NORTHWEST INDIANA - In a person's most painful moments, forensic nurses are a source of comfort, not only treating victims of violence, abuse and trauma, but giving them a voice.
During Forensic Nurses Week from November11 to 15, Franciscan Health in Northwest Indiana recognizes the difficult work these SANE (sexual assault nurse examiner) nurses do in our Centers of Hope, designated spaces where victims are given one-on-one trauma care.
Forensic nursing is the application of the nursing process to public or legal proceedings and the application of forensic healthcare in the investigation of trauma or death related to abuse, violence, criminal activity, liability and accidents. Or as Michelle Resendez, RN, SANE-A coordinator for Franciscan Health, puts it more succinctly: "It's where healthcare and the law intersect."
Resendez was drawn to forensic nursing after an experience as a rape victim advocate. "My first call and experience at the bedside was where I saw this amazing nurse, who provided trauma informed care to someone who had experienced and survived the most horrific experience of her life. The victim was beaten beyond recognition. The Forensic Nurse Examiner was so patient, compassionate, and sensitive to the patient's situation. I saw how the patient responded to her care. At that moment, I knew that's what I wanted to do," she said.
From left, SANE nurses at Franciscan Health Crown Point Andrew Hanyzewski, Laura Rowen, Stephanie Walker, Patty Steel and Michelle Resendez.
Lori Bridegroom, RN, SANE coordinator at Franciscan Health Michigan City, said she is often asked why she does this job. For her, the answer is personal: "I have always been fortunate that during the roughest times in my life, someone has always been there to offer a kind word, understanding, a friendly smile or sometimes just an ear to listen. It is because of those people I was able to pick myself up and move on. Being a SANE nurse I, have the opportunity to be that person, to listen, to help, to make a difference."
Resendez says each Franciscan facility is recruiting and investing in staff to attend training to be able to provide this very specialized service. Currently, each facility is focusing on the recruitment and training of pediatric SANE nurses. Franciscan Health Crown Point offers a five-day intensive SANE adult/adolescent training course that instructs nurses to:
- Be culturally sensitive
- Provide trauma-informed, victim-centered care
- Trained in injury identification
- Evidence preservation
- Forensic photography
- Forensic documentation
- Be aware of acute and long-term effects of sexual violence
- Provide courtroom testimony and some expert testimony
Resendez says that courtroom testimony is often the biggest fear for forensic nurses. To counter this, Franciscan Health works with the Lake County prosecutors to provide mock courtroom testimony training for nurses.
The Indiana Criminal Justice Institute has a sex crimes victims fund that provides medical treatment and forensic services at no cost to victims. "No one should ever hesitate to come in for evaluation and services," Resendez says. Time is of the essence because the window of evidence collection in the adult/adolescent population is five days and in pediatrics, it's three days.
Patty Steele, RN, SANE nurse at Franciscan Health Crown Point, says, "Aside from collecting the forensic evidence, our program promotes a holistic approach by creating a safe environment, providing support, a feeling that they have been heard and believed. And finally, leaving the client with informed resources and with a sense of being in control to begin their healing."
SANE nurses at Franciscan Health Michigan City Amanda Kramer, left, and Lori Bridegroom.
Franciscan Health's Center of Hope Mission program in Northwest Indiana provides community outreach and education, and works collaboratively with law enforcement agencies, including Sexual Assault Response Teams in Lake and LaPorte counties. Crown Point's Center of Hope is currently the only facility in Lake County providing pediatric SANE examinations and the only facility that has a board-certified forensic nurse examiner on staff.
Resendez says it's particularly important to promote awareness and education because Indiana has the second highest rate of child abuse nationwide. "We need to teach parents and care providers how to have those 'scary conversations' because nothing is scarier than not talking about it. Silence enables it to continue," she said.
Stephanie Walker, RN, SANE nurse at Franciscan Health Crown Point agrees with the need to raise awareness. "This program is so important because this type of violence is so intimate and not easily talked about. Sexual assault is something that every woman knows about but nearly none feel comfortable discussing."
Human trafficking is another issue that can fall below the radar, but one that forensic nurses are trained to detect. Sara Montalbano, BSN, RN, SANE coordinator at Franciscan Health Hammond, Dyer and Munster, noted that victims are discreetly provided with a sticker they can place on a urine sample to quietly let staff know they are a victim of human trafficking.
Ultimately, it's the desire to help those who are vulnerable that keeps these nurses doing such difficult work. SANE nurse at Franciscan Health Hammond Amanda Inskeep, RN, puts it this way: "We believe you and we're here for you. I feel like that's the biggest thing they need to hear."
HERO Image Caption: From left, SANE nurses at Franciscan Health Hammond Tracey Bolda, Amanda Inskeep, Sara Montalbano, Emily Pizzulto and Kele Ivey.