Child Protection Case Study: Nursing Obligations in NSW

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 and sexual, emotional, and physical neglect. In Fiona's case, the most significant risk of harm is neglect (NSW Government, 2018b). Fiona burnt part of her feet on a heater three days ago. Susanna, on noticing, cleaned the wound using tap water, applied pawpaw ointment, and covered it with an adhesive bandage. Under these circumstances, a critical question arises: where was the mother when Fiona, a three-year-old, got burnt?

Summary of MRG Answers

Main concern: Clothing and hygiene. A child has been found to have sustained a serious condition caused by poor hygiene and inadequate clothing. The parent is either unwilling or 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 occupied by work. The concern is that the level of care Fiona requires may not be forthcoming. Susanna cannot provide adequate care because she has two other children to look after, in addition to daily household responsibilities. 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 environments should be free from violence and abuse. While it is a crime to abuse a child, it remains an issue of ongoing concern in Australia (WHO, 2002). Neglect is defined as a situation in which a caregiver fails to provide a child with the basic necessities to support healthy growth and wellbeing. A child requires food, shelter, healthcare — including dental care — proper supervision, and parental love and attention.

As defined by WHO (2006, p. 10), neglect constitutes a pattern of failing to provide a child with the necessary material and psychological needs for proper growth, development, and wellbeing, when the parent is capable of doing so. These needs include:

In Australia, neglect warrants protection by the state (CFCA, 2016). Such cases present challenges to child-protection officials, as they are difficult to process through court — particularly when the impact is low in severity but occurs frequently. High-impact, infrequent incidents present a different set of difficulties. The core challenge lies in demonstrating a clear relationship between parental behavior and outcomes for the child.

Courts also find it unjust to declare a parent neglectful when they are impoverished but are actively struggling to meet their children's needs. Indeed, NSW expressly provides that courts cannot declare that a child's basic needs have not been met solely as a result of the parent's economic situation or disability. Where a parent cannot provide adequate care due to circumstances beyond their control, the state has a responsibility to intervene and support. Parents also bear a responsibility to engage with state services and make use of available support (CFCA, 2016).

It is an offense in many Australian jurisdictions for parents to fail to provide primary care — including food, shelter, clothing, healthcare, and education — to their children. The laws are written differently across jurisdictions. In the Northern Territory, for instance, they apply only to children under the age of two. In NSW and Queensland, the law applies to children under seven (ALRC, 2010).

In the present case, there are several indicators of neglect. First, Fiona sustained a foot burn three days ago. While Susanna cleaned the wound and treated it with pawpaw ointment, Fiona continued to report pain, and the situation worsened. The area around the wound became inflamed two days ago, and Fiona woke up with a high fever. The situation suggests neglect because Susanna was not present when Fiona was burnt. Furthermore, the placement of the heater at foot level reflects a lack of attention to the child's safety. More critically, no medical care was sought for three days, and the bandage was not changed.

There are also signs of poverty in the household. Susanna's mother-in-law appears to be the only family member in gainful employment, and the family reportedly walked to the hospital — suggesting they do not own a vehicle or other means of transport. Whether the courts ultimately consider these factors as poverty-related mitigating circumstances is a matter for judicial determination.

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 or abuse children, yet the practice continues in Australia. The present case may constitute a candidate for a finding of child neglect. There is considerable evidence pointing in this direction, including non-compliance with healthcare provisions, failure to seek timely medical attention, food deprivation, and the child's apparent inability to thrive physically. Additional concerns include the child's exposure to environmental hazards, inadequate supervision, poor hygiene, and lack of access to education.

It is therefore incumbent upon the RN to take the steps required by law and the Mandatory Reporter Guide. In this instance, the RN complied by identifying possible signs of abuse, violence, neglect, and prenatal harm; consulting the NSW Mandatory Reporter Guide to support initial decision-making; and reporting the suspected risk of harm to the Child Protection Helpline.

The case incorporates both direct neglect and contextual factors that stretched the mother's capacity to adequately supervise her child. Fiona was burnt as a result of a combination of negligence and circumstances that overwhelmed Susanna's ability to maintain constant supervision. The family comes from a disadvantaged background, with only the mother-in-law in employment and the father incarcerated. It is ultimately for the courts to determine the way forward for both 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

World Health Organization. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. Geneva: WHO.