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Deconstructing the role of the public health nurse in child protection
1Department of Nursing Studies, University College Cork, Ireland.
Insights
Irish public health nurses (PHNs) lack the specialist skills for at-risk children, creating a risk gap. A mismatch in perceived roles undermines child protection efforts, necessitating improved services.
Area of Science:
- Public Health
- Child Protection Studies
- Nursing Practice
Background:
- Children identified as 'at-risk' require specialized interventions beyond current capabilities.
- The Irish public health nurse (PHN) role in child protection is complex, influenced by diverse client groups and service provision.
- Existing child protection services face scrutiny due to failures in safeguarding vulnerable children.
Purpose of the Study:
- To analyze the gap between the actual and perceived roles of Irish PHNs in child protection.
- To investigate how role discrepancies impact child protection practices and outcomes.
- To identify potential solutions for enhancing child protection services through improved role clarity.
Main Methods:
- Analysis of two recent inquiry reports into child protection failures.
- Review of existing evidence on service provider perceptions of the PHN's role.
- Examination of the PHN's remit within primary, secondary, and tertiary child protection contexts.
Main Results:
- Evidence indicates PHNs fulfill prescribed roles but face expectations of additional, unfulfilled responsibilities.
- A significant discontinuity exists between the PHN's actual duties and how other services perceive their role.
- This role mismatch leads to practices that inadvertently hinder rather than support child protection.
Conclusions:
- The current structure places at-risk children in further danger due to inadequate specialist intervention.
- Addressing the perceived versus actual role of PHNs is crucial for effective child protection.
- Recommendations are proposed to resolve role discontinuities and strengthen community-based child protection services.
Abstract:
This paper argues that children who have been deemed to be 'at-risk' need specialist intervention and that the Irish public health nurse (PHN) cannot provide this intervention. It is further argued that a failure to acknowledge and act on this is placing children at further risk and it is suggested that the mismatch between actual and perceived (or expected) roles leads to practices which undermine rather than support child protection. The PHN's remit in protecting children is situated within the following contexts: the variety of client groups with whom the PHN works, overall provision of child health services in the community, her education and training, and primary, secondary and tertiary protection of children. Two recent reports on enquiries into the failure of the services to protect children living with their families are used to explore the discontinuity. Existing evidence on how personnel involved (directly and indirectly) in community care services perceive or understand the PHN's role in child protection is described in the context of what the PHN's role actually is. The evidence suggests that the PHN fulfils a range of prescribed roles but that there is a perception or expectation among other service providers that she is also fulfilling additional roles. The paper concludes by suggesting some possible solutions to this discontinuity with a view to improving child protection services.