Forensic nurses play pivotal role in criminal cases

3/19/2004

Kate Myers doesn't carry handcuffs or a gun, but for five years she has been on the front line in the battle against rape.

She's one of 114 sexual assault nurse examiners in area hospitals who comfort victims and gather crucial evidence that law enforcement uses to prosecute rape cases. She said she enjoys not just helping victims, but helping prevent future assaults.

"Something I collect might put somebody away for 30 years," she said as she sat in a special examination room in the St. Vincent Mercy Medical Center emergency department.

She pointed to a rape kit that she and other SANE nurses use to collect evidence, and added, "We've had instances where something in that case makes the case." In the last few years, Ms. Myers, who is a coordinator of St. Vincent's SANE program, and other SANE nurses noticed a trend. Because of their training in collecting evidence, more and more they were being asked informally to help out with domestic violence cases, as well as cases of child sexual abuse.

Curious as to just how much this was happening, officials at St. Vincent and Toledo Hospital - the two largest hospitals in the area - began keeping an informal tally of how often SANE nurses were called in on domestic violence or pediatric assault cases.

"We were just blown away by the statistics," said Karen Peckinpaugh, the SANE coordinator at Toledo Hospital.

Last year, SANE nurses at the eight hospitals in Lucas County were involved in 282 sexual assault examinations. In 10 months last year, at just Toledo and St. Vincent hospitals, those same nurses were called in to gather data in 140 domestic violence and pediatric sexual

assault cases - everything from elderly women beaten by their husbands to toddlers sexually assaulted.

The finding has sparked an effort by the YWCA, which helps coordinate the local SANE program, and nurses to expand the role of SANE nurses. They want SANE nurses to be called in on domestic violence and child sexual assault incidents.

The challenge is coming up with an estimated $138,000 annually to fund training and other expenses. But nurses, YWCA, prosecutors, and law enforcement said the existing SANE program has been so effective they're committed to the expansion.

"We're going to find the [money]," said Lisa McDuffie, chief executive officer of the YWCA in Toledo.

"I am 100 percent behind [the expansion]," said Sgt. George Kral, supervisor or the Toledo Police personal assault unit. "I can't wait for it to happen. They do such a fantastic job of securing evidence in rape cases, it would be a huge asset to have those same nurses do all of the forensic examinations for domestic violence and pediatric cases."

Julia Bates, Lucas County prosecutor, agreed:

"It's so beneficial, so why not allow that same philosophy SANE uses with adult sexual assault victims and apply it to domestic violence and child sexual assault victims," Mrs. Bates said. Area SANE nurses said they've always helped out in domestic violence and child sexual abuse cases, but said in order to formally expand their role - as well as improve their ability to help - they need more training.

"It's not like the system is broken, we just want to improve it," said Sally Royston, coordinator of the SANE program coordinated through the YWCA in Toledo.

The YWCA coordinates SANE nurses in the eight Lucas County hospitals, as well as SANE nurses at hospitals in Fulton, Wood, Sandusky, Erie, Henry, Williams, and Wyandot counties.

Some hospitals, including St. Vincent and Toledo Hospital, have rooms set aside in emergency departments that are used only for sexual assault examinations.

The goal is to expand the role of SANE nurses at all Lucas County hospitals, but Ms. Royston said it could be expanded at other sites too.

"It will make us more efficient and more thorough," Ms. Myers said of more training "It seems like more people are reporting abuse in children, so we said, 'Wow, we need to be educated in this.'●"

Just as examining and comforting an adult rape victim requires special skills, so too do domestic violence and pediatric sexual assault investigations, she said.

In the case of domestic violence, nurses must be trained to recognize telltale bruise patterns and other evidence of assault.

Pediatric investigations require a specialized knowledge of a child's anatomy, as well as interview skills needed to comfort and talk with children.

SANE programs are becoming increasing popular, from 20 nationwide in 1991 to more than 500 today, according to information gathered by the International Association of Forensic Nurses.

Recently, more SANE programs have been expanding their training to include domestic violence and pediatric sexual assault investigations, according to Patricia Speck, a SANE nurse in Memphis and president of the association.

Ms. Speck said the programs have become so popular she predicted eventually the government or organizations that accredit hospitals will require hospitals to have SANE nurses in place to better treat victims of violent crime.