How can we work together?' Nurses using relational skills to address child maltreatment in Australia: a qualitative study

Background: Nurses working with children often encounter child maltreatment. Nurses' roles in mandatory reporting are well-documented, but less is known about additional ways nurses respond to child maltreatment. This is important because children experiencing less extreme maltreatment may have unmet needs without receiving a child protection intervention. Objectives: This paper reports one key finding from a qualitative study exploring nurses' perceptions and experiences of keeping children safe from maltreatment. Specifically, it reports nurses' perspectives of their relational skills used to support children experiencing maltreatment. Design and methods: Qualitative inductive thematic analysis followed by a secondary analysis using a social constructionist framework. Data were collected through in-depth, semi-structured interviews and data saturation was achieved. Transcripts were inductively analysed with support of NVivo software. Participants: Registered nurses (n = 21) working with children in Australia. Results: Nurses saw relational practice as core to addressing child maltreatment. Key themes were: 1) 'Walking the line': relationships in the context of surveillance, 2) 'You are a good mum': focusing on the positives and 3) Seeing and being the voice of the child. Conclusions: Nurses are uniquely positioned to identify and respond to child maltreatment through relational practices. Nurses maintained therapeutic relationships with parents to ensure ongoing access to vulnerable children. Although nurses recognised the importance of a child-centred approach, its enactment was varied and required ongoing critical reflection. This highlights the importance of supporting nurses to develop, maintain and continually improve their relational practices to enhance outcomes for children.