The Forensic Nurse

The Georgia Bureau of Investigation  has published a document for the requirements needed to submit evidence collection kits for processing.

 http://www.ganet.org/gbi/labmanual.html 

Law enforcement agencies (local, state and federal)
Judicial systems
Medicolegal community
Other government laboratories
Regulatory and public service governmental agencies
Non-law enforcement security departments (for criminal cases only)

HOURS OF OPERATION

Laboratory hours are from 8:00 a.m. to 4:30 p.m., Monday through Friday.

Evidence receiving hours are from 8:00 a.m. to 3:30 p.m. , Monday through Friday .

The Crime Laboratory observes the State of Georgia official holiday schedule.

A gang rape is when a group of two or more attackers sexually assault one or more victims. This type of group rape is sometimes referred to as a “gang bang” or “running a train”. Approximately 10-20% of all sexual assualts are gang rapes. The word tournante is a French adjective meaning “turning” and is used as a slang term to mean a gang rape. According to the testimony of numerous victims, young Muslim women who stray from traditional conduct in the immigrant neighborhoods, such as behaving and dressing like a westerner, or wanting to live as Europeans or refusing to wear the traditional clothing, have been considered by some to be “fair game” for tournantes.

According to Samira Bellil in a CNN interview, there was a trial in Lille regarding a 13-year-old girl who had been allegedly gang-raped by 80 men.

Samira was first gang-raped when she was 14, by a gang led by someone she knew. They beat her viciously and raped her all night. A month later, one of the most violent attackers in the gang followed her and dragged her off a train by her hair, while other passengers looked the other way. She was then brutally gang-raped by the gang members again.

She did not report her rapes until two friends told her that the same gang had raped them too. The typical scenario that takes place is that the targeted young woman is drawn or lured into a secluded area where she is brutalized and repeatedly raped by groups of men who take turns raping her. The victim is usually insulted for behaving in a Westernized manner. Typically the girls are often released afterwards, but rapes are often unreported for fear of reprisals against their families. In nearly every case on record the young victim who does report the crimes committed on them says that days later they would again be caught by the gang and gang-raped again.

These types of attacks can also be further categorized into sub categories like: opportunistic rape, street gang rape, male rape, aquaintance rape.

Opportunistic Rape: The most common scenario is during a burglary or robbery. During the process of committing the robbery the attacker(s) may be startled or interupted by a female who happened upon them. Rather than fleeing the scene they may linger and decide to “take advantage” of the situation by raping her. Often these types of attacks are not especially violent, but may escalate into a violent situtation due to the impulsive nature. Because the attackers were suprized by the person being there, they typically have not planned out what or how to deal with the person. They may use improvised restraining devices or no restraints at all, and simply threaten or imply violence if the victim does not comply.

This type of impromtu sexual assault is usually short in duration. If they were there to commit a robbery in the first place, they may still be trying to get away with the stolen goods. A condom is rarely used since the rape was not premeditated and opportunistic. Ejaculation may or may not occur. Recent SANE-SART statistics on ejaculation sites.

Street Gang Rape: This type of rape is almost completely intracial. Rarely does it cross racial boundaries. Increasingly this type of sexual assault is used as part of the gang initiation process. Sometimes it may involve a younger member of a sister gang who is also being initiated, sometimes it may be a random target chosen off the streets, and in other cases, it may involve a same sex target of a rival gang. This is meant to humiliate and degrade the rival while proving that the attacking gang is stronger.

In many cases there are many levels of insult and intimidation. Forced oral (fellatio) and anal sex are common. Urination  on the victim, especially by later members of the “train procession” as a way to further degrade the victim may occur. With each “round” the levels of degredation, torture, and acts tend to escalate.

 Male Rape: Males who are sexually assualted typically are lower reporters than female victims. Depending on the study used, most statisitics show about 5-10% of victims are male. One study indicated that approximately 36% of male prisoners are sexually assualted by more than one perpetrator. Usually the first time prisoner, illegal immigrants, or phyiscally handicapped (weaker and more vulnerable targets) are the ones targeted for repeated assaults. The majority of these rapes are done by heterosexual males, much like the rival gang rapes listed above.  Violence is much more likely on male on male rapes, as well are the demanding of multiple physical acts. Weapons are also more common method to enduce coersion.
Gang Acquaintance Rapes:  In most instances in a gang aquaintance rape the victim has been carefully selected and includes some group collaberation and forethought before the attack occurs. The victim may have one or more of the following characteristics:

• New student, or new to the area with few friends
• unpopular
• unattractive
• overweight
• already had sex with one of the group members
• intoxicated
• drug use
• low self esteem, may be easily lured / flattered by attention before an assault
• Sorority sister

College campuses are a common location for such incidents. Often at parties or on the way home from a group date. While most acquaintance rapes involve one perpetrator and one victim, the campus gang rape is far too prevelant.

Incoming freshmen females are the most targeted for gang rape. They are usually more naive, tend to be more vulnerable, have fewer friends, and be more willing to be lured into a position of isolation. The first few weeks of the new school semester are the most vulnerable times for gang rape for incoming freshmen.

These types of gang rapes are often planned well in advance and can endure for hours as each group member has their turn. The use of alcohol and other narcotics to subdue the victim. It is not all that uncommon for their to be multiple spectators to the events, and even video taping of the assault. In most cases there is limited to no physical injury to the victim, except for any genital injuries as the result of repeated intercourse.

When and if defendants are ever charged in such cases, they most often don’t deny that sex occured, but that the victim was consentual, or that “she never said no or stop”.

The Northside Hospital - Forsyth, Sexual Assualt Nurse Examiner program is proud to announce that they have become the only SANE  program in the state of Georgia to use employ the use of SDFI technology.  

Secure Digital Forensic Imaging technology offers digital imaging clarity that is on the cutting edge. This technology is also fully compliant with federal rules of evidence, ensuring that the images stored will be admissible in court if necessary.

The use of digital forensic photography is steadily gaining in popularity almost everywhere, but one item that is almost universally raised is the authenticity of these photographs.

Digital Photographs are much easier to manipulate or alter than a traditional photograph. I’m sure that just about everyone reading this has seen some kind of ‘photoshop’ doctor’d image. From the supermodel airbrushing, or cellulite adding for shock value, to the bin laden doing various activities, the use of digital photograph editing is widespread.  (Browse thru your local supermarket checkout tabloids if you would like some fresh examples.)

But not all altering of digital photographs is necessarily harmful, at least in intent. Take for example, the straightening or cropping of a photograph to help highlight that perfect shot, or the masks and filters that take the annoying red eye out of a photograph caused by the lense flash.

These are often innocent “enhancements” to photographs to make the captured subject more pronounced, or centered into the picture. But be careful treading into this arena if these photographs are going to be used in a criminal or forensic proceeding.  

Image Enhancements

Any process intended to improve the visual appearance of the image falls under the category of an image enhancement. That includes contrast, brightness, color adjustments, color rebalancing, cropping, bluring, dodging and burning.

Unless the photograph is admitted and agreed to by the stipulation of both parties, the party attempting to admit the photograph into evidence must be prepared to offer testimony that the photograph is an accurate representation. Or more to the point, be prepared to testify in court that the image being submitted into evidence is accurate and unaltered in any way.

Federal Rules of Evidence, Article X (Contents of Writings, Recordings, and Photographs), Rule 101 defines writings and recordings to include magnetic, mechanical or electronic recordings. Rule 101 states that if data are stored in a computer or similar device, any printout or other output readable by sight, shown to reflect data accurately, is an “original.” A “duplicate” is defined as a counterpart produced by the same impression as the original…by mechanical or electronic re-recording … or by other equivalent techniques which accurately reproduces the original. Rule 103 (Admissibility of Duplicates) states a duplicate is admissible to the same extent as an original unless a genuine question is raised as to the authenticity of the original or in the circumstances it would be unfair to admit the duplicate in lieu of the original. This means a photograph can be stored digitally in a computer, that a digital photograph stored in a computer is considered an original, and that any exact copy of the digital photograph is admissible as evidence.

In part Two, we will discuss the proper chain of custody for digital evidence

The IAFN does allow for the re-take of the certification exam. below is an excerpt from their website regarding the re-examination process.

A candidate who does not pass the examination has one year to re-take the examination at a reduced fee.  The fee is $150 for IAFN members and $275 for nonmembers. A candidate who does not pass the second examination is considered failed.  Any repeat examination will require completion of a new application and payment of the full fee.A total score of approximately 75% correct is required to pass the certification examination.  Candidates will be notified of their scores approximately four (4) weeks after test administration. C-NET will forward all examination scores to the candidate as follows: 1.     A total score will be provided for candidates        who successfully pass the examination. 2.     A total score and sub-scores in all the major        test areas of concentration will be provided for        candidates who do not pass the examination.

Most forensic nurses, work out of an emergency room setting or in a freestanding clinic. The Emergency Nurses Association, or ENA published an official statement on their stance of forensic evidence collection by nurses in the emergency room setting for Victims of sexual assault, child maltreatment, elder abuse and other violent incidents are often brought to the emergency department (ED) for care.

· ENA believes that it is the emergency nurse’s role not only to provide physical and emotional

· ENA supports collaboration with emergency physicians, social service, and law enforcement

· ENA encourages emergency nurses to become familiar with the concepts and skills of

This week a 911 operator in  Nashville, Tennessee was been fired after he was recorded on a taped 911 call stating that he didn’t “give a s—” about what happened to a woman who had just called to report her ex-boyfriend was threatening her.

Frank Roth, the man who made the statement didnt actually utter those words to the woman who called in. According to Emergency Communications Center spokeswoman Amanda Sluss said, Roth was in training during the February incident and was fired a month later.

Roth made the comments after promising to the woman that police would arrive shortly to assist the woman who was reporting her ex-boyfriend held her at knifepoint and later was threatening her.

The statement was made after hanging up with her but while still being recorded, he said, “I really don’t give a s— what happens to you.”

It took the police nearly three hours to respond to the scene after the initial 911 call.

So why should you give a s—?

According to the American Institute on Domestic Violence, health-related costs of rape, physical assault, stalking, and homicide by intimate partners exceed $5.8 billion each year.

Intimate partner violence victims lose nearly 8.0 million days of paid work each year - the equivalent of more than 32,000 full-time jobs and nearly 5.6 million days of household productivity!

Indirectly we are all shouldering a much greater burder than many of us realize. As a result of domestic violence, you will pay greater cost in health care coverage, longer wait times in the Emergency room, police diversion to respond to these domestic assaults, other co-workers in the office need to work harder to pick up the slack when victims are hospitalized, or unable to attend work.

More Statistics on Domestic Violence from AIDV:

Your Corporate Peers

68% of senior executives surveyed agreed that their company’s financial performance would benefit from addressing the issue of domestic violence among its employees.

94% of corporate security directors rank domestic violence as a high security risk.

78% of Human Resource Directors identify domestic violence as a substantial employee problem.

56% of corporate leaders are personally aware of specific employees who are affected by domestic violence.

60% of senior executives said that domestic violence has a harmful effect on their company’s productivity.

The Human Factor

85-95% of all domestic violence victims are female.

Over 500,00 women are stalked by an intimate partner each year.

5.3 million women are abused each year.
1,232 women are killed each year by an intimate partner.
Domestic violence is the leading cause of injury to women.

Women are more likely to be attacked by someone they know rather than by a stranger.

Domestic Violence in the Workplace

Homicide is the leading cause of death for women in the workplace.

Of the approximately 1.7 million incidents of workplace violence that occur in the US every year, 18,700 are committed by an intimate partner: a current or former spouse, lover, partner, or boyfriend/girlfriend.

Of Battered Workers:

96% experience problems at work due to abuse

74% are harassed while at work by their abuser

56% are late to work

28% leave work early

54% miss entire days of work

Forensic Nursing has been around for many years now, but it wasn’t until 2002 when the Forensic Nursing Certification Board officially came into being. Its’ mission: “to promote the highest standards of forensic nursing practice through the development, implementation, coordination and evaluation of all aspects of the certification and recertification process”.

The Forensic Nursing Certification Board, or FBCB offers certifications of SANE-A and SANE-P. SANE-A and SANE-P are the earned credentials which recognize that the highest standards of forensic nursing for sexual assault nurse examiners has been achieved. Nurse Examiners can become certified by meeting eligibility requirements and successfully completing the SANE-A or SANE-P examination. Re-certification is available by examination or documented continuing education over the three year period.

Sometimes the professionals who help victims of sexual assualt may inadventently experience injuries as the result of trying to help those who have been victimized. Not physical injuries, but the emotional injuries, just as real as those experienced by their victims.

Dealing with horrific and traumatized victims on a daily basis can drain on the mental strength of these professionals. Forensic Nurses, child protective services, prosecutors, therapists, and law enforcement officials are often exposed daily to the kind of nightmares that many of us can’t even, or maybe just don’t want to think about.

One website called www.silentinjuries.com is dedicated to trying to help support those who support others. They specialize in trying to help SANE’s and other professionals of sexual abuse to deal with relationship problems, depression, sleep deprivation, and social issues that they may experience as a result of their work.

Friday, May 16, 2008 (8:00 AM - 4:30 PM)

Event Web Address: www.forensicconsultofeasttn.com
Event Sponsor: Forensic Consultants of East TN

Contact Person: Vicki Sickau
Contact Phone Number: (865) 202-7044
Contact Email: vsickau@forensicconsultofeasttn.com

Event CEUs: Yes
Event Fee: $175.00

Training Event?: Yes

Description: How to collect evidence and other tips for how to practice forensics in your nursing practice. Basic course for those that are not experienced in forensics or for those that need some refreshing.

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