Domestic situations with children

Domestic Situations with Children When a child comes to the emergency room there is a certain protocol that is followed. The possibility of a caseof child abuse must be ruled out when an injury has occurred. What can contribute even more stress is when there are two parents present, they are not together, and not in agreement over the child. Tensions are elevated, and in the middle of it all can be a child in need of an X-ray or sutures.

How to Handle the Parents Your priority is the patient, the child. The parents cannot be a major concern untilsuch time the childis examined and is deemed to be ok.

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Ask, or direct if necessary, the parents to go into a private consult room to have their discussion. Offer to have security accompany them to ensure neither party feels threatened or in danger. Inform the parents they may return once they have settled things and can turn their focus to the child. The parents should not be allowed to remain in the room if they are in a heated discussion.

If there are additional parties with the parents, it's likely to add to the conflict at hand. Suggest that immediate family members only remain with the child that will most likely lessen the tension.

Depending on the child's age, discuss the injury, howit happened, and who was with them when it happened. Avoid saying did someone hurt you, as the child may have been coached to say no one. By asking who was with them, they may answer more openly.

Always call social services if there is any question regarding the child's safety. There is never a time that you can over-react when a child may be in danger. Call for assistance and let authorities do an investigation to ensure the child's safety.

Related:

What to Do if Your Pediatric Patient Does Not Cooperate

It is an all too common occurrence to have an injured child in the emergency room, and the parents are upset, perhaps blaming one another, and more importantly upsetting the child. In most cases, it's best to have security standing by to ensure the safety of everyone.

A nurse working in an emergency room recalls an incident from early in her career. A mom brought her 9-year-old daughter to the emergency room with pain in her abdomen and a fever. Tests showed the child had a urinary tract infection, and when the nurse was explaining this to the child, her mom

stepped out to make a phone call. The nurse picked up on it when the child said she probably got the infection from her neighbor. This sent up red flags, as it should have. The nurse alerted security that the child could not be discharged until social services arrived, and the mom was told more tests were being ordered. As it turned out, the girls 17-year-old neighbor was sexually abusing her, and threatening her not to let anyone know. Her slip to the nurse set the investigation into action, and saved this patient from further abuse. The girl’s parents had no idea, and were devastated, luckily it came to an end as the neighbor was arrested.

This above case involved someone outside the family, however keep in mind that there are times a family member may be suspected of abuse. Always observe the juvenile patient and pay attention to anything said that may cause suspected abuse.

Child abuse is at least recognized now and talked about. Children are taught in school what abuse is, and what is and is not acceptable touching.

Teachers, coaches, nurses, counselors, and anyone working with children are trained to recognize a potential case of abuse, and to alert proper authorities. As a nurse, you often have a better idea of repeated and unexplained injuries, so it falls to you to speak up anytime you suspect aproblem. Remember, a loving parent will understand and appreciate your concerns, and for thechild’s sake it's better to be safe than sorry.

Related:

International Nurses Association

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