The news was distressing; 11-year-old Joella Reaves allegedly was hogtied, starved and beaten to death by her parents in November 2003, according to Henry County authorities.

Two Eagle's Landing Middle School employees, including the school nurse, were fired for not reporting teachers' suspicions that the girl was being physically abused. A grand jury indicted them, along with a physician, on misdemeanor charges that they failed to report the possible abuse. The three have pleaded innocent.

Rodney Reaves, Joella's father, and Charlott, her stepmother, have been charged with murder and could face the death penalty.

Reporting suspected child abuse is mandatory for school nurses, said Joyce Allers, manager of school health and community health development and advocacy for Children's Healthcare of Atlanta. And documentation is essential - both for the protection of the child and the nurse.

"If nurses suspect child abuse, they must report it to [Department of Family and Children Services]. And they need to document that they reported it," Allers said. "Sometimes, the principal prefers that the social worker report it ... but I think the nurse needs to be in the loop somewhere."

The Reaves case has highlighted the child abuse reporting process. State law requires school staff who suspect child abuse to notify the principal, or the principal's designee, who is then responsible for forwarding reports to the Department of Family and Children Services.

Many school nurses are alerted to abuse during routine health screenings when they find unexplained bruises, lacerations or abrasions, Allers said.

During a scoliosis screening, one school nurse identified child abuse when she noticed buckle marks and bruises on a child's back. When questioned about where he got the marks, the boy told the nurse that his brother had the same marks, Allers said.

"There were old and new bruises. You know that this child was beaten up severely. The school nurse was able to get the children help right away. [DFCS] removed them from the home that night," Allers said.

Sometimes reporting suspected child abuse is not so cut and dried, and without proper screening, a nurse cannot detect abuse. And there are other factors that may inhibit a report.

"A parent may be active in the school, and [the administration] don't want to anger them ... or there may be some worry that if the parent is aware that someone suspects abuse, they will pull the child out of the school," said Allers. "These worries shouldn't be a factor in reporting abuse."

Laurie Eubanks, child protection and advocacy manager at Children's, said the key is to "sensibly report, not just overreact because you're afraid. There's a delicate balance. If a school nurse reports to child protection services about abuse, they are obligated to respond."

For information about proper procedures to report suspected child abuse in schools, contact Eubanks at 404-785-3826. The advocacy center can provide training on how to identify signs of child abuse.