Recently we had a respite placement at our house. He ran through the living room and slipped on the wood floors bumping his head. We went to have lunch and he complained that his head hurt and he wanted to lie down. Heart palpitation began for me. What you wouldn't think twice about with your birth or adopted children, a scrape on the knee or bruised elbow, quickly becomes a game of "What If?" in the foster parents mind.
What if their is some major hidden injury behind this minor one and I don't take him to the ER? A bump on the head leads to a concussion or a bruised elbow becomes a fractured one in your mind.
What if the child makes a false allegation or doesn't answer questions in just the right way to explain the injury to others?
What if the birth parent sees the injury and makes a false allegation?
What if the school, doctor, case worker, sees the injury and hot lines it in?
These are not paranoid thoughts, many foster parents have been in these exact situations. Its amazing how quickly something can spin out of control in "the system". Its not even just your foster license or foster placement on the line, many situations trickle down and risk removal of your birth/adopted children as well during an investigation. So what should you do in the event of an injury?
First, follow any guidelines set out by your county or foster agency! If you have a manual be sure to check what it says as well as any verbal instructions you have received from your agency. Obviously, it is better to be safe than sorry, so if in doubt call the pediatrician or 911 and have the child seen immediately.
If it is a minor injury (bump, scrape, bruise, etc.) and you do not feel it needs any professional attention you will still want to document the injury to protect yourself. I use this form to document any injuries. (Edited to add: This form includes a spot for pictures, if you don't use this form I highly recommend you take a photo of any injury or even a photo showing there were no visible marks from the injury to have for your records or to send to caseworker). If there are any witnesses to the incident you may want to ask them to write an account of what happened as well, especially if the child is prone to false allegations, or at least include their contact information if a question arises.
I will place a copy in their foster care binder and then usually email a copy of it to the caseworker, especially if there will be a visit soon.
Depending on your relationship with the birth family you may want to communicate it directly with them as well. In some situations I have kept a Communication Log with the birth family in a journal that travels with the child for visits. I will often jot down in there if there as an injury, especially if it will be evident at a visit.
Any tips or thoughts on foster care injuries from your neck of the woods?
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