School nurses’ operational modes and ways of collaborating in caring for child abusing families in Finland

Abstract

• The purpose of the study was to explicate and conceptualize school nurses’ work and working methods while caring for child abusing families. Child abuse in the family refers to physical or psychological abuse, sexual abuse or neglect by parents or other caregivers. • Data were collected using semi‐structured interviews with broad themes from Finnish school nurses (n=20). School nurses were selected so that the sample represented a varied experience of school health services in various schools, differing in size, environment and number of pupils. Data were analysed by using qualitative content analysis. • The analysis resulted in a description of school nurses’ operational modes with child abusing families. These were the ‘active and firm’ mode and the ‘passive and uninvolved’ mode. In addition, the study describes school nurses’ collaboration with other professionals working in school, mainly teachers. • The primary goal of school nurses was to promote the child’s well‐being as effectively as possible, whereas caring for the whole family was of secondary importance. The difficulty in taking care of families with problems was shown in different operational modes, especially in ‘passive’ nurses. • The results of the study can be used to plan and develop nursing education and the work of school nurses. Nurses need more knowledge about child abuse and working with families in school healthcare. It is important that nurses are trained to work with families who abuse their children.

Recognition of neglect and early response: overview of a systematic review of the literature

“…Buckley's research suggested that this could be an effective approach (Buckley 2005). The findings in Paavilainen et al. 's (2000) study offer an interesting perspective on a more active role for school nurses.…”

“…A study of calls to Childline (Scotland) showed that few children would call to seek help about neglect, whereas they would call about physical abuse and sexual abuse (Vincent & Daniel 2004). Hints about child help‐seeking behaviour emerge from a Finnish study on the role of school nurses who noted a ‘first sign pointing to problems was often the fact that the child consulted the school nurse more frequently than before’ (Paavilainen et al. 2000, p. 5).…”

“…In Finland, Paavilainen et al (2000) took a broader perspective on the concept of response. They interviewed 20 school nurses about perceptions of their role in 'supporting and caring' for families and children where there is abuse or neglect.…”

Effectiveness of resource‐enhancing family‐oriented intervention

“…They might be able to suggest useful ways to develop services or indicate what kind of clients or families do not benefit from the support provided. In family work, for instance, withdrawal has turned out to be related to the caregiver's work orientation, the communication between families and the caregivers as well as the dysfunction of families (Paavilainen et al 2000, McKay et al 2001, Onyskiw 2002, Harrison et al 2004.…”

“…The nurse's personal working style and orientation, individual characteristics and ability to establish a confidential relationship affect the client's experiences. (Lynn-McHale & Deatrick 2000, Paavilainen et al 2000, Harrison et al 2004, Hä ggman-Laitila 2005.…”