1. Chang, Emmeline

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A missionary zeal for forensic nursing first seized Virginia Lynch, MSN, RN, FAAFS, FAAFN, when she was a nursing student working with rape victims. "I saw that survivors of violent crimes were often in the hands of emergency room physicians with no forensic training," she says, "and that the failure to preserve specimens for forensic science evaluation often resulted in a miscarriage of justice. I wanted to find a solution and have been trying to do that for the last 25 years."


Now, thousands of forensic nurses across the country collect evidence in the aftermath of rapes, perform death investigations, and work with victims of accidents and crimes. Sexual assault nurse examiners (SANEs) have been changing the nature of the medical examination of rape victims. "We used to have problems with the medical staff in a hospital doing what they always do," says Beryl Skog, MEd, RN, who works as a SANE in Bergen County, New Jersey. "Getting victims undressed, taking their blood pressure-all that interferes with the evidence collection. You have to get them undressed on a sheet of paper like a drop cloth so that any debris, grass, or other evidence will fall onto the sheet. You need to put the underpants in a separate bag." According to Skog, when a SANE is working on a case of rape, prosecution is more likely to be successful.

FIGURE. Beryl Skog, ... - Click to enlarge in new windowFIGURE. Beryl Skog, MEd, RN, a sexual assault nurse examiner (SANE), says that when a SANE is working on a case of rape, prosecution is more likely to be successful.

As important as training in evidence collection is it's professional education and sensitivity that forensic nurses bring to law enforcement. A police officer might fail to recognize a diabetic coma, for instance, says Lynch; nurses are also skilled in psychosocial intervention. "Any time you're working with victims of rape, you're dealing with emotional trauma. Even if the patient is dead, you're dealing with the emotional trauma of family, friends, and colleagues. Police officers and doctors are not trained in this." Such sensitivity is crucial after a rape has been committed--the examination process should involve many things, from asking about the specifics of the rape, to combing the victim's hair and swabbing the mouth for evidence, to wiping the external genitalia for specimens.


Skog recalls one case in which a nurse's sensitivity helped to clarify a situation. An elderly woman in a senior center was found with a male neighbor--his pants down, her diaper removed, and her blouse open. "The victim was so distressed by being found that she was speechless," Skog says. "Everyone was seeing this as a sexual assault." But Skog and a rape crisis counselor spent a few minutes alone with the woman and discovered that the man was the woman's companion. Forensic nursing can be difficult but also fulfilling for those attracted to it. As Lynch says, "We deal with some of the darkest aspects of the human experience: sexual assault, domestic violence, elder abuse, and crimes against children. We deal with the perpetrators of violent crimes. And we chose to do this."-Emmeline Chang