Introduction
Safeguarding children in adult wards especially when they visit these wards has become one of the key demands in healthcare service delivery. Children are generally defenseless and may be subjected to variety of abuses which may include neglect of basic and psychological needs, sexual abuse, emotional maltreatment and physical harm in adult wards. Rothschild (2009, p. 180) indicates that there are three important concerns that point towards neglect of children in adult wards. These include failure by professionals to listen to children, lack of necessary training and adequate support for healthcare staff, and lastly poor sharing of information and ineffective communication between agencies concerned and health professionals. Safeguarding the welfare of children in wards is a priority that requires setting up of policies and support from communities, organizations and health agencies across faith, private, voluntary and statutory sectors.
Discussion and risk factors
Rafieian and Hosier (2011, p. 90) define the term safeguarding as a precautionary measure against an emergency, injury or impending danger. Protecting children and adults from emotional and physical harm has become an important aspect in healthcare service provision. Reports indicate that there are several vulnerable children in healthcare centers who are being treated together with adults in wards meant for adults with mental health problems (Wilson & James 2007, pp.56). These children may be subjected to series of abuses which may include neglect of psychological or basic physical needs, sexual assault as well as physical and emotional abuses. There is need for adequate waiting area and well defined policies for safety of children.
Nursing has become a very central factor in defining and fostering primary and secondary healthcare at all levels of the society (American Psychiatric Association 2006, p. 24). Besides, it is a profession that has greatly been shaped by historical orientation of communication, focus and differentiation in terms of service delivery. The mode used to conduct nursing care dictates the success or failure when safeguarding patients. In childcare services, nurses have been keen in observing the code of conduct. It is imperative to mention that the Nursing and Midwifery Council (NMC) spells the responsibilities and duties of nurses towards protecting children at risk of being harmed. However, as significant as this requirement may be, there are several children with disabilities and mental problems who still find themselves in adult wards and are faced with high risks of abuse (Mason 2000, p. 1297). This leaves one to wonder whether enough has been done to protect children and if the current policies against this practice are effective as intended. The staff members should also be assessed on whether they are suitable to work with children admitted in wards.
Is the care good or bad?
Mental health problems pose some of the greatest concerns in a healthcare setting today due to the extended effects to individuals, patients and the entire nursing practice. This has been the scenario following the extreme cases exhibited by adults, children and adolescents in terms of mental disability that affects their patterns of behaviour. Pihl (2010, p.41) indicates that mental health is a crucial determining factor of an individual’s overall state of well-being. The state of individuals in a mental ward brings into picture the impending problems that may be experienced by children admitted in adult mental health wards. The standard of care offered to the children should also be assessed in terms of suitability.
According to Sar et al. (2009, p. 40), the role of any healthcare facility is based on the need to offer protection for its population in a manner that propels growth and development. Mixing adults and children in an adult ward should be seen as a major source of harm to the defenseless patients. Though it might be argued that nurses and other health workers on duty might offer enough protection to the young patients, Makeig (2000, p. 208) insists that separation of the mentally handicapped young and old patients is critical in ensuring reduced negative affects to the children. Researchers agree that most of the mentally challenged individuals have highly reduced abilities to determine the right things to do and at what time (Janicijevic 2010, p.85). This has been linked to their erratic behavior which culminates into great outcry in the community especially on the issue of children sharing wards with adults.
What are the learning needs and how can these be addressed?
It is critical to mention that safeguarding children at all levels of healthcare service provision should be an on-going practice. Governments and healthcare institutions ought to set up policies which aim at ensuring that children are provided with efficient health services that care for their rights and protection (Wilson & James 2007, p.56). From an ethical point of view, analysts have indicated their concerns in the practice of admitting children in adult wards. One of the key measures that are used today springs from the Children’s Act of 2004 which offers a legislative framework that protects the rights and freedoms of children. Another learning need should be the code of conduct that ought to be adopted by Nursing and Midwifery Council (NMC). In addition, effective communication and elaborate healthcare programs should be part of the learning needs among healthcare practitioners offering care to children. The new elements of healthcare delivery should be enhanced so as to reach out people who have special needs that demand to be examined.
Conclusion
In summing up, it is vital to reiterate that safeguarding children is a process that has increasingly come to be appreciated in the modern world. This implies that children ought to be protected from any kind of harm. Ensuring the protection of the young ones when they share wards with adults has however led to major dilemmas between the supporters of the processes and its opponents. In mental health wards, children are susceptible to physical or emotional harm from adults and may even be neglected by nurses. As such, healthcare facilities must focus on developing policies and defining strategies which aim at keeping children separately from adults. It is essential that the pertinent issues like the need to guarantee children safety and nursing care are addressed in order to ensure strong ethical considerations of the entire nursing practice.
References
American Psychiatric Association 2006, Diagnostic and Statistical Manual of Mental Disorders DSM-IV TR (Text Revision), American Psychiatric Publishing, Inc,.Arlington, VA.
Forzano, L, Michels, J, Carapella, R, Conway, P & Chelonis, J 2011, ‘Self-control animpulsivity in children: multiple behavioral measures’, The Psychological Record, vol. 61 no 3, pp. 425-448.
Janicijevic, N 2010, ‘Business processes in organizational diagnosis’, Management Journal of Contemporary Management Issues, vol. 15 no.2, pp. 85-106.
Makeig, S 2000, “A natural basis for efficient brain-actuated control’, IEEE Trans Rehabil Eng., vol. 8 no. 2, pp. 208-211.
Mason, S 2000, ‘A brain-controlled switch for asynchronous control applications,’ IEEE Trans Biomed Eng., vol. 47 no. 10, pp. 1297-1307.
Pihl, R 2010, ‘Mental disorders are brain disorders: you think?’ Canadian Psychology, vol. 51 no 1, pp. 40-49.
Rafieian, S & Hosier, S 2011, ‘Dissociative experiences in health and disease’, Human Architecture, vol. 9 no. 1, pp. 89-109.
Rothschild, D 2009, ‘On becoming one-self: reflections on the concept of integration as seen through a case of dissociative identity disorder’, Psychoanalytic Dialogues, vol. 19 no. 2, pp. 175-187.
Sar, V, Taycan, O, Bolat, N, Özmen, M, Duran, A, Öztürk, E & Ertem-vehid, H 2009, ‘Childhood trauma and dissociation in schizophrenia’, Psychopathology vol. 43 no. 1, pp. 33-40.
Wilson, K, & James AL 2007, The child protection handbook: the practitioner’s guide to safeguarding children, Elsevier Ltd, Philadelphia, PA.