Nov 01, 2021, By: Laura Eggertson
The day a battered six-year-old arrived in the emergency department of the Alberta Children’s Hospital in Calgary, nurse clinician Donna Warren’s 25-year career in child abuse services began.
The little girl was bruised from head to toe. She’d been beaten by her mother’s boyfriend — his attempt to “discipline” her.
“She was black and blue,” Warren remembers.
Warren’s immediate task was setting up treatment for the girl. But as she talked to the police and social workers, the nurse was aware of another person who needed help and attention: the child’s mother.
Because the mother failed to protect her child from her boyfriend, she, too, was deemed responsible for her daughter’s injuries.
“If someone is hurting your child, that person needs to go,” Warren says.
But she also understood what prompted the mother to want a partner to share parenting responsibilities.
“I could empathize with her on the lack of having another caregiver and on being on her own and needing to get out. I could really feel for all of them,” she says. “It was that family that really motivated me and made me aware of child abuse.”
Her young patient was later taken by social services and placed in a foster home.
It was 1992. Warren had already spent almost 20 years as an ICU and emergency department nurse. She’d seen every kind of trauma.
When a part-time opportunity arose to work in child abuse services, Warren felt compelled to shift her specialty. She applied and got the job. Eventually, it became full time.
To prepare, she read everything she could find on the causes, prevention and treatment of abuse, trauma and addiction.
There are many underlying factors that affect child abuse that people don’t understand, she says.
“Most people don’t want to hurt children intentionally,” she says.
Poverty is one of the biggest underlying issues, she says, as is intergenerational trauma. Another is not having extended family support.
“If you have a history of abuse, of mental health problems — that’s all part of it,” she says. “It goes on and on from there.”
Warren’s ability to understand those factors and to empathize with the entire family made her stick with a field many find too distressing to enter. Now 68 and retired, it is her experience in child abuse services that she finds most rewarding.
Advocated for families
For a quarter century, Warren advocated for child victims of abuse and their families at the Children’s Hospital Child Abuse Program, which became linked to the Sheldon Kennedy Child Advocacy Centre (now the Calgary and Area Child Advocacy Centre).
She liaised with police, prosecutors, social workers, foster families, grandparents, birth parents, adoptive parents, psychologists, doctors and other nurses to set up treatment plans and refer people to community services. Warren managed intake and crisis intervention, facilitated parenting groups and educated people on domestic violence prevention and positive parenting.
Most people who attended her groups were eager to learn better parenting techniques. A few were not.
Despite her empathy, there were ‘awful’ stories that were difficult to bear.
“I really advocated for families,” she says. “I talked to them, I listened to them, I assessed what was going on. I made a concerted effort to understand and empathize with everyone’s individual situation even if I didn’t agree with what they were telling me.”
Children referred to the Advocacy Centre had experienced physical, sexual, verbal and emotional abuse or a combination of abuses.
She remembers one girl whose father humiliated and shamed her before shaving her head because she was undergoing normal development and not adhering to his cultural norms.
“Abuse comes in many different forms,” Warren says.
Treating everyone with respect was critical to assessing children’s safety and their parents’ ability to care for them.
“That was my biggest concern: was the child safe?” she says.
She ached for the children separated from their parents and did her best to teach people skills to help them change. She urged those caring for children who had suffered trauma and abuse to seek respite when they could.
Facilitating the parenting group was one of the aspects of her job that Warren loved the most.
“People can get so much from the group and so much from each other,” she says.
She wishes teenagers and young adults were taught parenting and healthy relationships skills in school. “We need to be taught what this looks like so that we know when we are in a troubling relationship and when to seek help,” she says.
Warren describes her own upbringing on a farm in northern Saskatchewan as “difficult.” Her father was a Second World War veteran who suffered from post-traumatic stress disorder.
Her parents worked hard to provide for their five children, but the family experienced poverty and deprivation. Nevertheless, she has some good memories.
“To this day, I still love the Prairies and the tiger lilies and crocuses,” she says.
Role of poverty
Warren’s childhood experiences made her particularly conscious of the role poverty plays in family dynamics and abuse, she says.
Despite her empathy, there were “awful” stories that were difficult to bear, she says.
To cope, Warren talked to her supportive team of co-workers. On days off, she immersed herself in her own family’s activities, including camping and golfing.
Warren raised her three children in a nurturing home.
Working full time and attending the University of Calgary part time to earn her bachelor’s degree in nursing and her master’s degree, Warren and her husband, Alan, attended all of their children’s sports activities and weekend tournaments.
Recently, Warren’s grown daughter asked her mother if she knew about attachment-style parenting (she did). Her daughter told Warren she thought she and her siblings were securely attached — meaning that her mother must have done a good job.
“I thought that was a really nice compliment,” Warren says with a laugh.
Currently, Warren plans to write a book on the history of nursing in Canada by profiling four or five nurses, describing how their roles and practices have changed across the decades. She is looking for other nurses to participate.
Although she has now lived in Calgary for decades, when reflecting on her career, Warren thinks back to the way her Saskatchewan childhood influenced her — just as their backgrounds shaped the families she tried to help.
“A person’s environment and upbringing can have a profound impact on them,” she says. “You have to give everybody a chance.”
NOTE: Nurses wishing to participate in Warren’s book may contact her at firstname.lastname@example.org.
Laura Eggertson is a freelance journalist based in Wolfville, N.S.