Children in Foster Care: Outcomes and Nursing Implications

Background: Approximately 407,000 children remained in the foster care system by the end of 2020, with 217,000 entering and 224,000 exiting the system. The foster care system is meant to be a temporary living arrangement for children born into or raised in non-flourishing homes. However, the uniqueness of the system and the interactions of foster parents lead to undesirable foster home situations while the child is left in the system for longer times. The child in foster care faces several adverse life events that make it difficult for the child to develop into a successful adult. Purpose: This paper examines the literature on the experience of children in foster care, their outcomes, and how nurses can advocate for them. Method: Literature was searched using search terms such as foster care, fostering, out-of-home care, child welfare, child abuse, child neglect, transition from foster care, foster children, and mental illness. Peer-reviewed publications were accessed. Of the 80 articles retrieved, 18 met the inclusion criteria. Results: Foster care graduates predominantly suffer from mental illness due to the adverse childhood effects in their biological home and foster home. These mental illnesses lead them to have a difficult time thriving in school, developing a career, starting a family, and making logical and sound decisions in life. These children often encounter health care services where the pediatric surgical nurses can have an impact on their lives. Implications: Nurses must be aware of the foster care system so that processes such as consent, follow-up care, and long-term care can be supported. Nurses must be sensitive to the ‘ambiguous loss’ and associated grief in these children and help them flourish in life.