>>Sara: Hi. Good morning everyone. Thank you for joining us for this Facebook Live for Sexual Assault
Awareness Month. My name is Sara Jennings and I'm the manager for Bon Secours Richmond
forensic nursing services.
>>Bonnie: Good morning I'm Bonnie Price. I have the
pleasure of being the director of the forensic nursing program as well as the human trafficking
initiatives for Bon Secours Richmond.
>>Sara: We wanted to talk this morning about our program.
We're actually celebrating our 25th anniversary so I'm going to turn it over to Bonnie so
she can give you a little history about the program.
>>Bonnie: We are very excited about the fact that we have made it 25 years. The program started
in November of 1993 and we had one patient the first year and last year we had over 2,300
patients so each year we've grown. We started with three nurses, myself and two other nurses,
from the emergency department here and we saw a brochure one day about how to collect
evidence better in cases of sexual assault. We thought it was interesting. Little did
we know that, or little did I know that would be the start of my career as a forensic nurse.
So from the three on-call nurses that we had we're now up to 12
>>Sara: 12 almost 13 >>Bonnie: full-time forensic nurses and we're one of
the few forensic programs in the country that has a forensic nurse on duty. Nurses aren't
called from home and don't work other jobs. They strictly work as forensic nurses so they're
much more available to respond.
>>Sara: So we actually cover all of Bon Secours Richmond
so we travel to all the other Bon Secours facilities. Our home base is here at St. Mary's
Hospital but we see patients at all of the facilities. Our forensic patients are very
varying. We take care of all different types of victims of violence, from sexual assault,
physical assault, domestic violence, interpersonal violence. About 40% of our patient population
is pediatrics. We also care for victims of human trafficking, workplace violence, and
we also take care of suspects of crime.
>>Bonnie: The program does stay very busy. In addition
to seeing patients we also do quite a bit of community education and presentations to
community groups on the various topics so we're very happy to have you join us on this
Facebook day.
>>We'd love to have any questions that you have.
We'll be happy to answer them, tell you more about our program. All of our nurses here
are very engaged in what we do. They also help with a lot of the community education
that Bonnie spoke about. We're speaking with local law enforcement, commonwealth attorneys,
firefighters, EMS providers about how to better care for victims of domestic violence, sexual
assault, strangulation, and how to properly take care of those patients.
>>Bonnie: We're also very fortunate that we get to participate in our professional organizations.
In fact Sara is going to be the upcoming president of our
International Association of Forensic Nurses.
Sara why don't you tell them a little bit about forensic nursing in Virginia?
How many programs are there?
>>Sara: Sure so we have about 13 to 14 forensic programs
in the state. Some of them vary. Some just see pediatrics, some see both adult and pediatrics.
We have about 70 forensic nurses in the state and we meet about every one or two months
as a group to talk about what issues are happening in the state, how from a legislative perspective
can we better care for victims of violence. So I've had the privilege to serve on that
board for numerous years and we also have two of our current staff, Megan Pond serves
as the chapter secretary and Angela Maudlin serves as our chapter treasurer, so we stay
very active in that group to help advance the career of forensic nursing, make it more
aware in the community because one of the things we want to do is bring awareness to
every hospital that there's a need for forensic nurses within their facility.
>>Bonnie: Absolutely. Access to care is something that Sara and I
talk about frequently. How we can
get more forensic nurses across the state as well as across the country so that when
patients have needs they can come. And I think it's important, since this is Sexual Assault
Awareness, for everyone to know that if you have someone that you know that reports that
they have been a victim of sexual assault or physical assault or domestic violence please
come to the hospital. There are nurses here that can help you. We're specially trained
to collect evidence, to document the injuries, we take photographs of any of the injuries
and then we testify in court as expert witnesses.
>>Sara: Absolutely and while you're here at the hospital
we're providing both medical care and the forensic components so we're making sure that
there's not other things going on that could make the actual assault worse or different.
And we're giving medications to treat for potential sexually transmitted diseases.
>>Bonnie:The other thing that's really good is we have a program called RHART.
Do you want to tell them about that?
>>Sara: So RHART stands for the Regional Hospital Accompaniment Response Team.
And we have a group of advocates that are volunteers that
come into the hospital and they're here with every patient that's 13 or older that has
experienced either some type of interpersonal violence or sexual assault. And they stay
with the patient throughout the whole entire process, providing resources such as counseling,
emotional support, if they need resources once they leave the hospital they're able
to help identify those needs and meet those needs.
>>Bonnie: Absolutely and I think it's important that, that we have that type of program.
The forensic nurse often has to focus on the evidence collection
and the scientific process but there's always
somebody here to provide that emotional support that they need and they follow up afterwards.
>>Sara: Absolutely. Something unique to our program, we participate in multiple different
Sexual Assault Response Teams, or SARTs,
in the area so we are always working jointly and collaboratively
with both local law enforcement, the advocates and victim witness personnel in the area,
commonwealth attorneys and then the forensic nurse and we come together as a team to better
care for these victims.
>>Bonnie: We do and all of the jurisdictions locally,
but I think it might surprise some people to know that we serve 26 different counties,
cities, towns across the state of Virginia.
Some of the patients are up to two hours away
that come to see us. And that goes back to the access of forensic nursing care is not
everywhere in the state. So law enforcement and victim witness and commonwealth attorneys
make that trip because they know it's so important for the patient to have a forensic nurse.
>>Sara: Something that's unique about asked all of our forensic nurses, most of them historically
have been prior emergency room nurses so they have really great critical thinking and some
a very good experience with assessment but they've all received specialized training
on how to be a forensic nurse. They've completed a certain number of clinical requirements
and then about nine of our nurses currently are certified as a Sexual Assault Nurse Examiner
- Adult so a SANE-A and also a Sexual Assault Nurse Examiner - P for Pediatric and that's
something that we find that is a a plus for our team. We are specially trained. We also
have the certification that's nationally recognized.
And all of those things help us to testify
objectively as expert witnesses in court.
Frequently we're asked, how often do the nurses
go to court? What would you say?
>>Sara: It depends on which nurse but a couple of times a year for the most part.
>>Bonnie: Yeah I think last year we received over a
hundred subpoenas, so request for court, that's for the entire team so we spend a fair amount
of time going to court. I think the other question that we're frequently asked is, How
do I become a forensic nurse? Let's talk about that.
>>Sara: Sure. So um that is a really popular question actually and most of our nurses, like I said,
prior ER nurses, a lot of them have been in some type of critical care setting, so that's
something that we find is very helpful. A good critical thinking, good assessment
background. But if you have an interest in becoming a forensic nurse that would be where
to start. We also like our nurses to have a minimum of a bachelor's degree
>>Bonnie: Absolutely >>Sara: and at least about two years of experience
as a registered nurse. >>Bonnie: And our hope -- well let me rephrase that.
My hope is that they'll go back to school -- and Sara's --
>>Sara: Yes >>Bonnie: and get masters degrees and doctorate degrees.
Education is important to us. So the other thing I think that's important for people
to know who might be thinking about becoming a forensic nurse is that there's a lot of
research you can do out there on your own. The International Association of Forensic
Nurses is a great place to start. We have a state chapter of forensic nurses and there's
various free trainings and conferences held across the country and webinars that people
could attend to learn more about what we do.
>>Sara: Absolutely if you go to www.forensicnurses.org
that's our professional organization. That's a great place to start for some good information.
[Off screen voice] >>Patients come in to St. Mary's to be treated. Are they treated in the ER?
>>Sara: That's a great question. So if you didn't
hear our friend that's with us, they asked: The patient presents to the hospital as a
sexual assault. Are they seen in the emergency department or somewhere else? Something that
makes us very unique is our patients for the most part present through the emergency room.
We do see some patients that are on the inpatient side and we can talk more about that. But
we actually have a suite that is a part of the hospital but not connected to the main
part of the hospital that's a very quiet, private area where we have a interview room,
a waiting room for our patients, and then we have our exam room. So we are taking the
patient out of a very chaotic at times emergency department to give them as much privacy as
possible. We're ensuring their safety throughout the whole entire visit. So there is a brief
period of time that's spent in the emergency department, it's a majority of the time is
spent in our office suite. >>Bonnie: And I think it's important for people to know
the reason they're in the emergency department is to make sure any emergent medical needs
are taken care of first. Medicine always takes priority over forensics. So if they have any
injuries or need x-rays or CTs of their neck, say for example, it's a patient who was strangled,
those things need to be taken care of first. So let's talk about strangulation.
>>Sara: Sure, great. So it was July of about three years ago
>>Bonnie: I think so >>Sara: in Virginia strangulation became a felony
offense. And we knew that we need to address our patient population because we were seeing
more patients present to the hospital saying that they had either been choked, which is
more of a layman's term, and strangled. So we developed a strangulation protocol for
our facility and we are screening all of our patients that either a victim of physical
violence or sexual violence to see if they have been strangled. Something that is unique
to our program is we actually collect potential DNA touch evidence from their neck. We are
having them demonstrate how they were strangled with a mannequin head and we're photographing
that and then we are releasing that potential DNA evidence to law enforcement for the purpose
of their case.
>>Bonnie: And I think it's important for people who
again might have friends or someone you know that says to you they've been choked or strangled
that even if they don't have external injuries, they're still sometimes injuries and symptoms
that they can have and it's really important that those things are documented so that there's
a record of that when they go to court. Some examples of symptoms is difficulty swallowing,
difficulty speaking, ringing in the ears, >>Sara: amnesia, forget what happened
>>Bonnie: some patients will tell us that they were incontinent, they had a loss of bowel or their
bladder and these things are really serious.
>>Sara: Absolutely, and it's very important that they
seek medical care and they can come to any of our Bon Secours facilities, tell the person
at the ER that they were strangled and they're going to also consult the forensic nurse in
addition to taking care of those immediate medical needs.
>>Bonnie: And not only do we do the initial exam, we also follow them up in about three days. And
the reason we do that is because sometimes the symptoms don't show up right away and
some of the injuries don't show up right away. So you might see something we call petechiae
which are small red blood vessels on the face, eyes, or ears, mouth, and they might not show
up immediately. [Off screen voice] >>Several people have said
hello in the comments. [overlapping] >>Sara: Hi >>Bonnie: Hello
>>Bonnie: I was gonna say let's talk about community
>>Sara: Sure >>Bonnie: support.
>>Sara: Yeah absolutely. So something that's very unique to our program also is we rely heavily
on community support. One of our largest fundraisers that we do each year is Wine, Women and Shoes
which is held typically in the fall in Short Pump. You wanna tell them a little bit about
Wine, Women and Shoes? >>Bonnie: Sure so the title of the event I think kind
of tells you that it's meant to be a fun event to help raise funds. And so we have a committee,
a Wine, Women and Shoes committee, that's made up of some of the most dynamic, wonderful
people we've ever met. >>Sara: Absolutely.
>>Bonnie: And then we have a group called Shoe Guys and our Shoe Guys are fantastic. They're probably
the best support team a forensic nurse could ask for. And the event is a chance for ladies
and gentlemen to get together to learn more about forensic nursing, to visit some really
fantastic vendors, sample >>Sara: silent auctions
>>Bonnie: sample wine, that's kind of the purpose of the event, the silent auction
>>Sara: lots of fun, a wine wall >>Bonnie: each year they do a closet giveaway. I'd like
to have that closet in my house. So it is a great event. And I think it's important
for people to know that we are very blessed to work for Bon Secours and Bon Secours supported
this program for 25 years. And so it's through Bon Secours and the community support that
were able to do the things that we do. Why don't you tell them about some of the things
we've been able to do with the community support? >>Sara: So you know if we didn't have this community
support it would be very hard for us to care for these victims of violence. Something that
in the last two years we were able to do is purchase a coloposcope, which is a very large
microscope that helps us identify injuries that we can't see with our naked eye, which
is super helpful in a sexual-assault exam. We can also see oral injury. And we were able
to purchase that because of community dollars and support. Other things, or something is
simple to others but it's great to us, are gift cards. And we receive gift cards to give
to our patients either for gas, if they're trying to flee a domestic violence situation,
or medication money that they may need, or just a gift card to a grocery store so that
they can provide food for a family that they may not have been able to do before because
of their situation that they're going through. On the other side of that we're able to use
some of those community donor dollars to help train our forensic nurses. Forensics is ever-changing
and there's new things coming out each and every day and we want our nurses to be the
best trained possible. So we are sending them to conferences such as the Strangulation Institute,
we've had several of our nurses attend that. The IFN conferences. Our scientific assembly
to help learn what's going on in the forefront of forensic nursing across the entire country.
>>Bonnie: It changes rapidly and we need to make sure that all of our staff stay on the front end
>>Sara: Absolutely >>Bonnie: of everything that's out there. I think the
next big thing that that Sara and I would love to see with community commitment dollars
is potentially expanding our space. We have a very cozy space now and I think if we had
a little bit more space we might be able to serve a little bit more.
>>Sara: Our big goal is to have some type of training area. We do a ton of training and we'd love
to be able to do that here on-site to make it a little bit easier for everybody.
>>Bonnie: I think one of the other new initiatives that we haven't spoken about much is may be human
trafficking. So several years ago we were approached because one of the advocacy platforms
of the Sisters of Bon Secours is human trafficking and they knew that forensic nurses often took
care of patients who were trafficked. And so Bon Secours Richmond and Bon Secours Health
System put together a strategic quality plan of how we could adjust human trafficking.
And we started with collaboratives and a task force. Do you want to tell them about those?
>>Sara: Sure. So we meet several times a year as a group of -- sorry our microphone was dropping
-- we have a regional law enforcement collaborative so we're working with many different law enforcement
jurisdictions and victim witness including the FBI and Homeland Security. The purpose
that we're meeting is to come together as a collaborative to have an agreement of how
are we growing -- we are going to better treat these patients of human trafficking. How to
identify it, how to treat them and then how to better serve them once they're identified.
Another group we have is the advocacy collaborative so it's a group of local advocacy resources
such as Safe Harbor, Gray Haven, Richmond Justice Initiative, Replenish Richmond and
Impact and so we all get together to look at the advocacy side on how to better serve
victims of human trafficking. Something that we feel very proud to say that we partnered
with two years -- a year ago now, a year ago in January we partnered with Safe Harbor to
open the area's first human trafficking shelter. And then just recently we announced that we
are partnering with them to do a transitional shelter for human trafficking. So once they've
met some of their basic needs in the emergency human trafficking shelter they'll be able
to transition to the transitional shelter. >>Bonnie: And both of those things have been really
important >>Sara: Absolutely
>>Bonnie: in our program over the last two years that we've been monitoring how many human trafficking
patients that we've seen. We've had 110. I think it might surprise people to know that
most of them are from this country. While some patients are foreign nationals most of
them are from America. And are forced into this really violent evil lifestyle of being
trafficked. >>Sara: So once they're identified and they're brought
to the hospital the forensic nurses responding and assessing the patient, meeting their basic
medical needs some of these patients haven't had a meal in a very long time or they haven't
been provided proper nutrition, and they have a ton of medical needs that haven't ever been
addressed. So we're helping to be the liaison between law enforcement and advocacy in the
medical field. >>Bonnie: Absolutely. And I think it's important to know also that
there's two kinds of trafficking. So there's commercial sexual exploitation as well as
labor trafficking. Out of the 110 patients that we've had the majority have been sexual
trafficked. I don't think that's necessarily that it happens more, I think that that's
just what's being investigated and found more. But people often say we don't really have
trafficking here right? and the answer to that is we absolutely do. And I think if you
never turn over the rock you'll never see the issue. And it's not in one part of central
Virginia, it's really all over, >>Sara: Absolutely
>>Bonnie: in all of the counties that we serve we've seen some trafficking.
>>Sara: And it's very unique to Richmond because we
have a lot of Interstate traffic. So we see a lot of 95, 288, 295 and how trafficking
victims are being trafficked using those major interstates in the area.
>>Bonnie: Absolutely >>Sara: Good? Anything else?
>>Bonnie: I think that's good.
>>Sara: I think that's covered everything. If you
all have any questions we're happy to sit tight for just a second. If you don't we really
appreciate you joining in. If you have any questions about forensic nursing feel free
to either reach out to Bonnie or myself we would be happy to answer those. Help spread
the word about forensic nurses. Make them aware in your community that you have them
and please use them and tell your friends.
>>Bonnie: And thanks to everyone who's supported us >>Sara: Absolutely
>>Bonnie: over the last 25 years. We couldn't have done this without you: our law enforcement, our attorneys,
I don't want to forget anybody, our victim witness, forensic scientists, our advocates,
the people that work at the shelters, it's just been a team effort, the Child Advocacy
Center who we work with -- >>Sara: it truly takes the village
>>Bonnie: It absolutely does. We thank you very much for everything.
Yes thank you.
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