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Child Abuse Risk Up During COVID: What Pediatric Nurses Can Do

The COVID-19 pandemic has created an environment that no one could have expected. Government mandated stay-at-home orders cut access to public venues, restaurants, schools and offices, which led to millions of American losing their jobs and an increase in families’ isolation. 

At the end of April 2020, just six weeks after the pandemic began, a reported 20.6 million U.S. jobs had been lost, resulting in a staggering unemployment rate of 14.7 percent. More recently, in March 2021, the Bureau of Labor Statistics reported that the unemployment rate has dropped to 6.0 percent, with 9.7 million still unemployed. 

Even as states begin to relax restrictions in 2021, many parents may still feel stuck at home: searching for work, seeking help to provide for their families and/or overseeing distance learning for their kids—all without their typical support groups like church, daycare, organized sports and extended family.

Unfortunately, the financial strain of unemployment and other pandemic-related stressors may lead to additional problems. An April 2020 article for the American Psychological Association highlighted research by psychologist Josie Serrata, PhD, which found the stress and isolation caused by Hurricane Harvey raised the risk of domestic violence and child abuse. And the national COVID-19 crisis has many similarities.

“We found social factors that put people more at risk for violence are reduced access to resources, increased stress due to job loss or strained finances, and disconnection from social support systems,” Serrata said. “With this pandemic, we’re seeing similar things happen, which unfortunately leads to circumstances that can foster violence.”

So what can nurses do?

Pediatric travel nurses and other healthcare professionals care about their patients, and have an obligation to report when they suspect a child is being mistreated or neglected at home. Here are a few ways you can identify child maltreatment and help get a child to safety.

Recognize The Red Flags of Child Abuse

Pediatric travel nurses should be on the lookout for any signs of sexual, physical, emotional and neglectful abuse when a child comes in for their checkup or treatment. In a continuing education article for Lippincott Nursing Center, Amanda Perkins, MSN, RN, noted that the these red flags may include:

  • Injuries – burns, bruises, dislocations, welts, injuries that follow the shape of an object
  • Sexual abnormalities – redness and swelling of genitalia, difficulty walking or sitting comfortably, sexually transmitted infections, enuresis, recurrent urinary tract infections
  • Scars and healing injuries from lacerations, abrasions, bruises and cut marks, including potential suicide attempts


Recognizing these marks and injuries could be the first step in getting a child the help he or she needs. If you do find that a child you are treating is experiencing abuse, contact social services immediately, or talk to a supervisor about the proper reporting procedures in your assignment facility.

Ask Questions, Listen Carefully and Observe

There are also more subtle signs of abuse that a nurse can uncover through asking questions, speaking with the child, listening attentively to what they’re saying, monitoring their actions, and observing their family dynamic. 

Perkins noted a few factors that could indicate a greater risk for child abuse: 

  • Parent dynamics – lack of knowledge of child development and care, insufficient income to support child, substance abuse, unbalanced family relationships, or single parenting;
  • The child’s behavior – fear of going home, wariness of adults or caregivers, difficulty with peer relationships, sudden changes in behavior, running away from home, suicide attempt;
  • Signs of neglect – inappropriate clothing for time of year, poor hygiene, hunger, poor growth patterns, developmental delays, lack of supervision.


It is important to note that just because a child is experiencing one of two of the above factors it does not mean that they are being abused. If you suspect something is wrong, ask the child questions and listen for other identifiers. Or bring in physicians or other providers for a second opinion. 

You can never be too safe. Your awareness, followed by appropriate action, may be able to save a child from harm—or get a family the help they need.

Why Nurses Need to Get Involved

In addition to the potential for physical injuries, there are many long-term complications associated with child abuse, like anxiety, depression, cognitive disorders and criminal behavior. Nurses can play a vital role in stopping abuse by being alert, contacting their on-site nurse manager, and calling child protective services (CPS) and/or local law enforcement and submitting a written report when necessary.

No one wants to accuse an innocent parent of wrongdoing, but nurses can’t afford to ignore the potential signs of child abuse, either. In fact, nurses are mandated by law to make a report, in all 50 states and the District of Columbia. Each state has specific guidelines and information for mandated reporters as to what is deemed abuse or neglect and how and where to report. So if you are working a new state as a travel nurse, confirm the specific process with your facility.

Just because you’re making a report, however, it does not mean that you are making an accusation. You are simply requesting an investigation and assessment of the child and his or her home to ensure his/her well-being. And that simple act could mean a world of difference for that child.

Be a hero

Pediatric nurses—whether in a staff position or working as a travel nurse—play a critical role in a child’s life. Not only do they support a child’s health and wellness, but they also help them build good habits during their formative years which could help them live healthier lives. 

It may be hard to know exactly how the pandemic is affecting the number of child abuse cases, but a greater awareness by travel nurses and others can help put an end to it. And if that isn’t being a hero, then what is?

For more information:

How COVID-19 May Increase Domestic Violence and Child Abuse - APA

The Red Flags of Child Abuse – Lippincott Nursing Center

How Pediatric Nurses Can Better Detect Child Abuse


Want to care for kids in a new setting? Find current pediatric travel nurse jobs with Onward Healthcare.

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