Wednesday, January 12, 2011

Nurses bring a touch of CSI to ER

From the Times Colonist: "Beaten and emotionally traumatized, victims of assault, particularly sexual assault, can present a difficult challenge for medical practitioners and police investigators.

While nurses and doctors work to begin the healing of physical and psychological injuries, police and the legal establishment want evidence to be properly collected and preserved.

But in Victoria, about 15 nurses have signed up to work as forensic nurses, helping to meet both sets of challenges.

The nurses are specially trained to deal with a victim's medical trauma, but, at the same time, can gather key evidence that can put the assailant in prison.

Originally they were known strictly as sexual assault nurse examiners. Now they favour the broader term of forensic nurse because they can also collect evidence in cases such as child abuse.

"I'm the CSI [crime scene investigator] in the ER," jokes forensic nurse Janet Kalnan, co-ordinator of the program in Victoria.

The program started in 1996, following others launched on the Lower Mainland. The nurses, trained in forensics, perform regular work in various departments, such as emergency or recovery room, but are on call to report within 30 minutes to Victoria General Hospital to assist the victim of a sexual assault. The first priority given to the victim is always medical care. It is provided on a one-to-one basis and can last for several hours.

"It's our patient, and it's the only patient we look after at that particular time," Kalnan said.

The forensic work involves preparing a "traumagram." Checking from head to toe, injuries such as scrapes or bruises are noted, described and documented on a "map" of the patient's body. Observations of mood and demeanour are also recorded.

Samples, like swabs from various parts of the body, are taken. Any substance or smear that might provide a DNA match to a suspect is collected. The victim's blood and urine is collected to be tested for drugs and alcohol. Foreign material, such as twigs in the hair, are collected and packaged.

Samples are marked, recorded and preserved in a cooler. But to be valid legal evidence, the movements and whereabouts of samples must be tracked and recorded. It must be noted who collected a sample and when, who received it next, who transported it and when it arrived in the secure area where it was set in a cooler.

Records of the handling of evidence is crucial to any court case so nobody can argue that it has been tampered with.

"This is how you maintain a chain of custody," Kalnan said. "You can't just throw it in a box and put it in the back cupboard and walk way from it."

The forensic nurse can restore a sense of autonomy and control to a victim by offering options to evidence collection and police involvement. The victim can elect to have no police involvement and no forensic examination. Or he or she can involve police immediately in the forensic examination, and officers will document the crime.

If it seems too intimidating to make statements to police and begin the legal process, a victim can put the decision off for days or weeks, even months.

The forensic nurse will store evidence for up to a year. Victims may prefer to make up their own minds whether to talk to police once they are more emotionally stable.

Providing such options, particularly for a victim of sexual assault, goes a huge distance in helping rebuild a traumatized individual, said Tracy Lubick, resource development manager for the Victoria Women's Sexual Assault Centre ..."

Click here to continue reading the story.


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