School nurses' operational modes and ways of collaborating in caring for child abusing families in Finland

The purpose of the study was to explicate and conceptualize school nurses' work and working methods while caring for child abusing families. Child abuse in the family refers to physical or psychological abuse, sexual abuse ol neglect by parents or other caregivers, Data were collected using semi-structured interviews with broad themes from Finnish school nurses (n = 20), School nurses were selected so that the sample represented a varied experience of school health services in various schools, differing in size, environment and number of pupils. Data were analysed by using qualitative content analysis. The analysis resulted in a description of school nurses' operational modes with child abusing families, These were the 'active and firm' mode and the 'passive and uninvolved' mode. In addition, the study describes school nurses' collaboration with other professionals working in school, mainly teachers. The primary goal of school nurses was to promote the child's well-being as effectively as possible, whereas caring for the whole family was of secondary importance. The difficulty in taking care of families with problems was shown in different operational modes, especially in 'passive' nurses. The results of the study can be used to plan and develop nursing education and the work of school nurses. Nurses need more knowledge about child abuse and working with families in school healthcare. It is important that nurses are trained to work with families who abuse their children.