Identifying risk Ms Moran stresses that the process after the death of a child is not about apportioning blame. ‘It is about trying to improve things, learn things, and to identify risks to the general public.’ As she says, child death is rare – but not for professionals tasked with reviewing all child deaths: they are in a position to detect trends. Something that appears inconsequential to someone who rarely encounters child death may, in fact, be part of a pattern. The job presents practical challenges. By definition, it is unpredictable, which can make planning difficult. But of course it carries huge emotional strain, too. ‘Mostly,’ says Ms Moran, ‘you’re a professional, you can manage it.’ Sometimes, however, reviewing a case and reading the notes is ‘like reading a book where you know the ending – and it’s very, very distressing’. Supervision and peer support help, and she has clear boundaries between her professional and personal life. ‘As a nurse manager I used to take a lot of work home. But with this role you can’t blur the boundaries. You’ve got to cut off.’ Daniel Allen is a freelance writer

Care system must do more to protect girls from mutilation Guidance urges nurses to view female genital mutilation as child abuse and to honour their safeguarding obligations. Nick Triggle reports SCHOOL NURSES and health visitors have a crucial role to play in tackling female genital mutilation (FGM), according to a new report. Produced by several royal colleges and trade unions, the report says there needs to be greater awareness about the issue and willingness to address it. Among its recommendations are that FGM should be treated as a form of child abuse and, as such, lead to referrals to social services and the police, and that agencies should be doing more to identify children at risk, including the sharing of information across sectors. The nine recommendations are: ■■ Treat female genital mutilation as child abuse. ■■ Document and collect information. ■■ Share that information systematically. ■■ Empower front line professionals. ■■ Identify girls at risk and refer them on. ■■ Report cases of FGM. ■■ Hold front line professionals accountable. ■■ Empower and support those affected. ■■ There should be a government public awareness campaign. Legislation The report contains a reminder that there has been specific legislation in the UK banning FGM since 1985. The law has subsequently been updated to cover people who take girls abroad for the procedure. Offenders face prison sentences of up to 14 years. As yet no criminal prosecutions have been brought. However, former director of public prosecutions Keir Starmer QC, writing in a foreword to the guidelines, said that it was ‘only a matter of time before this happens’. FGM is estimated to have affected at least 66,000 women in the UK – but this is a conservative estimate. A helpline set up by the

Nick Savage/Alamy Live News

unexpected death or the child has cancer or a life-limiting condition, the parents are still not prepared – it’s the most horrendous thing that can happen to them. Parents have a varying range of responses but they must be central to all this – they are the people who probably know most about the child.’ Supporting the family has to be balanced with eliciting any information from them that could help to protect children in the future. Small things can make a difference. Ms Moran gives the example of parents worried about their child and who tried to get health advice over the telephone from staff already involved in giving care. ‘In some cases it was hard for parents to get through to specialist support services and in others the messages did not give specific enough advice about how and where parents could get help,’ she explains. As a result services reviewed their systems so that parents could get through and receive clear advice from an answerphone message.

Protest groups rallied in London’s Parliament Square in October before lobbying MPs over women’s rights

charity the National Society for the Prevention of Cruelty to Children this year received more than 100 enquiries in its first three months, resulting in 38 referrals to the police. The report calls FGM a ‘hidden phenomenon’ because the taboo surrounding it means the practice goes on largely undetected and there is ‘growing consensus the system is failing to protect girls’. Children aged five to eight years are at highest risk, although the practice can happen at any time. Guidance in the report calls for girls to be referred to police and social services, and be given medical and psychological assessments. Where health and social care staff believe a child is at risk of FGM, it should trigger the existing child safeguarding obligations. ‘All health and social care professionals have a responsibility to do all they can to identify and prevent this abuse,’ says RCN director of nursing Janet Davies. Public health minister in England Jane Ellison agrees: ‘We have to safeguard girls from this form of child abuse and address the longer term health needs of those girls and women living with FGM.’ Nick Triggle is a freelance writer

Find out more Tackling FGM in the UK. NSPCC FGM helpline: +44 (0)800 028 3550. Email: [email protected]

NURSING CHILDREN AND YOUNG PEOPLE December 2013 | Volume 25 | Number 10 Downloaded from by ${individualUser.displayName} on Dec 07, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.


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