Child abuse takes place in different forms as a child may be abused physically, emotionally, or sexually. Moreover, neglecting a child is also considered child abuse. But the definition of child abuse is not confined to these legal parameters only as various states in the United States have included newer parameters used to define child abuse. These parameters would include failure by the parent, guardian, or caretaker of the child to act and such action leads to death, sexual exploitation or abuse, or adverse physical or emotional injury to the child. Some states even include the bearing of a feeling or need to commit serious harm to a child emotionally, physically or sexually. Child abuse as a crime may be committed by anyone in the society including close family members such as parents, siblings, and members of the extended family, guardians, caretakers distant relatives or even just any criminal in the street (Hoyano & Keenan 2007).
An abused child usually shows signs of being abused as most tend to be afraid and in most cases become introversive. These, coupled by the word of the victim, are reasons enough for the nurse in charge to report a case of child abuse. If the offender or any other individual contends otherwise, the nurse has the liberty to carry out any medical tests such as forensic, DNA tests, to ascertain his or her case especially in cases of physical and sexual abuse. However, issues may arise despite the fact that the nurse has facts that can be used to report a child abuse case. Such issues, which are usually ethically based, may cause a conflict in both the mind of the nurse and the victim as well. The fact that child abuse can be committed by those closest to the child, especially parents, presents an enormous challenge, not only to the legal officers but also to the nurses, the child victim and even other siblings.
The challenges that come with the child being abused by people close to her or him, especially parents, guardians or caretakers, presents a legal and ethical challenge to the nurses who are supposed to take care of the child victim hence the nurse in question should apply proper decision making approaches and models (Janie& Karen 2007). This will enable the nurse concerned to make rational decisions while reporting the case. One of the ethical issues that complicate the issue of child abuse especially by parents is the rights the parent still has over the abused. This issue is especially made worse when the victim must seek medical attention where the parent has a say and legal redress. The victims of child abuse are usually reluctant to report to the concerned authorities thus they usually confide the nurses, doctors, therapists, and other medical professionals. Moreover, professional ethics may be breached in child abuse cases as the nurses, doctors and other medical professionals may be forced by law to divulge private information about their patients.
In such scenarios, nurses may be called upon by both the children’s rights officers to make decision while the prosecution team or the defense team may ask the nurse to appear before the judges as witness. In such a case the nurse must be in a position to give clinical evidence while at the same time keeping in mind the nursing ethical codes. One of these codes is the confidentiality; the nurse is only allowed to divulge the information about a patient in their care if it is going to serve a higher purpose as preserving life. Observing these ethical nursing codes becomes a tall order for the nurse because nurses are also compelled by the law to tell the truth about the patient she or he is taking care of (Susan & Katherine 2008).
Despite these challenges, the nurse must rationally make a decision either to report a child abuse case or divulge such information concerning an abuse child to the child welfare authorities. The main stakeholders in a child abuse case are the nurse, the victim, the victim’s parents, guardian or caretaker, siblings and the child welfare authority. Obviously each would prefer a proper course of action to take. Most victims, parents, guardians and caretakers, as well as the child welfare authority would want the offender to be prosecuted. On the other hand, since the nurse would be forced to tell the truth which ultimately conflicts with the confidentiality code, the nurse would, in most prefer that the case be handled in another way that would not force her to divulge her or his client’s secrets. However, in cases of sexual abuse, the victim, parents and siblings would wish, in many instances, that such a case is hushed since they would want the victim to go through the trauma by being reminded by the sympathizers in the society.
Thus, without these constraints, a nurse would gladly report a child abuse case without a second thought. Such constraints as stigmatization by some siblings especially when the offender was a close family member, parental rights over the child, psychological trauma due to the reliving of the incident by the victim in cases of sexual abuse would hinder the reporting of a child abuse case. However, the reporting of a child abuse has no easier choice thus the nurse has no choice but to report the case and in the process follow the ethical code of nursing which calls for confidentiality of information regarding a patient but at the same time compelling the nurses to tell the truth regarding a patient (Susan & Katherine 2008). No matter what form of child abuse or who the offender is, the nurse must report it to the concerned authorities such as child welfare authorities especially when the parents, caretaker or guardian is reluctant to do so. The nurse must also make sure that the case, if reported by another party and it concerned a patient under her or his care, is correctly reported; without leaving out any vital information that might help the case.
The morally permitted decision in case of child abuse is reporting and such a case has no alternative especially if there is evidence of the occurrence of such a case. The decision to report a child abuse is morally defensible as it would be more difficult and painful for the child to live with the trauma of being abused and the case not reported despite the evidence being there, than to live with pain knowing that the offender faced justice.
In conclusion, the ability for the nurse to report any child abuse case depends on the information and evidence she or he has about the case. Thus, the nurse and the victim must form a collaborative relationship which will enable her or him get the necessary information and evidence needed to support the case. Such a decision requires a thoughtful process as correct approaches must be made by the nurse to retrieve the required information, use it as evidence to report the case while at the same time maintaining a good and collaborative nurse-patient relationship.
Hoyano, L., & Keenan, C., (2007). Child Abuse: Law and Policy Across Boundaries. Oxford University Press.
Janie, B., & Karen, R. (2007). Nursing Ethics: Across the Curriculum and into Practice (2nd). New York: Jones & Bartlett Publishers
Susan, W., & Katherine, D. (2008). Essentials of Nursing Law and Ethics. New York: Jones & Bartlett Publishers.