The curriculum revolution in action: nursing and crisis intervention for victims of family violence.

The curriculum revolution might have been born at the University of Detroit in their RN-to-BSN program. Situated in an urban environment where violence is an ever-present problem, the faculty developed an innovative clinical course for senior students, entitled Nursing and Crises Intervention for Victims of Family Violence. The curriculum was designed to respond to a social problem that affects individuals, families, and groups at both physical and psychological levels. It was hoped that creative use of the educational process would promote nursing intervention with a population whose needs have traditionally been unrecognized and unmet by the profession. The response to the course has been very positive and students have applied the content in nontraditional clinical agencies such as shelters for battered women and children, sexual abuse centers, and phone crisis centers. More importantly, these RN students report not only a change in personal attitudes, but an integration and application of their knowledge in their own professional practice. They act as educators to their peers and colleagues while reshaping their own practice in light of their newly acquired sensitivity. By creatively using the nursing curriculum, educators can prepare nurses to deal with many of the social ills affecting individuals, families, and groups. In so doing, they encourage nurses to step into the forefront of health care. They invite nursing practitioners to become proactive rather than reactive. Ultimately, such curriculum creativity will ensure that clients currently ignored or unrecognized by the health care system are identified and treated in a caring fashion by the profession that prides itself on its ability to care.

Circadian dysregulation in abused individuals: a proposed theoretical model for practice and research.

Trauma in the form of physical and sexual abuse remains a major issue confronting health professionals and society today. Despite the identification of large numbers of children at risk, no studies exist on the association between childhood abuse and the development of acute and long-term disruption of sleep/wake patterns. Furthermore, identification of the most effective nursing interventions to restore healthy sleep rhythms is sorely lacking. As a basic human process, sleep follows a circadian pattern, effecting sleep onset and stages. This article explores a possible model to link the sleep disruption seen in abuse children with circadian and rhythmic theories.

Managing angry feelings: teaching troubled children to cope.

Children who have a history of physical and emotional abuse present special problems to nurses who attempt to teach them more effective ways of dealing with anger. Since the adults in abused children's lives have not modeled constructive conflict resolution, the social and cultural learning about aggression in such children frequently has been inadequate. The author asserts that because nurses are in close contact with the children and can observe patterns of behavior during their regular daily activities, hospitalization may prove the ideal situation to teach such children appropriate social and assertiveness skills.

Maladaptive mother-child relationships: a pilot study.

The primary purposes of this pilot study were to identify maternal psychosocial correlates of unrealistic expectations of children and of child abuse potential, and to investigate the relationships of these factors with child behavior. A cross-sectional, two-group design was used. One group consisted of 20 low-income mothers whose preschool children were referred to a family care center for suspected abuse or neglect. A comparison group was made up to 20 low-income mothers whose children attended a university-based pediatric clinic and who were not referred for abuse or neglect. Data were collected during structured in-home interviews with the mothers. Measures of parental bonding, maternal depressive symptoms, unrealistic expectations of children, child abuse potential, and child behavior were obtained. Preschool teachers of the children also rated the children's behavior. Mothers with high depressive symptoms reported more unrealistic expectations of children and had greater child abuse potential scores than those with fewer symptoms. The more child behavior problems mothers reported, the greater their unrealistic expectations of the children and the higher their score for child abuse potential. Maternal depressive symptoms were not directly related to child behavior. Teacher reports of child behavior were moderately correlated with maternal reports, but no study variable was associated with teacher reports.

Prenatal screening for illegal drugs. Dilemma for the nurse-midwife.

Prenatal screening for illegal drugs poses very complex ethical problems for the nurse-midwife who must make the decision whether to screen for illegal drugs and whether to report positive results to state child abuse investigators. We argue that the results of prenatal screening for illegal drug use should not be used for determination of child abuse and that the nurse-midwife should not be required to report the results of these screens for illegal drugs to state child protection agencies. It is far from clear that required reporting offers any benefit to the fetus or future child, and there are serious ramifications of reporting for the fetus, the pregnant woman, and the nurse-midwifery profession. However, we do argue that prenatal screening for both illegal and legal drug use should be encouraged and should be done as early as possible in the pregnancy. Prenatal screening for drugs should only be used by the nurse-midwife as a diagnostic procedure wherein standard informed consent and confidentiality restraints are maintained.

Caring for abused children in the emergency department.

The destructive behaviors of child abuse affect children, families, and health care professionals. It is imperative to develop mechanisms for evaluating systems to guarantee optimal holistic care. The suggested methodologies include chart audits, peer review, case conferences, and community outreach programs. These mechanisms will establish a definitive feedback loop to ensure optimal case management and ongoing improvement related to child protection issues.

Rol del enfermero especialista en salud mental en los programas de prevencion del maltrato fisico y psicologico al menor por parte de padres y adultos / Rol of nurse specialist in mental health in programs of prevention of child physical and psychological abuse by parents and adults

Con el proposito de establecer las funciones del enfermero especialista en salud mental en la prevencion del maltrato al menor se establecio un flujograma de actividades para el profesional de enfermeria en educacion, asistencia administracion e investigacion tanto a nivel institucional como de la comunidad. Se recomienda implementar este perfil ocupacional para verificar su viabilidad en la practica..