The Forensic Nurse

We have dramatically redesigned theforensicnurse.com website to better deliver the most up to date new information and training guidelines for our readers. Our new membership area offers targeted content to users directly affected by their geographic region. This includes statistics, training information, legal resources, local news headlines, local job opportunities for nurses, and so much more.

 come check us out. http://www.theforensicnurse.com/members/login.cfm

If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:

• See a licensed health care provider, even if you do not feel sick. Try to find a health care provider who has experience treating HIV. There are now many medications to treat HIV infection and help you maintain your health. It is never too early to start thinking about treatment possibilities.
• Have a TB (tuberculosis) test. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
• Smoking cigarettes, drinking too much alcohol, or using illegal drugs (such as methamphetamines) can weaken your immune system. There are programs available that can help you stop or reduce your use of these substances.
• Get screened for other sexually transmitted diseases (STDs). Undetected STDs can cause serious health problems. It is also important to practice safe-sex behaviors so you can avoid getting STDs.

There is much you can do to stay healthy. Learn all that you can about maintaining good health.

Not having (abstaining from) sex is the most effective way to avoid transmitting HIV to others. If you choose to have sex, use a latex condom to help protect your partner from HIV and other STDs. Studies have shown that latex condoms are very effective, though not 100%, in preventing HIV transmission when used correctly and consistently. If either partner is allergic to latex, plastic (polyurethane) condoms for either the male or female can be used.

The National Sexual Violence Resource Center serves as the nation’s principle information and resource center regarding all aspects of sexual violence. It provides national leadership, consultation and technical assistance by generating and facilitating the development and flow of information on sexual violence intervention and prevention strategies. The NSVRC works to address the causes and impact of sexual violence through collaboration, prevention efforts and the distribution of resources.

Often SANE programs go unnoticed and unpraised for their efforts. Most people would tell you that its not really polite conversation to talk about the needs for such programs.  

But the Chicago Tribune recently published an article about a SANE program in cook county. There is a phenominal qoute in the article by Tom Fleming Jr of the Park Forest Police department:

“We know that a SANE nurse who is trained in evidence collection has done the correct work for us,” he said. “Our goal is to not have a trial. Our goal is to get a confession from that offender. And we’re best equipped to do that with medical evidence. If we can do that, if we can get an offender to take a plea and not go to trial, then we’ve served that victim right at that very moment.”

Read the Full Article here:

http://www.chicagotribune.com/news/local/chi-sex-assault-treatment-sw-zon.ar0apr08,0,7944054.story

Northside Hospital in coordination with TheForensicNurse.com and North Georgia College is offering a 40 hour Adult / Adolescent Sexual Assault Nurse Examiner Training at Northside Hospital Forsyth, located just outside of Atlanta Georgia.

The SANE program at Northside hospital has grown from infancy to one of the most highly respected in the state of Georgia. They not only service Forsyth county, but serveral of the other surrounding counties at well. The program also is the only facility in the state that uses the SDFI telemedicine system for advanced digital forensic evidence collection.

Class Information: 

 Date: May 18 - May 22 (5 days)

Location:

1200 Northside Forsyth Drive

Cumming GA, 30041

Cost: $350.00

Registration Website: http://www.theforensicnurse.com/atlanta_georgia_sane_training.cfm

Northside Hospital is an approved provider of continuing nursing education by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Centers Commission on Accredidation.

Course Material Outline

• Overview and History of Forensic Nursing
• Myths and Barriers
• Rape Trauma Syndrome
• Roles of SANES
• Continuum of Care
• Crime Lab Kit
• Photography
• Medical Forensic History
• Head to Toe Assessment
• Genital Anatomy / Variations
• STD’s
• Trauma Identification
• Death Investigation
• Evidence Collection
• Serology & DNA Analysis
• Drug Facilitated Sexual Assault
• Multi Disciplinary Team Concept
• Advocate / Police Roles
• Profiling of Sex Offenders
• Special Populations
• Sexual Assault / Domestic Violence
• Clinical Requirements
• Documentation and Testimony
• Expert Witness Testimony
• Judicial System and Laws

A true Christmas miracle happened for a 9 year old girl in Pharr Texas. The girl wrote a letter to Santa Claus, but instead of asking for toys or dolls, she begged for Santa to get a family relative to stop touching her and her sister.

The girl wrote the letter and it was turned in at Cesar Chavez Elementary School. The school counselor reported the letter to authorities and the man was arrested.

Investigators familiar with the case believe that the molestation occured for as many as four years. The man was charged with continuous sexual abuse of a young child and could face as many as 99 years in prison if convicted.

Lets hope that Santa can see to that as well.

While most people in the industry know the acronym IAFN, as the International Association of Forensic Nurses, is also as a same industry acronym “Imaging And Forensic Networking“. This phrase was coined by the SDFI Telemedicine group. SDFI stands for Secure Digital Forensic Imaging.

The SDFI camara system is meant to be a colposcope replacement, offering increased clarity, file encryption, and secure sharing of images across organizations.

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.

Child Sex offenders can be exceptionally resourceful at finding ways to place themselves around children in settings that may allow them to abuse their position and sexually assault children. 

While most agencies, and places of employment targeted toward children (like day care centers, foster child homes, etc) are mandated to conduct a background screening for past child sexual assault (or any sexual assaults for that that matter), this type of arrest history check is ineffective at stopping child predators.

A simple arrest record check in most cases will come back clean. Study statistics vary from study to study, but in general they indicate that less than 1-5% of child sex abusers have a prior criminal record. Unfortunately, most child sexual abusers have dozens of victims before they are ever arrested for their crimes.

But what if there was a way to help detect these people before allowing them to commit their crimes.  While this may sound like a far fetched hollywood movie idea like “the Minority Report“, a company called Abel Screening claims to be able to do just that for detecting child sexual predators.

They call it The Diana Screen. This two part computerized test is used to determine the risk of the test-taker having sexually abused a child in the past. According to their website:

The Diana is a pass / fail test, it goes beyond a simple questionnaire to include objectively measured sexual interest in children. The technology that identifies sexual interest, which is a major part of The Diana Screen^® formula, is empirically validated and has been used by therapists and criminal justice professionals more than 100,000 times.

The website further claims The Diana Screen^®identifies over 50% of actual child sexual abusers.

It may sound like a simple question, “Does mandatory reporting help?”, but it’s one that can be a much more difficult than most health care providers think under the surface.

As a health care provider, you can provide documenation of current injuries, and in many cases in past injuries as well. As a Forensic Nurse, you have the training to collect evidence that may be used in trial to prove the types of offenses that happened. Your medical charting of events can provide a detailed interpretation of facts and injuries than the victim himself/herself would have been able to provide on their own.

Obviously, by reporting that an event of domestic violence or sexual violence against a patient has occurred brings the situation out into the open where other agencies like law enforcement, DFACS, counciling services, and others can offer help and support to the victim, and even counciling to the perpetrator.

What if the patient doesnt want to report?

Informed consent is one of the principle foundations of modern medicine. This empowerment of patients to make informed decisions over their treatments and what happens to their bodies.  For a victim of sexual assult, or domestic violence, this control has been taken away from them. As a mandatory reporter, you are again taking away any sense of control away from the victim. They have no choice in the matter, since you are obligated to notify proper authorities.

The knowledge of confidentiality and essense of trust can be critical components in getting any successful intervention of a sexual assult or domestic violence. Mandatory reporting may directly affect that relationship though, since in effect a mandatory reporter must violate that patient confidentiality to inform proper authorities. Here is an excerpt from a battered woman focus group

“What made it difficult for me to confide was the fact that I feared for my life, you know. And I knew that if I was to tell them what actually happened, that they would call the police and I would have to file a report and they couldn’t guarantee me that they would be there 24 hours to protect me from this maniac. So, therefore, I wasn’t taking that chance on my life. … What would make it easier for me would be….to be my choice….[I] f this happened to me but I don’t want the police involved, can you please treat me and keep my confidentiality? There’s supposed to be a law that they keep confidentiality between the patient and the physician.”

Because of this violation of trust, some will argue that in order to get an accurate story from a patient that you should not tell the person that you are a mandatory reporter until after they have given their recount of events. Others will say that is ethically wrong, and that you should tell that person up front about your reporting status and in effect, give them the choice of reporting what actually happened, or just receiving their medical care and moving on.

Mandatory reporting laws were developed to provide a safety outlet for individuals who may be too afraid or unable to seek help (children, elderly, controlled spouse ,etc). The question that many of these victims ask is that “what are you going to do to protect me?”. Law enforcement can’t be in a home 24 hours a day. So what happens when the victim goes home, and the victimizer gets released from custody in a few hours or days? Is that person(s) safer now?

“Abused women hare had their autonomy taken away by their abusive partners. Forcing me to report her abuse again takes that autonomy and control away from her. She is a better judge than I of the consequences to her of reporting.” - PhysicianSurvey Statement

Right or wrong, mandatory laws exist for many health care providers.  What do you think ?? 

Addtional Resources:

http://www.endabuse.org/