Given the current burden on the national child welfare system, the article by Schneiderman, Askew and Reed (A clinical experience with foster families. Nurs Educat. 2002;27(4):178-181) was both timely and encouraging. The authors described the development of a clinical program to introduce student nurses to the role of public health nursing and its impact on children in foster care.

As illustrated by Schneiderman et al, a staggering number of children enter Child Protective Services. As a result of the abuse or neglect that they have endured, a good many require medical or psychological intervention. While countless children enter the system with a variety of physical or mental illnesses, the foster care environment may also be responsible for generating barriers to adjustment. 1 To compound the problem, the lack of staff and the difficulties associated with procuring an accurate medical history when removing children from their homes has led to inadequate maintenance of health records. 2 While the social worker continues to function as the case manager for child welfare services, the authors explain that the nursing professional's role in this particular arena of community health is an expanding and ever-vital asset to the well-being of foster care children.

The clinical course outlined in the article provides students with the opportunity to explore an avenue of nursing not normally offered in a traditional academic program. Further, research has shown that academic programs are necessary in order to provide adequate education on the identification and treatment of child abuse. 3 Emphasizing the need for a thorough and integrative approach to childcare, particularly in a system that is overwhelmed, overburdened, and subject to the constraints of the law, will afford students a clear understanding of case management and its value in healthcare.

This innovative addition to nursing school curriculum may guide students toward a future in public health with a focus on child welfare. Consequently, an increase in the number of professionals entering this field may provide the necessary continuity to bridge the gap between Child Protective Services and foster children, resulting in a vast improvement in the care provided to them.

Kathy Swan, BSN, RN

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