Report on Progress of Professional Portfolio

Competency
Number, Letter
and Category

Major Competency: L
Pediatrics L-1-5
Demonstrate knowledge and ability to identify, manage and report signs
and symptoms of abuse of pediatric clients according to agency policies.

One Significant
Learning
Experience in
This Course
Related to
CLPNA
Competency.
Provide an
Example

Abuse can come in many forms, and can be physical, emotional, sexual,
as well as neglect. Abuse is everywhere and is something that should be
taken very seriously. In my work, I have not yet had to deal with a
situation that involved child abuse. However, through learning the signs
and symptoms in theory through this course, I will have the theoretical
knowledge to help me to identify child abuse when I am presented with
a situation involving it in the future.
Aspects of learning in regards to abuse, which will especially help me in
my future career, is that abuse does not always have evident symptoms,
and must be assessed beyond bruises and scars. It can be psychological,
resulting in the child to be withdrawn, fearful and possibly displaying
abnormal behaviours, or even resulting in decreases level of
consciousness. An example would be, the child becoming fearful or
shying away whenever the caregiver enters the room, or playing with
dolls in a sexual manner, beyond what they should know (anatomically
correct male doll forcing penis into female dolls mouth). (Maternal
Child Nursing Care in Canada, pp. 1072-1078, 2013).
I have also learned how to deal with the situation, which is talking to the
child separately so that they do not feel fearful or pressured by the
caregiver. It is also important to evaluate the childs developmental
level, in order to identify the best way of addressing the situation and the
child. The child must feel safe and that they are able to trust you. The
issue must then be reported following the hospitals guidelines and
procedures, to prevent further abuse from occurring. The nurse who has
examined and reported may be asked to testify if the case goes to court.
(Maternal Child Nursing Care in Canada, pp. 1072-1078, 2013).

What I Learned
and How It
Relates to the
Competency, and
Why It is
Meaningful

Through this course, Ive learned the signs and symptoms of abuse, and
how to identify and report them. Signs of abuse may consist of bruises,
broken bones, decreased consciousness, emotional withdrawal, signs of
malnourishment, unusual fearfulness, failure to thrive, etc. (Maternal
Child Nursing Care in Canada, pp. 1077, 2013). Some forms of abuse
may be more difficult to identify than others. For example, physical
abuse, such as Munchausen Syndrome by proxy, or Shaken Baby
Syndrome, may not have very evident indications. Munchausen

Proficiency
Rating and What
Ive Done to
Achieve This
How I Will Apply
This Learning in
My Current and
Future Nursing
Practice

Syndrome by proxy is when the caregiver/guardian induces symptoms

so that the child has to undergo unnecessary treatments and or tests, sat
may be painful (Maternal Child Nursing Care in Canada, pp. 1072-1073,
2013). This can be difficult to detect as the symptoms may initially
appear as an illness, when in reality, it is actually the caregiver causing
these symptoms to arrive. Shaken Baby Syndrome can also be a difficult
form of abuse to identify, as you may have to go by cognitive symptoms
(such as decrease level of consciousness), instead of evident physical
abuse signs such as bruises and broken bones.
Confronting abuse is also difficult. The child needs to feel safe and
secure and be addressed alone, so that they do not feel fearful due to the
potential abuser being present. Confrontation and evaluation is also
determined by the childs developmental level. It is important to ensure
that the child is removed from the abusive environment and situation, to
prevent further harm. This is done through reporting the incident. A
nurse who has examined the child and reported the issue, may be
required to go to court to testify. (Maternal Child Nursing Care in
Canada, pp. 1078, 2013).
I would rate myself as fair in regards to this competency. I understand
the competency in theory, as I have studied it, yet am unable to gage my
ability to apply it in an authentic nursing scenario, as I have never been
confronted with this form of situation.
Abuse is everywhere. I know at some point in my work, I will be faced
with a circumstance where a child has had to endure child abuse.
Knowing how to identify and report abuse will be crucial when these
situations are presented, especially since the signs and symptoms are not
always very prominent. Although I plan on furthering my nursing career,
once I initially begin working as a practical nurse, I will probably begin
working partially in an acute unit, as well as in emergency. In
emergency is where I will initially be confronted with these situations,
when children are brought in. Although I currently have no actual
clinical experience pertaining to child abuse, my knowledge of the signs
and symptoms will help me in the future to identify them, and
potentially save a child from further harm.

Student Name: Beverly McGuckin

Course: NFDN 2005
Date: December 27, 2016
Instructor: Cathy MacDonald