Nursing Care for Children in the Foster Care System: Tips & Resources

In 2021, over 391,000 children lived in foster care in the United States, according to the U.S. Department of Health and Human Services. Of these youth, up to 80% experience significant mental health conditions, compared to 18-22% of the general population.

If you’re a nurse caring for foster children, you support a unique group of American youth, as many lack a stable support system to help them. This guide explores the complex world of the foster care system and highlights important statistics and issues faced by the children and families involved in foster care.

You’ll gain valuable insights into foster care in the U.S., including resources for supporting those within the foster care community.

Children in the foster care system tend to experience neglect, abuse, and abandonment from those who were supposed to protect and care for them, which often makes it harder for others to gain their trust later. While providing care, you’ll likely meet children with a fear of abandonment. These youth tend not to trust others easily, especially adults, which can serve to protect them from being harmed as they have been before, but it can also create barriers to care.

For many children in the foster care system, building trust is a challenging task. This may make it difficult for them to form meaningful connections and engage in healing processes.

Another common barrier is limited access to proper care and other necessary resources. Children in foster care tend to face disparities in accessing healthcare, education, mental health services, and other essential resources.

These challenges stem from systemic problems. Overworked caseworkers, inadequate funding, cultural and historical patterns of discrimination, and bureaucratic complexities can limit resources, worsen trauma, and hinder foster children from reaching their full potential.

Without addressing these barriers, it is nearly impossible to improve the well-being of children in the foster care system. How children are raised can affect who they become as adults.

It is crucial that adults working in the foster care system strive to help children overcome these challenges, creating supportive environments where children can heal and thrive.

For general healthcare or urgent needs, nursing care for children in the foster care system requires an adept response to the barriers they may face. These tips can help nurses address the healthcare needs of children in foster care and champion establishing trust and patient education.

Building trust with the children you care for is an essential but challenging initial step to providing quality care. Foster children have commonly experienced multiple, complex traumas and disruptions in their routines and lifestyles.

You are working with children who may fear abandonment and may struggle in ways you may not be prepared for, including forming new connections. Tell them that you’re dedicated to their well-being and show consistency in keeping that commitment through your actions. Respect their autonomy and dignity, practice active listening, and keep your communications private.

Since you’re working with children with a history of trauma, which impacts their health and wellbeing, it’s best to adopt a trauma-informed approach to care. This means learning the long-term impacts of trauma. Recognize the potential triggers and sensitivities of these children so you can tailor your care to support their healing.

Caring for children in foster care goes beyond the physical side of their health. As a nurse, you can act as an advocate and a care coordinator. Work closely with social workers, mental health professionals, educators, and foster parents to ensure these children receive comprehensive, holistic care and support.

Nurses are mandated reporters, which means nurses are legally required to report any suspicion of child abuse or neglect. Part of being a trauma-informed carer is noticing signs of abuse or neglect and immediately reporting these concerns to the appropriate authorities.

Remember to keep accurate and detailed notes or other documentation to support the reporting process, ensuring the safety, autonomy, and dignity of the children you support. In particular, you can learn how to keep children informed about what you will do as a consequence of what they may say or do around you, what their options are in working with you and others, and other resources available to them.

Frequent placement changes and trauma-related challenges often result in educational disruptions for children and youth in foster care. As a nurse, you can play a role in advocating for children’s educational needs. Collaborate with school personnel to ensure the administration provides appropriate accommodations. Help promote a supportive learning environment that matches the child’s learning style.

Since children in foster care commonly move between multiple healthcare providers and facilities, many of them experience fragmented or episodic care. As a nurse, you can contribute to the continuity of care by providing well-documented, comprehensive health information during transition — working closely with the team of healthcare professionals involved in the child’s care.