Dealing with child abuse cases

[mrsbull]

This thread will be one that I am sure many will not post on, however it is a topic that as EMS we see. Hopefully not often but it is out there. Being a mother I have found this site a bit hard to deal with. This topic is about Child Abuse. I have recently found this website that tells stories (with articles to back them up) of the horrors children go thru.

My question is If you have had to deal with care for one (or more) of these types of things. How did you do it? Hopefully you were able to do your job and the child is well off. However I can understand it being hard to complete a task when emotions run so highly. This is the website. http://badbreeders.net/

There are some children who did not make it. Some who lived in Squalor, some who were so abused they will not ever have a normal life. What is your thoughts on this?? How do you cope?

Here is just one article that is inside this website. THIS WAS POSTED ON APRIL 4th.

ABUSE DEATH IN NEWTON KANSAS:

Here is the article http://www.kansas.com/2010/03/31/1249145/mother-of-newton-toddler-who-died.html?storylink=fbuser

Mother of Newton toddler who died is charged:

20-year-old Katheryn Nycole Dale and her 26-year-old penis, Chad Carr, have been arrested in Newton, KS for the abuse death of her son, 19-month-old Vincent Hill.

Among them were “terrible cuts” on the inside of the boy’s mouth, fingernails that had been ripped out, a leg that was twisted in an unnatural position, a fractured collar bone, and an eye swollen shut, Yoder said. Evidence shows that the injuries “didn’t just start recently,” he said.

To make matters worse the egg donor and the penis had only been together for 4 months. How does one go into this form of abuse in a span of four months. Or were they both child abusers before that?

Thanks to Cara for the tip.

Edited April 6, 2010 by mrsbull

[VentMedic]

You maintain your professionalism at all times.

We deal with this in the Peds ICU unfortunately too often. Until the "parents" are charged, convicted and put behind bars, you will have to exercise your own restraint by focusing on the child and maintaining your composure around the "grown-ups" even if you know in your heart they are guilty. If you allow yourself to be sucked down to their level, you may give grounds for a lesser charge or even a dismissal on some technicality as well as putting yourself into the spotlight and subject to an investigation. Thus, put the child first and allow the justice system a chance to do its job. Or, give the inmates at the jail or prison an opportunity to show their "love" for child abusers.

[emtannie]

I have unfortunately, dealt with child abuse cases as well.

The patient is your priority - you have to deal with them as best as you can. As Vent said, you HAVE to maintain your professionalism as best you can. NO making judgmental comments, or making any move that is anything less than absolutely professional. This can and is incredibly hard to do sometimes, as you just want to tell the "adults" exactly what you think.

Document, document, document - absolutely everything... from the state of the scene that you entered, to EVERYTHING about the patient's condition, to anything that was said or how the "adults" acted in your presence. Ensure that you follow your area's protocols for informing the triage nurse, doc, and law enforcement, and document that as well. Be prepared to go to court over these calls.

Sometimes they are hard to deal with, and you will be angry - your service should have people you can talk to about these calls, to vent your frustrations to. These calls are just part of the reason that we want to keep our skills and knowledge as sharp as possible - we always want to give the best care, but for some reason, those little ones who have been abused just tug at our emotions a little more.

[mrsbull]

You maintain your professionalism at all times.

We deal with this in the Peds ICU unfortunately too often. Until the "parents" are charged, convicted and put behind bars, you will have to exercise your own restraint by focusing on the child and maintaining your composure around the "grown-ups" even if you know in your heart they are guilty. If you allow yourself to be sucked down to their level, you may give grounds for a lesser charge or even a dismissal on some technicality as well as putting yourself into the spotlight and subject to an investigation. Thus, put the child first and allow the justice system a chance to do its job. Or, give the inmates at the jail or prison an opportunity to show their "love" for child abusers.

I agree maintaining professionalism is key. When I was doing my ED rotation during school a few years ago. I went to help a nurse triage 4 kids ages 3 or 4 - about 13. They were all drunk. No one knew where mom was and the kids looked like they belonged in the movie "Annie". The younger ones were found wondering the streets at 1 am. I think the oldest girl about 12 was sleeping with moms BF at the time. I was able to do my job with the children. The ED was busy that night so I was the one who sat with the kids while PD was there questioning them.

I think eventually they found mom.

However I will NEVER forget that. I did my job. Sometimes tho the legal system is not very good about holding ppl accountable. I just hope the ppl in the penal system read up on abusers and are "waiting" on them.

Sometimes I am glad we do not know the "outcome" but it would be nice to know the kids are ok. The ones who survive anyways.

[spenac]

Been there done that got the t-shirt. Best thing is not confront the parents or care givers. If they claim the obvious abuse is because of something else act as if you agree. If you argue they grab the child and leave before law enforcement arrives and child suffers. Learn to be a good actor. Get the child and get to hospital. Enforce your no rider policy and while en route to hospital notify police and hospital.

What hurts the most is when a child has been abused to the worst extent and no death is not the worst extent, then parents attend a short parenting class and get the child back. Then you get called and see the same things again.

[fireflymedic]

I try to maintain professionalism as best I can, but there are times that I am left going what snapped in your head? At a prior job I worked at (at this is public knowledge so I can safely post it) the partner I worked with one evening seemed a little off, but then again he was one of those people who always seemed a bit "off". I was scheduled to work with him the following evening, and while I was working two jobs, went on to a shift in another county considerably farther away. THat night when I came in, I was pissed because my partner was missing and assumed he walked off the job (a frequent occurance there unfortunately due to poor management and miserable pay). I started asking around and discovered he had killed his child the night before shortly after getting off work by strangling him with a thick rope chain (no not a ghetto chain - like a solid necklace) and killing the kid because he was "tired" of him. I couldn't process it then, and I certainly can't even now almost 10 years later. It's something I'll never forget. Sometimes you can't always read what people will do and there wasn't an individual thing that made him snap like most people say "the kid wouldn't stop crying" he simply said - I was tired of him...scary thought. THat is definitely someone that should not be allowed to further have children. We allow people with charges of animal cruelty to never have children again, but few have laws preventing those with child abuse to prevent them from having children. We have a problem, that we must address. THis can't keep happening, it's not fair to the children.

[mrsbull]

Annie I completely agree in Documentation!! It is the thing that will help the most. Not your "Personal Recollection" Even if/when that particular call stays in your head forever.

How have these cases affected you personally?

[Dustdevil]

Thread title changed to reflect content. "What would you do" is a specifically prohibited thread title in the rules.

I don't handle them any different than any other run, and they don't bother me in the least. If they bother you, you should leave the profession, because there is no way to change that.

Edited April 6, 2010 by Dustdevil

[mrsbull]

I try to maintain professionalism as best I can, but there are times that I am left going what snapped in your head? At a prior job I worked at (at this is public knowledge so I can safely post it) the partner I worked with one evening seemed a little off, but then again he was one of those people who always seemed a bit "off". I was scheduled to work with him the following evening, and while I was working two jobs, went on to a shift in another county considerably farther away. THat night when I came in, I was pissed because my partner was missing and assumed he walked off the job (a frequent occurance there unfortunately due to poor management and miserable pay). I started asking around and discovered he had killed his child the night before shortly after getting off work by strangling him with a thick rope chain (no not a ghetto chain - like a solid necklace) and killing the kid because he was "tired" of him. I couldn't process it then, and I certainly can't even now almost 10 years later. It's something I'll never forget. Sometimes you can't always read what people will do and there wasn't an individual thing that made him snap like most people say "the kid wouldn't stop crying" he simply said - I was tired of him...scary thought. THat is definitely someone that should not be allowed to further have children. We allow people with charges of animal cruelty to never have children again, but few have laws preventing those with child abuse to prevent them from having children. We have a problem, that we must address. THis can't keep happening, it's not fair to the children.

Wow that is something that had go to be hard to deal with. I get tired of my daughter whining,telling me she dosent want to go to bed, do her homework but I would NEVER hurt her. She is the one who keeps me laughing and keeps me going when I feel I cant anymore not the other way around. Makes me want to go hug my kiddo..

Thread title changed to reflect content. "What would you do" is a specifically prohibited thread title in the rules.

I don't handle them any different than any other run, and they don't bother me in the least. If they bother you, you should leave the profession, because there is no way to change that.

Oh alright Dust I suppose if you need to change the title then go ahead!

Personally I think bothering someone and letting it get to you are 2 different things. Absolutely things bother me I don't think "I" would be OK mentally if they didn't. But do I let it get to me to where I can't do my job? No. If it did then hell yea I would find a different job where I did not "see" it.

I understand where you are coming from but to be completely void of ANY emotion is something that personally I am not capable of. As a mother I suppose. Even if I had no kids I would still be bothered. Like I said if it gets to you and you can not differentiate your feelings or emotions and separate that from your job specially if you take it "home with you" then find another profession perhaps in social work.

But it does not mean it is not out there.

[emtannie]

Annie I completely agree in Documentation!! It is the thing that will help the most. Not your "Personal Recollection" Even if/when that particular call stays in your head forever.

How have these cases affected you personally?

Certain calls do stay in your head. The very first call I went on in my career was a domestic dispute - no serious injuries, but I think I remember that one for two reasons a) my first call, and the entertainment value (long story).

I don't think the child abuse cases that I have dealt with have truly affected me personally... I am who I am, and I do my best, and sometimes we see things that just are not nice or pretty. That is part of our job. Yeah, there are days I think there should be an exam and large fee to be able to have children, so that we can screen parents (for those who want to bash this, please insert sarcasm here). There are people in this world who are just evil, who have mental health issues, who have problems I can't begin to understand. I can't cure the world, but I can do what I can in my small corner of it, and that is to do my job to the best of my ability.

Sometimes, some calls affect you more, and you have to be aware of that. The first "old lady with abdominal pain" call I had after my mom died was a little stressful for me. Did I let it affect my professionalism or my care? No. Was I worried that my personal feelings might have affected care? Yes. What did I do about it? I discussed the call with my partner after, and asked if he had seen anything I might have done differently because I was still mourning the loss of my mom. He said he thought I handled that call with the same care and efficiency I had any other call. If calls are affecting your performance, you have to look at whether you are effective in the field, or a hindrance. If you are a hindrance, you better get off the car until you can be sure that you have dealt with your own demons.