Exploring risk assessment in school nursing and safeguarding practice: A mixed methods study
School nurses in the UK have a unique position to recognise and respond to suspected abuse and neglect through their universal contact with the school population (HM Government, 2018) although a dearth of in-depth research exists to understand their role. The aim of this research study is to understand how school nurses identify and work with school children aged 5-19 years at risk of child abuse and neglect. Three research objectives informed the study; (1) to explore the processes through which school nurses identify school children aged 5-19 years at risk of child abuse and neglect (2) to explore how school nurses make assessments of school children aged 5-19 years at risk of child abuse and neglect, and the types of school nursing interventions offered to them, and (3) to explore the experiences of school nurses in identifying and working with school children aged 5-19 years at risk of child abuse and neglect: including the perceived challenges and opportunities of their role. A mixed-methods approach was taken to the study, underpinned by the epistemological stance of pragmatism (Creswell and Plano Clark, 2007; Teddlie and Tashakkori, 2009). A sequential design was conducted in two stages; Stage One explored the context of school nursing caseloads and appointments with children and young people using secondary data from electronic diaries and caseloads, and Stage Two explored in-depth the experiences of school nurses through semi-structured interviews, informed by a constructivist Grounded Theory approach (Charmaz, 2014). A process model of risk assessment in school nursing practice, developed from the findings of this study, is presented in three key stages; ‘becoming aware of safeguarding concerns’, ‘detective work’ and ‘managing risk’. Key concepts of risk, trust and communication are explored, which form the foundations of a school nursing safety net of care for vulnerable children and young people who may otherwise fall through the gaps of current service provision. Much greater clarity is needed at a local and national level as to the remit of school nurses in safeguarding and child protection. School nurses are expected to operate at any given point along the spectrum of preventative to reactive care; they must not only be regarded as an expanding catch-all service in this way, but rather a speciality with focus.
Networked Digital Library of Theses and Dissertations