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Is child abuse a concern of OR nurses?
Editorial
Is child abuse a concern of OR nurses? Articles published in the Journal are reviewed first by the Editorial Committee. When we sent out the articles we had planned on child abuse, we were surprised at some of the reactions of the reviewers. "I don't see that this applies to OR nurses." one wrote. Another reviewer commented, "This would be more appropriate for a general nursing journal." One reviewer rejected an article more critically. "This article borders on sensationalism and would be more appropriate for a tabloid. It does not contain nursing information." Another reviewer reacted to the same article more positively. "I feel nursing literature is long overdue to hear the truth about abuse of children. This article is a good beginning . So the editors are presented with a dilemma of diametrically opposed opinions and reactions. Is child abuse an appropriate topic for an operating room nursing journal? Are the articles being considered of value and interest to the readers? We decided that the topic was pertinent to operating room nursing and that the articles merited publication. As you read the articles in this Journal you may find yourself reacting negatively as some of the reviewers did and think "This is an unpleasant subject that I don't want to hear about." Or you may feel, "Here is a subject that is disturbing to read about, but as a nurse, I probably should know something about why child abuse occurs." What does it have to do with operating room "
r-1
nurses? Probably many operating room nurses have at one time or another taken care of a child in the operating room who is a known or suspected victim of child abuse. If this happens to you. you will probably feel angry. disgusted. and frustrated. You may wonder what you can do or what you should do. If operating room nurses are conducting preoperative and postoperative interviews. they may have direct contact with children who have been abused and their families. If you are in this situation, you need to know enough about child abuse to understand why some parents battered a child. why some children in a family are injured and not others, or why the behavior of an abused child may be passive or aggressive. You need enough understanding to get beyond your own feelings so you can deal with the abused child and his family. Moreover. operating room nurses have a responsibility and can do something. If you come in contact with a child you suspect of being abused, you have a legal responsibility to report it. In the hospital setting, so many professionals come in contact with the abused child. you may think, "Well. someone else will do it." This is the danger when responsibility is fragmented. There is a natural tendency to let someone else take the responsibility. You not only have a legal obligation but also a moral one to take some action. In an article in this Journal. Dorris Davis, RN, formerly an OR nurse in an Arizona hospital and now on the AORN Headquarters staff, describes an abused child being brought into the operating room for the second time. She was told, "Nothing can be done." But she did not accept this, so she and her colleagues tried again and this time managed to get authorities to intervene. She went beyond this
AORN Journal, March 1978, V o l 2 7 , N o 4
609
individual case and. with a colleague. presented inservice programs and workshops for nurses and other health professionals so they would have a better understanding about child abuse and neglect. Others in turn started programs in the community to provide help for abusing parents and their children. This article is a striking story of what two nurses could accomplish in their community. Child abuse and neglect are much more than a health problem or a family problem. They are a social and community problem. Traditionally, society has accepted physical force in child rearing. "Spare the rod and spoil the child" is an age-old admonition to parents. Brandt Steele. MD, professor of psychiatry at the University of Colorado, Denver, states, "The abusive parent is supported by cultural factors that encourage physical discipline of children, and the parent often feels strongly that he IS doing the right thing in punishing his child." Yet physical punishment may not achieve the parent's goal. Dr Steele cautions that children who are punished for being too aggressive become more aggressive: children who are punished for infractions of toilet training tend to have more bedwetting than those who are not punished. Our democratic society also places great value on individual rights and regards the parent as having a right to raise his child as he or she feels fit without interference. Others are often reluctant to interfere in this relationship. Yet society pays a high price for child abuse and neglect. These children, if they survive, are often mentally retarded or have learning difficulties and emotional problems as they grow up and as adults. Juvenile delinquents often have a history of child abuse. Operating room nurses who are interested in doing something about child abuse and neglect may become involved in educational activities for fellow professionals or the lay public. Increasing public awareness of the problems of child abuse and neglect can help to develop effective community programs for treatment and prevention. Nurses should know what laws in their state govern child abuse and neglect and whether they are adequate. A model child abuse and neglect reporting law has been created by the Juvenile Standards Project of the Institute of Judicial Administration of the American Bar
610
Association This can be used as a guide in evaluating state laws As individual professionals operating room nurses need to know their legal responsibilities for reporting and how to provide professional nursing care to abusing families We hope the articles in this Journal although perhaps not pleasant to read, will serve as an introduction to child abuse and neglect and stimulate some of you to learn more They may even instigate some of you to take some action for prevention or treatment of child abuse in your own community Is child abuse and neglect an appropriate topic for the AORN Journal7 We would be interested in your opinion
Elinor S Schrader Editor
Statewide program for California nurses A new seven-course program for registered nurses in California has been designed by the University of California (UC) Extension Council on Continuing Education in Nursing. The statewide program will assure uniformity of goals, content, and student evaluation on each participating university campus. The program will prepare nurses to work with increasing independence using specialized knowledge and skills, to set criteria for the quality of patient care, and to assess the health needs of clients in an adult acute care setting. It will be of special interest to registered nurses who are changing from one area of practice to another, RNs who are returning to professional practice, and RNs currently in practice who wish to develop more in-depth knowledge and skills in assessment, intervention, and evaluation of nursing care for a specific patient population. Currently offered at UC's San Diego, Irvine, and San Francisco campuses, the program will be implemented on the Davis, Los Angeles, Santa Barbara, Santa Cruz, and Riverside campuses in the near future. Program information may be obtained from the departments of continuing education in the schools of nursing on any of the participating campuses.
AORN Journal, March 1978, V o l 2 7 , No 4
Is child abuse a concern of OR nurses? Articles published in the Journal are reviewed first by the Editorial Committee. When we sent out the articles we had planned on child abuse, we were surprised at some of the reactions of the reviewers. "I don't see that this applies to OR nurses." one wrote. Another reviewer commented, "This would be more appropriate for a general nursing journal." One reviewer rejected an article more critically. "This article borders on sensationalism and would be more appropriate for a tabloid. It does not contain nursing information." Another reviewer reacted to the same article more positively. "I feel nursing literature is long overdue to hear the truth about abuse of children. This article is a good beginning . So the editors are presented with a dilemma of diametrically opposed opinions and reactions. Is child abuse an appropriate topic for an operating room nursing journal? Are the articles being considered of value and interest to the readers? We decided that the topic was pertinent to operating room nursing and that the articles merited publication. As you read the articles in this Journal you may find yourself reacting negatively as some of the reviewers did and think "This is an unpleasant subject that I don't want to hear about." Or you may feel, "Here is a subject that is disturbing to read about, but as a nurse, I probably should know something about why child abuse occurs." What does it have to do with operating room "
r-1
nurses? Probably many operating room nurses have at one time or another taken care of a child in the operating room who is a known or suspected victim of child abuse. If this happens to you. you will probably feel angry. disgusted. and frustrated. You may wonder what you can do or what you should do. If operating room nurses are conducting preoperative and postoperative interviews. they may have direct contact with children who have been abused and their families. If you are in this situation, you need to know enough about child abuse to understand why some parents battered a child. why some children in a family are injured and not others, or why the behavior of an abused child may be passive or aggressive. You need enough understanding to get beyond your own feelings so you can deal with the abused child and his family. Moreover. operating room nurses have a responsibility and can do something. If you come in contact with a child you suspect of being abused, you have a legal responsibility to report it. In the hospital setting, so many professionals come in contact with the abused child. you may think, "Well. someone else will do it." This is the danger when responsibility is fragmented. There is a natural tendency to let someone else take the responsibility. You not only have a legal obligation but also a moral one to take some action. In an article in this Journal. Dorris Davis, RN, formerly an OR nurse in an Arizona hospital and now on the AORN Headquarters staff, describes an abused child being brought into the operating room for the second time. She was told, "Nothing can be done." But she did not accept this, so she and her colleagues tried again and this time managed to get authorities to intervene. She went beyond this
AORN Journal, March 1978, V o l 2 7 , N o 4
609
individual case and. with a colleague. presented inservice programs and workshops for nurses and other health professionals so they would have a better understanding about child abuse and neglect. Others in turn started programs in the community to provide help for abusing parents and their children. This article is a striking story of what two nurses could accomplish in their community. Child abuse and neglect are much more than a health problem or a family problem. They are a social and community problem. Traditionally, society has accepted physical force in child rearing. "Spare the rod and spoil the child" is an age-old admonition to parents. Brandt Steele. MD, professor of psychiatry at the University of Colorado, Denver, states, "The abusive parent is supported by cultural factors that encourage physical discipline of children, and the parent often feels strongly that he IS doing the right thing in punishing his child." Yet physical punishment may not achieve the parent's goal. Dr Steele cautions that children who are punished for being too aggressive become more aggressive: children who are punished for infractions of toilet training tend to have more bedwetting than those who are not punished. Our democratic society also places great value on individual rights and regards the parent as having a right to raise his child as he or she feels fit without interference. Others are often reluctant to interfere in this relationship. Yet society pays a high price for child abuse and neglect. These children, if they survive, are often mentally retarded or have learning difficulties and emotional problems as they grow up and as adults. Juvenile delinquents often have a history of child abuse. Operating room nurses who are interested in doing something about child abuse and neglect may become involved in educational activities for fellow professionals or the lay public. Increasing public awareness of the problems of child abuse and neglect can help to develop effective community programs for treatment and prevention. Nurses should know what laws in their state govern child abuse and neglect and whether they are adequate. A model child abuse and neglect reporting law has been created by the Juvenile Standards Project of the Institute of Judicial Administration of the American Bar
610
Association This can be used as a guide in evaluating state laws As individual professionals operating room nurses need to know their legal responsibilities for reporting and how to provide professional nursing care to abusing families We hope the articles in this Journal although perhaps not pleasant to read, will serve as an introduction to child abuse and neglect and stimulate some of you to learn more They may even instigate some of you to take some action for prevention or treatment of child abuse in your own community Is child abuse and neglect an appropriate topic for the AORN Journal7 We would be interested in your opinion
Elinor S Schrader Editor
Statewide program for California nurses A new seven-course program for registered nurses in California has been designed by the University of California (UC) Extension Council on Continuing Education in Nursing. The statewide program will assure uniformity of goals, content, and student evaluation on each participating university campus. The program will prepare nurses to work with increasing independence using specialized knowledge and skills, to set criteria for the quality of patient care, and to assess the health needs of clients in an adult acute care setting. It will be of special interest to registered nurses who are changing from one area of practice to another, RNs who are returning to professional practice, and RNs currently in practice who wish to develop more in-depth knowledge and skills in assessment, intervention, and evaluation of nursing care for a specific patient population. Currently offered at UC's San Diego, Irvine, and San Francisco campuses, the program will be implemented on the Davis, Los Angeles, Santa Barbara, Santa Cruz, and Riverside campuses in the near future. Program information may be obtained from the departments of continuing education in the schools of nursing on any of the participating campuses.
AORN Journal, March 1978, V o l 2 7 , No 4