The Forensic Nurse

When documenting a SANE case, its important to use proper terminology when charting a patient. Some of those terms used to describe a level of sexual developmental maturity can be those from the Tanner Staging System. The Tanner stages look at three key components of sexual maturity: Pubic Hair, Breast development, Male Genetalia

Tanner Staging Levels

Many people know that the color of your skin can have an effect on almost every aspect of your life. But what about being raped?

Researchers at the University of Pennsylvania School of Nursing have released a new study that shows dramatic results when it comes to identifying injuries that may have occurred during a sexual assault depending on the color of the victims skin.

The Researchers conducted a study of 120 volunteers who were predominatly white or african-american and conducted examinations after they had engaged in consentual sex. They found that 68% of the white women had incurred at least one external injury (tearing, abrasions, or swelling), but only 43% of the darker skinned women showed the same levels of injury.

Because physical injury as a result of sexual assualt is usually the exception rather than the norm, being able to clearly show an injury often has a positive effect on people “believing” the victims story.

Being a Sexual Assault Nurse Examiner or SANE, I have heard countless times from law enforcement officers, social workers, other nurses, and even the victims own family members that they dont believe the victims story.

Sexual Assualts usually happen one on one, in a private setting with no other witnesses, cameras, or other ways to try and help determine if the sex was consentual or not.

Because most of these cases come down to a he said / she said scenario the ability to produce accurate forensic evidence is critical. There may or may not be DNA evidence and if injuries are harder to detect on darker skinned victims that puts them at a distinct disadvantage both clinically and in the criminal justice system.

Drug Faciliated sexual assaults are unfortunately a common happening in america and around the world. This video tells the story of a young woman’s experierence on a date with a friend which she had known for a while.

http://www.youtube.com/watch?v=KqF9ciGaEpI

Ways you can try to protect yourself from being slipped a drug:

• Never Accept Drinks from a stranger
• Never accept an open drink
• Never lose sight of your drink
• If you leave the table or area where your drink is, take it with you.
• if you forget to take your drink with you, get a new one
• Have trusted friends with you to help keep an eye out
• If your drink has a strange odor or color, throw it away.
• Know your limits.

I was recently asked about a case in which an adult male was raped and during the sexual assault had an ejaculation. Often the topic of male rape is forgotten when we talk about sexual assaults.

While rarely reported, male rapes do actually occur.  Perhaps it is male pride or ego, but reporting statistics for survivors of male sexual assault are even lower than that of women. One FBI statistic estimated that close to 3% of adult males will be raped at some point in their lives.

As for why the reporting statistics are so low, it may be due to the fact that this type of event may be even more shameful and traumatic to men than it is to women. Society in general tells men that in order to be respected and seen as desirable that they must be seen as strong, tough, and powerful.

All the experts agree that rape is almost never about the sex. Its about power and control. Excercising your will over someone elses. Essentially proving that you are the one in control. That you are stronger than the other person.

Bringing this type of shame to a man can be exceptionally devastating to their emotional self concienience. By not being able to fend off an attackers the victim may view himself as weak, undesireable, or even homosexual. 

These feelings of homosexuality can be even more confusing if the victim experiences an erection or even ejaculates. Both of these situations are very common and are often used as tools of shame by an attacker to make the victim think that they wanted or enjoyed being raped. In reality these types of reactions are more physiological than anything.

Often people believe that an erection equals sexual arousal. There are many reasons why a man may experience an erection during a sexual assault. The simple friction of touching the millions of tiny nerve endings on the penis could cause an erection, even if the touch was unwanted or unpleasant.

Being penetrated anally can also cause an involuntary erection. The application of pressure on to the prostate gland from digital, penile, or foreign object insertion to the anus can often cause an erection. Any proctologist will tell you that this type of reaction is very typical while performing a Digital Rectal Exam for prostate screening.  

Bringing the victim to the point of ejaculation is also quite common. Rapists will often make every effort possible to ensure that the victim does ejaculate to add the the feelings of guilt, shame, and homosexuality. This can add another layer of power, and dominance, and even increased pleasure for the rapist for having such control over the other person. Remember in most cases its about power not the actual sex.

Often we field many requests from interested readers who are asking, “What does it take to become a forensic nurse?” or “what are the requirements to become a forensic nurse?”.

There are various designations that can also be acheived. a CFN, a  

 The problem is, there is no one right answer currently. While there is a national standard that is currently being considered, each state currently makes its own rules for its licensing. So what requirements there are in New Jersey  to become a forensic nurse are not necessarily the same as the requirements in say Georgia or Michigan.

But for the sake of conversation. In general, you must complete / possess the following requirements to become a forensic nurse:

• A valid and active nursing license (without any restrictions)
• successfully complete a formal didactic educational program in forensic nursing. This should include a minimum of 40 contact hours in the core areas of forensic nursing. These core areas include; the history of forensic nursing; the forensic nursing process; violence and victimology; injury identification, interpretation, and documentation; criminalistics and forensic science; and nursing and the interdisciplinary process with law enforcement / and legal process.