Child abuse: recognition and reporting by health professionals

Nurses who are involved in child abuse and neglect have three major areas of concern: the child, the parent or caretaker, and their personal feelings. In terms of the child, the nurse needs to know the physical and behavioral indicators of abuse and neglect in order to make objective assessments. Indicators may be mild or severe, and usually occur in a pattern or in combination. The abused child may evoke sympathy in the nurse to an extent that may be detrimental to the resolution of a family problem. In terms of the parent, the nurse needs to determine the presence or absence of mental pathology and to recognize the good intent of the majority of abusive and neglectful parents. In dealing with parents, the nurse must always be honest, nonjudgmental, and supportive. Discussion of the report offers the best opportunity for providing support. Personal feelings are the greatest obstacle to the successful management of child abuse and neglect. Nurses must recognize their feelings regarding "proper" discipline and their fear of "getting involved." The feeling that "it's none of my business" must be overcome, and positive attitudes toward the parents and reporting must be promoted. Recognition of legal and moral responsibilities must take precedence over personal feelings. Through professional involvement, nurses can contribute to the primary prevention of child abuse and neglect.