{"id":31856,"date":"2020-12-16T19:43:21","date_gmt":"2020-12-16T19:43:21","guid":{"rendered":"https:\/\/caseyfamilyv2.wpengine.com\/public-health-nurses\/"},"modified":"2026-05-13T19:57:33","modified_gmt":"2026-05-13T19:57:33","slug":"enfermeras-de-salud-publica","status":"publish","type":"post","link":"https:\/\/www.casey.org\/es\/public-health-nurses\/","title":{"rendered":"\u00bfC\u00f3mo ayudan las enfermeras de salud p\u00fablica en las investigaciones sobre protecci\u00f3n de menores?"},"content":{"rendered":"
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On an initial visit with a family, a child protective services (CPS) caseworker notes that a young child in the home has asthma and asks whether the parents have medication on hand to treat it. They do. Upon review of the family\u2019s medical records, however, a public health nurse (PHN) working with CPS notices an increasing frequency of urgent care visits for the child. The PHN accompanies the caseworker on a return visit. She assesses whether the medication on hand is the correct type and dosage, and asks the mother to demonstrate how it is administered. She explains that the medication being used for acute attacks is actually a preventive medicine that needs to be taken regularly to control the condition. The mother is grateful for the information, saying, \u201cIf you hadn\u2019t told me, I never would have known! We would have landed in the E.R. again.\u201d<\/p>\n

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On another day, the PHN and CPS caseworker visit a family with an infant who recently suffered a skull fracture. While the CPS caseworker checks on the other children in the home, the PHN reviews the scene of the accident. She notices that, despite the parent\u2019s claim that the injury occurred when the infant fell off the bed, the bed is only 12 inches off the ground and the floor is carpeted. She shares these details with the CPS caseworker and together they communicate with the county\u2019s child abuse pediatrician, who confirms that the parent\u2019s explanation is not plausible and supports the recommendation to substantiate abuse and take steps to protect the child from future harm.<\/p>\n

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As these real-life examples illustrate, a CPS caseworker working alone may not have the expertise needed to accurately assess all aspects of child and family functioning, including normal child development and chronic medical conditions. The need for a multi-disciplinary approach is also particularly acute for children who are most vulnerable, including infants and those with special medical and developmental needs.<\/p>\n

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In some jurisdictions, public health nurses are utilized to provide this kind of teaming support to caseworkers during investigations. In addition to having medical training, nurses are highly trusted. Families often are more willing to open up about health and well-being challenges with a nurse than a CPS caseworker. The additional information they provide can be invaluable, both to ensure an accurate investigation and to promote the child\u2019s future health and well-being.Beyond investigations, child welfare agencies partner with public health nurses and agencies to play a number of other roles, including monitoring special medical needs, providing care coordination for complex cases, supporting the well-being of children and youth in foster care, and supporting families to prevent out-of-home placement.<\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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There\u2019s something magical about being a nurse. Parents and children will share things with nurses that they won\u2019t share with anyone else.<\/p>\n<\/blockquote>\n

— Sherry Rumsey, Division Administrator for Medical Services, Texas Department of Family and Protective Services<\/cite><\/figcaption>\n <\/div>\n\n <\/div>\n<\/figure>\n\n\n
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Key considerations<\/h2>\n \n \n \n

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The ways CPS agencies in different states and counties use PHNs vary greatly.1<\/sup><\/a> However, officials from several agencies noted that the demand for nursing services, once made available, grows quickly so it is important to set clear parameters around the services that nurses are (and are not) able to provide. Some parameters may be determined by licensing restrictions (for example, PHNs may not be licensed to provide direct medical care to children, the types of care they can offer may be limited, or their role may be consultative in nature). Other parameters, such as a triage system, may be necessary due to high demand.<\/p>\n

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Engaging PHNs for investigations requires agencies to make a number of key decisions, including the following:<\/p>\n

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Which cases require PHN involvement?<\/b><\/span> In some jurisdictions, consultation with a PHN is left to caseworker discretion. In others, caseworker staff are required to consult with a nurse under certain circumstances. These might include a child\u2019s known or suspected serious medical condition (for example, asthma, diabetes, or seizures), failure to thrive, allegations of severe neglect, allegations of physical abuse, known or suspected developmental delays, hospitalization for any reason, or drug-exposed infants. Some jurisdictions also take the child\u2019s age into account, prioritizing cases involving infants or children under 3, for example.\u00a0<\/span><\/p>\n

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Who is the focus of the PHN\u2019s assessment?<\/b> <\/span>In some jurisdictions, the focus of the assessment is only on the child or children listed as the subject of a report; in others, PHNs assess the health and well-being of all children in the home (and sometimes the adults).<\/p>\n

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What services will the PHN provide?<\/b> <\/span>PHNs employed for investigative teaming are responsible for some or all of the following tasks, depending on the jurisdiction:<\/p>\n