because she has two other children to take care of, apart from the daily house chores to attend to. Therefore, the central concern is supervision.
Child Protection Discussion
The law states that children and young people have the right to be kept safe in the homes and families they live in. These homes and families should be devoid of violence and abuse. While it is a crime to abuse a child, it is still an issue of concern in Australia (WHO, 2002). Neglect is defined as a situation where the caregiver cannot provide the child with the primary things to enable such a child to grow in a state of well being. A child needs to be provided with food, shelter, healthcare, including dental care, proper supervision, and parental love.
In the definition given by WHO (2006, 10), neglect constitutes a pattern of failing to care and provide a child with the necessary material and psychological needs for their proper growth and development and wellbeing; when the parent can provide the same such as:
· Health
· Emotional development
· Shelter and secure living environment
· Education
· Nutrition
In Australia, neglect warrants protection by the state (CFCA, 2016). Such cases present challenges to child-protection officials. They are difficult to process through court, especially when the impact is low but frequent. It is a different situation when it is of high impact and not done frequently. The challenge is in demonstrating that there is a relationship between parental behavior and the outcomes of the child.
Similarly, courts find it unjust to declare a parent as neglectful when they are poor but struggle to meet ends. Indeed, the NSW expressly declares that the courts cannot declare that a child's basic needs have not been met or likely not to be met as a result of the parents' economic situation or other disability. In a situation where the parent is not able to provide because of circumstances, the state has the responsibility to chip in. The parents also have the responsibility to get in touch with state officials and make use of such support (CFCA, 2016).
It is an offense in many jurisdictions in Australia for parents to fail to provide primary care, including food, shelter, clothing, healthcare, and education to their children. The laws are also written differently in various jurisdictions. In the Northern Territory, for instance, the laws only relate to children below the age of 2. In NSW and Queensland, the law applies to children below 7(ALRC, 2010)
Presently, neglect of children is apparent via several occurrences. Firstly, Fiona sustained the foot burn three years ago. Susanna cleared the wound and treated it with pawpaw ointment. Despite these interventions at home by the mother, Fiona has been reporting pain as a result of the burn. The problem has become worse in the recent past. The area around the wound became inflamed two days ago. Fiona woke up with a high fever. The situation smacks of neglect because Susanna was not anywhere near the child when she got burnt. Furthermore, the location of the heater, on the level of the feet, is a clear demonstration of just how the parent is careless. Worse still, there was no medical care provided for Fiona for a whole three days. The bandage was not changed either.
There is a sign of poverty in the home because it is only Susanna's mother-in-law who seems to be engaged in some gainful employment. Additionally, it is reported that the family walked to the hospital all the way. This shows that they do not own a vehicle or similar means of transport. Whether the courts will consider this an outcome of poverty, it is for them to decide.
Discussion of the Obligations of the RN
The protection Act 1998, for Children and Young Persons, outlines the legal responsibilities for healthcare staff in NSW as follows
· To work with interagency and NGO's to enhance children and young person's safety and wellbeing
· To report cases of neglect among the said groups
· To report cases where the unborn may be brought to suffer when and after their mothers deliver
· To proceed with providing care to young people and children and their families even after the cases have been reported to the helpline for Child Protection or to the wellbeing unit of NSW (New South Wales Government. 1998)
Apart from the legal obligations outlined above, there was an amendment of the Crimes Act 1900 in 2018 to take care of instances of concealment of abuse offenses (section 316A). The amendment details punishments for failure to report an offense of this nature and even failure remove the possibility of a child being subjected to such neglect and abuse in the future (section 43B). The changes are not expected to alter the operations and reporting systems of the current NSW health workers. If interested in finding details of the changes, you can refer to the New Child Abuse and Related Offences- Failure to Report and Protect.
All NSW healthcare personnel must promote the wellbeing of children and young people and protect them from abuse and neglect of any form. The NSW continuum across the levels, i.e., primary, secondary, and tertiary care settings, provides a lot of openings to identify young people and children at the risk of neglect and to help parents who are vulnerable to access the state support (NSW Government, 2018a).
Health workers have a rare privilege to spot and react to risk factors for abuse and neglect of children. They have a similar opening to improve the wellbeing of such groups. Health workers with NSW must respond to any case of a child or young person at the risk of being harmed.
Responsibilities for the RN in child protection include;
Identify:
· Signs of likely child abuse, violence in the family and prenatal harm
· Any adult health concerns that may prevent them from offering proper care
Consult:
· The manager and or colleagues
· Mandatory Reporter Guide to help with making decisions
· CWU for further guidance on Mondays to Fridays from 8.30 am to 5.00 pm or drop messages if after official hours.
Respond by:
· Proceed with providing health services even where there are reported concerns
· Share information with other healthcare workers by Section 6 of the PD2013_007, Child Wellbeing and Protection Policies and Procedures for NSW. There is also my online learning module for the same.
· Report suspected critical risk to the official helpline 132111 ( 24/7) or use online MRG
· Consulting with the Child Wellbeing Unit of the NSW regarding the options for referrals and interventions. A message should be left if the report comes after the official working hours or report via email to the CWU through the MRG.
RNs are expected to do the following about the Care and Protection Act 1998(NSW Government, 2018a);
Collaborate with NGO and interagency partners and embrace the information exchange guidelines for the safety, wellbeing and overall welfare of children and young people
· Meet the required provisions for mandatory reporting
· Report cases where the unborn are likely to be at risk of neglect and abuse
· Continue with healthcare provision as the cases are processed
· Report to community services and the children's court where there are requests for health services
· Respond to calls from the police and community service personnel to carry out medical examinations
· Help out in proceedings of the children's courts when called upon to do so.
Conclusion
Young people have a right to be kept safe in their homes and around the community. They should be raised in an environment free from violence and abuse. It is criminal to neglect children and abuse them, but the practice goes on in Australia. The present case might be a candidate for child neglect. There is a lot of evidence pointing at neglect, including the fact that there was no compliance with provisions of healthcare, failure to seek medical help, deprivation of food, and the child's apparent inability to thrive physically. Other points of worry include exposure of such children and young people to drugs and insufficient protection from environmental hazards. Furthermore, inadequate supervision, abandonment, poor hygiene, and lack of providing education have been viewed as evidence of neglect. It is thus incumbent upon the RN to take the necessary steps as provided by the law and the MRG. The RN complied, in this instance, through the identification of possible signs of abuse, violence, neglect, and prenatal harm. They consulted with the NSW Reporter Guide to help in the first decision-making and reported the suspected risk of harm to the Child Protection Helpline. The case under review incorporated both neglect and circumstantial factors that precipitate the incidences of neglect. Fiona was burnt as a result of both negligence and factors that overstretched the ability of the mother to constantly supervise her child. She hails from a poor background since it is only her mother-in-law in gainful employment. Her husband is under incarceration. Thus, it is for the courts to decide the way forward for Fiona and Susanna.
References
Australian Law Reform Commission (ALRC). (2010). Family violence: A national legal response. Canberra: ALRC.
Child Family Community Australia (CFCA). (2016). Australian legal definitions: When is a child in need of protection? (CFCA Resource Sheet). Melbourne: Australian Institute of Family Studies.
New South Wales Government. (1998). Children and Young Persons (Care and Protection) Act 1998.
NSW Government, (2018a). Child wellbeing and child protection fact sheet for NSW Health workers. Retrieved from https://www.health.nsw.gov.au/parvan/childprotect/Pages/child-wellbeing.aspx
NSW Government, (2018b). About child protection and wellbeing. Retrieved from https://www.health.nsw.gov.au/parvan/childprotect/Pages/default.aspx
WHO (2002). "Chapter 3: Child abuse and neglect by parents and other caregivers." World report on violence and health. Retrieved from https://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap3.pdf
World Health Organization. (2006). Preventing child maltreatment: a guide to taking action and generating evidence. Geneva, WHO.
Appendix 1: MRG Results
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