When a person goes to the hospital after being sexually assaulted, they require special care. Not only to treat their physical injuries, but to collect evidence and provide appropriate emotional support.
In the late 1990’s, Maine established a program to train nurses to provide that specialized treatment. More than two decades later, many advocates say there still are not enough of these nurses in Maine, but a new initiative aims to boost their numbers.
Emily Hilton still remembers a particular night shift in the emergency room, years ago. She was fresh out of nursing school, when a patient came in who had been sexually assaulted. Hilton was assigned to treat the patient and collect evidence, which she had never been trained to do. She says she was given a rape kit — a box filled with forms and envelopes to collect evidence — and a set of instructions.
"I was very overwhelmed, and I really — so, I did it, I followed the instructions,” says Hilton. “But I left feeling like I really failed that patient."
Hilton says she didn't know what to say to the patient, and that she was terrified that she made a mistake while collecting evidence.
"And that if this ever were to go to a trial situation, or there was an investigation, that it would be dismissed, and that person might not meet justice," Hilton says.
The experience haunted her. Which isn't surprising to Polly Campbell, who has been training nurses in forensic examination for 16 years — first for the state, and now with the University of New England. Campbell says that without that training, nurses are far less equipped to care for assault victims.
"It would be like asking someone who's worked for 10 years in labor and delivery to suddenly go and function well on an orthopedic unit. We are specialists," Campbell says.
She says there are about 125 forensic nurses in Maine, and that's not enough.
"No one hospital, not even our largest hospitals, they cannot provide 24/7 coverage," she says.
Campbell is currently overseeing an initiative to recruit and train more Sexual Assault Nurse Examiners. UNE recently got a three-year, $1.5 million federal grant for the effort, and is collaborating with the state.
The training requires a week-long course to be certified to treat adolescents and adults, and another week for pediatrics. The grant covers the cost of lodging to relieve some of the financial burden.
But Campbell says there is another reason for the shortage of these specialized nurses.
"The challenges with this work are — they can be huge," Campbell says.
To retain forensic nurses, support within the hospital is critical, Campbell says. At Franklin Memorial Hospital in Farmington, emergency room nursing Director Courtney Ryder says they have more forensic nurses serving patients than in some larger hospitals, in part because her job is dedicated to supporting the specialty.
"In my position, I encourage my nurses, I provide the training, I support them, I schedule regular meetings to make sure we're, you know, providing the absolute best care," Ryder says.
That care makes a difference for survivors of sexual assault, says Meagan Davis. She is the executive director of Sexual Assault Prevention and Response Services in Lewiston, whose advocates sometimes stay with patients in hospitals.
"One of the biggest things that we've seen, is one of the reasons why people don't come forward and don't want to report, is because of how they've been treated, possibly,” Davis says. “So maybe they did disclose something to somebody and they weren't believed or if it's the nurse in that realm, then if they're not being treated fairly and with compassion, then it really deters them from wanting to come out and reach out for some help."
Emily Hilton, the nurse who felt unprepared to treat a sexual assault patient when she was new on the job, says the experience motivated her to get specialized training as a forensic nurse.
"It was phenomenal. It totally changed my approach in nursing,” Hiltons says “And also within the emergency department, which is where I've primarily worked, we do a lot of triage. And so, we meet people who come through the door. And to be that first face they see, and to be able to understand and to reach them, it's very powerful. It's very powerful work."
Hilton is also a regional coordinator for UNE's program to increase the number of forensic nurses. The goal, she says, is for every hospital in Maine to have around the clock coverage.
Originally published 4:51 p.m. July 25, 2019