/Forensic nurses The first step toward recovery for sexual assault and trafficking patients

Forensic nurses The first step toward recovery for sexual assault and trafficking patients

She laughed and said, “My dog loves this one,” as she set down the teaching prop. It was one of many “fuzzies” that she uses to symbolize the virus or bacteria of sexually transmitted diseases. Sharp was training state nurses to become SANEs, sexual assault nurse examiners. Only two state-certified SANEs are currently working in the state. Sharp is a woman with a mission to train nurses to perform forensic examinations — any medical exam that can be used as evidence for law enforcement, especially for sexual assault investigations. Sharp coordinates the Mississippi Coalition Against Sexual Assault’s projects and works with the attorney general’s office, state health department and crime lab to provide the training. Mississippi’s new law decriminalizing prostitution for children younger than 18 years old aims to increase the number and quality of these investigations by strengthening human trafficking statutes, victim services, and other measures. Advocates say that the law does not directly allow for exams. However, it is the first step in ensuring wrap-around services to victims and the initial stages of any investigation. The law gives law enforcement more power and speed to assist victims of sex trafficking. Advocates argue for better coordination of services and worry that law enforcement aren’t well-trained to deal with victims in the initial stages of sexual assault intervention. Sharp is determined to disprove a myth: Sexual assault and trafficking are not a problem in health care. The TV show SVU is not real. Sharp stated that if hospital staff and law enforcement aren’t educated, patients don’t receive trauma-informed care and patients don’t believe them. She doesn’t want to lose these patients because they won’t return. #MeToo has made this clear — patients aren’t believed. This has been known for a long time by forensic nurses — patients are not believed.” She hopes that the nurses she trains will become certified. To be certified, nurses must pass a test and complete 40 hours of training. She wants them to be comfortable during the exams and to be able help law enforcement if needed — whether that’s through expert testimony in court or their evidence documentation and collection. She teaches everything, from sexual anatomy to direct examination techniques, photography, and interviewing, as well as rape kit collection. Although these nurses are crucial in the initial stages of a sexual assault, the training does not necessarily include traditional nursing school. Sharp rattles off statistics that you can see bother her. But she is so familiar with them it’s second nature. One person is sexually assaulted every 2 minutes, and only half of those are reported. The majority of those who are reported don’t get prosecuted and less than one percent of sexual assaults end in convictions, according to the Center for Violence Prevention. Sharp wants nurses to feel comfortable answering tough questions. Sharp wants nurses to be able to answer the tough questions. If the patient refuses to share, or because of fear of stigma attached to sexual assault or other reasons, this can make it difficult. Sharp emphasizes to nurses that nurses are there to treat and examine patients and then to gather evidence. She said that the patient must also consent to having evidence taken, even if they are under 18. Education of law enforcement is a big part of forensic nursing. She says that sexual assault can be difficult to prove because it is hard to show. Many don’t cause physical injury and very few show visible injuries. This and anatomy are part of the job. As is supporting the patient during this process. It is not referred to in the exam as “alleged” rape, or sexual assault. She says, “No other patient has an alleged injury — it is not ‘alleged abdomen pain’ until proven.” She says that the case is presented and treated exactly as it should be. Sharp and other advocates believe that support begins with SANEs, a medical professional who can treat and support victims in the early stages of their journey and tell them, “This is not your fault” as well as “we are here to help you.” Only one shelter exists in the state for victims of human trafficking. It is small and has six beds for adults. Advocates claim that victims are sent across state borders to other states because there are no designated spaces for children. Sharp emphasizes that victims of sexual assault and trafficking need priority treatment and care. They need long-term therapy and treatment, but there is no funding or resources to support that. If we try to put a Band-Aid on an arterial bleed, the outcome is not good. We tell nurses that you are only one piece of the puzzle. There are the investigator piece and the medical piece. Nothing works in a vacuum. Even though this case was not resolved, the patient received good medical care, an investigator who believed them, and an advocate who intervened for their cause. A prosecutor could also explain to the patient that if the case goes forward without conviction it is not their fault. It’s difficult to get everyone on the same page, and everyone at the table, if you don’t have everybody on one page. We all know what that looks and how it feels.”