Foster Care 101: Child Protective Services Aren’t The Enemy

There’s a common refrain among parents that their kids cannot have another injury, “because the hospital is just going to call CPS.” I’m not sure where the rumor got started, but we all assume that one too many slips off the jungle gym will land your family with in-home visits. It’s often said as a joke. But that doesn’t stop a parent’s fear every time their child gets hurt that someone might assume they’re an unfit guardian.

I’ve been there, marveling at the bruises my daughter had on her legs, and slightly embarrassed that anyone might see them. I didn’t want people to think that I didn’t look out for my little girl. After all, how on earth was she getting these marks? What wasn’t I protecting her from? This innocent fear can lead to flat-out panic if you have to visit an emergency room or doctor. No parent wants their child to get hurt, and the fact that happens at all can make adults inherently guilty and defensive.

These are the exact type of adults that my good friend “Lynn” gets to deal with on a day-to-day basis. She’s a social worker in our local hospital, and it’s her job to assess incoming patients and their families to see if they’re going to need any assistance or if Child Protective Services should be contacted. That’s right, Lynn is the woman we’re all afraid of when we walk into the hospital with an injured child. So I decided to ask her just how she makes those tough calls, how she works with families and what parents should know about social workers and the job they’re trying to do.

Obviously, I had to start how with the question on the forefront of every parent’s mind, “How do you know there’s a problem?” As with most matters in life, the answer is pretty complicated. Moms of accident-prone children can breathe a sigh of relief though, because it’s really not the number of trips to the ER that makes the greatest impact. “Listen, we’re realistic. I have three kids,” Lynn reminded me. “My four year old recently attempted flying off the top of our stairs. We all know accidents happen. But there is a list of specific injuries that automatically necessitate a call to CPS.” In these cases, every ER and social worker in the country has to respond the same way. Certain types of bone breaks, like spiral fractures, are an automatic warning sign. Also, any and all skull fractures must be reported.

“It doesn’t matter if the mom tripped and fell down the stairs and you can see her bumps and bruises as well. In those situations, we have no choice. But we try to be as gentle as possible.” Much in the same way that every gunshot wound, whether it was accidental or not, needs to be reported to the police, social workers have an obligation to report injuries on this specific list. Then, their job is to help the families and child protective services sort out what happened.

Beyond that basic list of problems to watch out, hospital social workers have a host of other ways to determine if a particularly family needs further assistance or investigation.

“Sometimes, the parents are the ones who come in sick or injured. It could be as simple as a single mom with a complicated pregnancy who has no back-up care for her older children. This woman needs time to recuperate, but she’s afraid of what will happen to her kids. We can send the kids to a short-term foster home while their mom recovers from a C-Section and bonds with her new infant.” Honestly, I had no idea this service was even available. It has nothing to do with CPS and doesn’t stay on a family’s record in child services. It simply gives the parents the time they need to recover and resume taking care of their family.

Children who need extensive care and medical attention are often those on a social workers radar. These kids normally have reams of paperwork showing how their parents have been working to help them. But the lack of that backround information with kids who have special needs and developmental delays is another way for social workers to notice a problem.

“So something as simple as having all my well-baby check-ups would help you see that we’re invested in our child’s health?” “Definitely,” my friend assured me. “The issues we get worried about are normally from parents who ignore special needs kids and their care. People who literally hurt their children more by refusing to see doctors or specialists. In our city at least, there is free care that comes straight to your door. We try to make it as easy as possible for parents to help their special needs kids, but if they aren’t making any effort, that’s another indicator of possible problems.”

And the final, most noticeable predictor of a scary situation? It’s as simple as your attitude. Most parents are frantic and stressed with concern when their child is hurt. “It’s really upsetting to watch someone berate and blame their child for being sick though,” Lynn tells me. She often sees parents who seem annoyed or angry that they’re put in the position of coming to the hospital at all. These are often the situations that social workers will look into first. They’ll start digging in the history and looking for problems.

“We look at the story of the accident and if it’s consistent with the injuries we see. And also, the timeline. Did you wait a day before bringing your child in?” Oddly enough, many people’s stories change as the time spent at the hospital increases. The more questions doctors or nurses ask, the more parents will adapt to make the injury fit. Inconsistency is always a red flag for a problem.

As parents, it’s easy to be offended when we think a social worker is casting doubts about our parenting abilities. After all, no one would enjoy having to defend themselves and the way they care for their children. But we should all remember that social workers have a job to do. And that job is to protect children.

“We have to make a gut decision in a very short amount of time. We can only help when the child is front of us. It’s not a perfect system, but someone has to make that call.” I could see the pain in my friend’s face as she talked about the abused children she sees. And I can’t imagine that it’s easy to keep your composure or your objectiveness when an injured child is in front of you.

Lynn once has to deal with a four month old infant who had multiple skull fractures to his head. In his four short months, his skull had been fractured four different times, evident because the wounds were healing at different levels. The child had been beaten so severely that it’s retina were detached. He would never be able to see again. And doctors were worried he might not live.

“Looking at that family, I was supposed to have compassion. But I also knew that someone had done this to a child. It was almost impossible not to be angry, not to want to keep them away from the little boy to make sure he wasn’t hurt again.” In this situation, the father later admitted to beating his child, but the mother had no idea what was going on.

“Sometimes, we make mistakes,” Lynn told me. “That woman didn’t know what was happening to her son and she was scared. My job was to help her. But at the same time, I’ve seen so many infants permanently injured or killed, my first instinct is to protect the child.” The balance needed to both serve the parent while also weighing the best interests of the kids is a delicate one. And social workers are only human. Some days, they might not make the perfect choice.

How does she cope with the pressure? “Well, after days like the one with that four month old… I go home and wake up my three kids at 11 o’clock at night. I kiss them, tell them how much I love them and how important they are to me. Then, I pray they go back to bed.” [tagbox tag=”child abuse”]

Social work isn’t easy. It’s not a group of bad guys swooping in to take your kids after one too much broken bones. It’s caring professionals who are doing their best to serve kids in danger. And even on their best day, they can only help those children who have made it in to the emergency room, or kids whose teachers and family members have reported a problem.

For all the highly-publicized stories of what happens when social workers miss something, or even if they over-react, there are millions of children who end up in safer homes because these professionals step in and make the tough call. I suppose social workers should be thought of as more than the bad guy. We all should be thankful that they’re helping keep kids safe, in whatever way they can.

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