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Clinical Managers in Action: Erin Pollitt on human trafficking

DCFNE Clinical Manager in Action_ Nicole on Court Testimony

DCFNE Clinical Manager in Action_ Nicole on Court Testimony

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What can forensic nurses do to identify and respond to survivors of trafficking? We talked with our Clinical Nurse Manager, Erin Pollitt, to learn more about the role of forensic nurses in anti-trafficking initiatives and what is being done to improve the response. 

As a Clinical Manager, you take on work beyond patient care. What is a project that you are working on that you are passionate about?

One of my goals since coming to DCFNE has been to increase our identification and response to patients who have experienced human trafficking.  When I worked in Maryland, I helped the MD Human

Trafficking Task Force to develop a medical screening protocol for identification of patients in healthcare settings.  I hoped that I would be able to put my experience to use to help benefit people who have experienced this type of abuse here in Washington DC.

What interested you about working on an anti-trafficking initiative?

Trafficking is not just a global problem; there are people experiencing this form of abuse and exploitation right here in DC.  We know that trafficking survivors often access health care services during the time of their abuse/exploitation.  With proper training and increased awareness, we have the ability to identify and help people who may have otherwise went unnoticed.

How does trafficking relate to Forensic Nursing? What is the overlap?

Forensic nurses are in a unique position to be able to identify patients who have experienced trafficking.  Patients that have been trafficked often seek medical care related to an incident of assault or violence. Many trafficking indicators mirror the same signs and symptoms of abuse that forensic nurses routinely assess. The forensic nurse is able to conduct a thorough and private assessment of each patient in a non-judgmental environment. womens health. We provide a safe environment that empowers patients to make choices regarding their own care, seek help and/or escape an abusive situation. 

How is DCFNE addressing trafficking within the program, and what plans do you have to increase this response in the future?

We have recently connected with FAIR Girls, an anti-trafficking nonprofit here in DC, to provide education to medical professionals in the area.  We continue to network with other organizations throughout the District in order to be able to provide the best resources we can for patients who report having been trafficked.  We are in the process of developing a detailed response plan as well as education for our nurses related to the care of this vulnerable population.

What are a few things that healthcare providers can do to address trafficking in the healthcare setting?

These situations aren't always black and white.  It's important for healthcare providers to keep an open mind. Look at the red flags in the context of the big picture. Indicators may be present when in fact, the patient is not actually being trafficked. If you feel like your patient may have been trafficked, ask questions! Screen them for abuse, but know that they may not disclose to you at that time.  

Meet a (future!) Forensic Nurse: Kendra Moats, BSN, RN

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Over the past few months, we've been lucky to have Kendra precepting with DCFNE while she completes her Masters in Forensic Nursing. She has worked alongside our nurses to gain a deeper understanding of forensic nursing and how our program functions, and she helped to develop resources and education around human trafficking. Kendra's last day was yesterday, but before she left we were able to ask her a few questions about her experience with DCFNE and here is what she had to say:

1. What inspired you to connect with DCFNE?
 
Initially I had a school requirment to find a preceptor in forensic nursing/ sexual/domestic assault that would assist me in developing and implementing a project that would be beneficial to that organization, so I did a random internet search that brought me to DCFNE. 
 
2. How does working with DCFNE support your professional goals?
 
I am totally on-board with becoming a SANE/FNE after working with DCFNE.  I have really enjoyed and learned tremendously about the methods, training and components of a forensic exam
 
3. What has been your favorite part of your experience with DCFNE?
 
My favorite part of my experience was being in the room with the patient observing an exam and helping to facilitate the trainings.
 
4. From your experience, what is the most important thing for the general public to know about forensic nursing?
 
The most important thing for the general public to know about forensic nursing is that the patient is most important.  In the midst of collecting evidence, the patient's needs and care must be at the forefront.
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Clinical Managers in Action: Nicole Stahlmann on Court Testimony

How does a survivor request a FNE to testify?

In criminal cases, forensic nurse examiners are subpoenaed to testify by the prosecutor, not the survivor themselves. Once the FNE receives the subpoena and the trial date, they are able to begin preparing.

What type of testimony can FNEs provide?

Forensic nurse examiners can provide both fact and expert witness testimony in criminal and civil legal proceedings. Fact witness testimony means the FNE will testify to what they personally observed during the medical forensic exam and documented on the medical forensic chart. Expert witness testimony means the FNE is qualified by the court as an expert in the field of forensic nursing, based on education, experience, and certification, and can provide their opinion on what the evidence presented may conclude.

How much preparation does it take prior to court?

If I am providing fact witness testimony, I generally prepare for 5-7 hours. However, if I have been asked to testify as an expert witness, I often will prepare for over 20 hours. Preparation includes researching and reading journal articles to support my testimony, reviewing the medical forensic chart and photos, and sitting down with the attorneys to cover practice questions.

When DCFNE nurses are subpoenaed to testify, they are required to complete court preparation with me prior to the trial date. This includes reviewing the medical forensic chart together for potential areas of discussion when testifying, and any areas for improvement to enhance their future testimony. We then analyze the photographs they took, and if necessary discuss ways to advance their photography skills.

The work of FNEs can be really clinical, how do you translate clinical language into language the jury and judge will understand? 

In all of our court preparation and in trainings, we practice ways of explaining medical forensic terminology to the judge, jury, and attorneys. For example, I don’t expect them to know what Patterned Injuries are, therefore I explain it as blunt force trauma or tissue trauma, in which you can identify an object or tool which created the injury. We do this to educate the courtroom, so they can better understand the medical forensic chart, review of photos, and different types of injury.

How often have you been called to testify in court?

In the past 2-3 years, I have prepared testimony for over 10 cases. Six were fact witness testimony and 4 were expert witness testimony. There were also several trials which have been continued or where the defendant took a plea deal. I’ve also prepared more than 15 FNEs for courtroom testimony. Each time I’ve worked with our nurses, it has provided me with valuable continuing education and a stronger foundation for testifying myself.

What is the most challenging part about testifying in court?

The most challenging part of testifying is remembering the jury is full of people from various backgrounds. Speaking to them inclusively, looking at them and making eye contact, helps humanize the situation and creates a connection beyond just a back and forth between the attorneys and myself. Another challenge for me is overcoming the urge to anticipate questions. It’s a struggle, because you never know what question is coming next, especially from the opposing counsel. To get over this, I tell myself and our nurses to relax and listen to the entire question before answering.    

Meet a Nurse: Rhonda Boyett

Rhonda Boyett, BSN, RN, CEN, SANE A

What inspired you to become a nurse?  I grew up in a small rural area in Alabama and I wanted a profession with good pay and job security. Nursing fit both. The hats were just a bonus fashion statement.

What drew you into the field of forensic nursing? "Murder in a small town"  Literally, a heinous crime in my sleepy town in Alabama. I love the legal aspects of the job, I want to make a difference in the injustice to victims within our legal system..

What is your favorite part of being a nurse? Having a new experience each time I come to work. Taking care of patients and working with other colleagues 

What do you do to take care of yourself in such a stressful job? Unplug with the family! I value my time away from technology:>) Love to travel with my daughter and husband.

 

 

Meet a Nurse: Kaitlyn Molé

 

What inspired you to become a nurse? 

I believe that the world functions best when everyone works collectively for each other's well-being and advocates for one another. There's few jobs that are better suited to advocate and to offer support for others than nursing! We have a unique opportunity to provide compassionate, holistic care and education and to serve as a guide for people in their own wellness. I love it! 

 

Why did you become a forensic nurse? 

 I worked in domestic violence advocacy before becoming a nurse as well as during nursing school. Traumatic experiences are so often categorized as solely having psychological and social effects, but they're deeply interwoven in health, both acutely and long term. So many people experience intimate partner violence and sexual assault. I think it's a huge social issue and can't imagine not working in anti-violence in some capacity, I feel as if it's an ethical calling for me.

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. I want to hold space for the complex experiences and needs that occur as a result of these traumas, it's so important to have private, focused and specially trained people to care for these patients. 


What's your favorite part of being a nurse?
 

I love listening and validating people's experiences. Everything moves so fast in the world, I think it makes all the difference to stop and really listen to someone. I also love guiding people in their own learning/understanding of their own needs and helping them manage their own wellness long-term. 

What do you do to take care of yourself in such a stressful job? 

I give 100% and try to be fully present when I'm at work so that I'm able to come home and know that I did all that I could for that person, that enables me to separate work and home. DCFNE is great about supporting self-care, I feel very supported by my peers in the organization and administration schedules in self-care which is great. Otherwise I spend time reading, cuddling my cats and my partner, laughing with friends, being outside etc. :)  I'm lucky to have great support! 

Meet a Nurse: Jen Marinaccio

What inspired you to become a nurse? 

After undergrad I worked within the organ and tissue donation field for about seven years. It was during this time that I noticed a paradigm shift, wherein patients and their support systems would rely heavily on the bedside nurse to answer their questions, provide support and comfort, and help guide their decision-making process (particularly with end-of-life issues). Observing the excellent care these critical care nurses provided inspired me to go back to school and get my R.N.

What drew you into the field of forensic nursing?

I was raised by an ethics attorney, and married one too - therefore, my role model, my support and I feel a strong need to help bring peace to those that may not have a voice, and justice to those who have committed criminal acts. Additionally, some of my previous training includes studies in forensic anthropology and death investigation. I consider myself so lucky to be able to function in this DCFNE role on a full-time basis, as forensic nursing is still considered an emerging field within the profession.

What is your favorite part of being a nurse?

Along with the importance I place on seeking justice, I also believe in providing compassionate care to the millions of people in our country that are edged out of opportunities for high-quality health care, affordable housing and livable income. Additionally, I appreciate and respect the stock the nursing profession places on higher and continuing education.

What do you do to take care of yourself in such a stressful job?

I am an avid (eclectic) reader, barre and spin attendee, world traveler, dog-parent and absolutely love delicious food and wine. And my husband is pretty darn cool!

 

Meet a Nurse!

What inspired you to become a nurse?Nursing is my second degree and career. I worked in the mental health field for many years before going into nursing. I was married to a Marine and wanted a job in the healthcare field that would be flexible. I knew that nurses were in high demand. anti herpes. I had worked as a behavior technician for a children's psychiatric hospital where I was able to observe nurses and their duties. I saw that I could still use the skill set I had already developed in mental health and have the flexibility I needed as a nurse.Why did you become a forensic nurse?

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In high school I had a forensics elective that I found absolutely fascinating. Later, as I was getting my undergraduate degree in Psychology, I also took a course in forensic psychology which only increased my interest. In nursing school I was very excited to learn that there were opportunities in the field of forensic nursing. Shortly after I graduated from nursing school, I took a certification course through Duquesne University.

What is your favorite part about being a nurse?My favorite part about being a nurse is how meaningful my work is. Often, as a forensic nurse your patients are having the worst day of their life. It's an honor to be able to give care and support to someone in such a delicate situation. At the end of the day you really feel like you have made a difference.What do you do to take care of yourself in such a stressful job?Self-care can definitely be challenging in a high stress job. I do guided meditations 2-3 times a week. mens health. This helps me compartmentalize stress and clear my mind. I like cleaning and reorganizing my house to decompress, it helps me emotionally purge some negative energy to physically "take out the trash". I also try to do yoga or some other physical activity several times a week to keep my endorphins high.

Happy Forensic Nurses Week!

On the last day of Forensic Nurses Week, we want to make sure you know where to find resources for forensic nursing here in our DC community and all over the world. Check out the DC Forensic Nurse Examiners website to learn about what forensic nurses in DC do. And check out the excellent resources the International Association of Forensic Nurse Examiners provided for Forensic Nurses Week, including a comprehensive FAQ. If you're a forensic nurse, today is a great day to make sure people in your community know how you assist victims of crime! If you know a forensic nurse, thank her or him today!

Happy 20th birthday, VAWA!

Last Saturday we celebrated the 20th anniversary of the signing of the Violence Against Women Act. This historic piece of legislation transformed the way we address domestic violence and sexual assault by expanding resources available to survivors like shelters and hotlines, improving law enforcements' ability to pursue perpetrators, and guaranteeing access to sexual assault exams. It also directs resources toward preventing these crimes. At the same time we applaud the advances made in the last 20 years, news about NFL players accused of domestic violence seemed to be everywhere. It is a stark reminder of just how much work remains, but it started a new conversation about how we can prevent domestic violence, how it should be punished, why victims of abuse may not leave a relationship, and how we can best serve survivors. Read more about the conversation that started on Twitter here. Finally, the White House has launched a new initiative to help everyone learn more about how we all can help prevent sexual assault and support survivors of sexual assault. The program provides tools and resources to empower anyone to learn how to recognize and intervene in situations in which consent is not given and how to raise awareness about sexual assault on college campuses. It aims to transform the way bystanders respond to situations that could lead to sexual assaults. Learn more at http://itsonus.org.Check out the resources DCFNE provides to survivors of sexual assault and intimate partner violence.

Back to School resources

It's that time of year! Fall is starting (not that it feels like it in DC) and lots of students are headed back to school. NPR has an in depth look at how college and university campuses are handling sexual assault. Read the articles here. Also, don't forget that the website notalone.gov, launched by the government to provide students with information about rights and resources for college sexual assaults.

Forensic Nursing Around the World

Two articles highlight the differences between forensic nursing around the world. Nurses in the Boston area talk about the advanced training they receive to perform forensic exams. A nurse in South Africa discusses being the only sexual assault nurse in the region (in addition to her full-time job). In addition to providing medical care and DNA collection, she may counsel rape survivors for up to 6 months. One common theme--it's a tough job, but it's a rewarding job.

DCFNE interviewed for U.S. News & World Report!

DCFNE's Intimate Partner Violence Coordinator, Heidi Marcozzi, participated in a U.S. News & World Report story about the importance of forensic nursing. She discussed the services DCFNE provides for survivors of domestic violence and sexual assault and our work with partner groups. She also provided details about the special training and knowledge forensic nurses bring to the exams they perform. We're very excited to see our work and the work of forensic nurses from all over the country highlighted in the national press! Read the article here.

Spike in homicide rate in DC

After years of falling homicide rates, Washington, DC has seen a surge in homicides. Police chief Cathy Lanier and anti- domestic violence advocacy organizations are concerned that domestic violence may be part of the reason for the spike. Although 2014 is only halfway over, more women have already been killed this year than in 2013. Our nurses offer free intimate partner violence exams at any time at Washington Hospital Center. Find more information on our website. There are also links to resources provided by other groups in the city and information about what to do if you or a loved one are facing an abusive relationship.

New campus sexual assault survey raises concerns

A new survey of campus sexual assault adds to already serious concerns about how our nation's colleges are responding to sexual assault. The survey, released by Senator Claire McCaskill (Missouri), reveals that many colleges are in violation of laws about responding to sexual assault or fail to follow best practices for responding to these crimes. Read more here and read the report here.

New sexual assault law for Maryland hospitals

Here  in DC, we watch the news about sexual assault and SANE programs in Maryland and Virginia closely because so many people cross between the three regions on a regular basis. The state of Maryland just passed a law requiring all hospitals to have a protocol in place for responding to sexual assault victims. Check out this article to learn more about Maryland's new law as well as a thorough overview of all of the different ways different regions across the country respond to sexual assaults.

National rape kit backlog, and our fabulous forensic scientists in Washington, DC!

The Department of Forensic Sciences in Washington, DC does a phenomenal job at processing our sexual assault evidence kits. Their forensic scientist and team have eliminated the backlog of kits in DC and have a rapid turnaround for test results. Kudos to them, thanks for doing such a great job with our kits!A Washington Post article about the national kit backlog. http://wapo.st/SOUXTg  

Local News Roundup!

Check out these local stories!DC works to address it rape kit backlog. And check out this very personal story about the consequences of untested rape kits and Congressional efforts to provide funding to end the national backlog.Earlier this week an Alexandria, Virginia deputy sheriff was arrested for sexually assaulting a female inmate. The sexual assault charges have now been dropped though he is still charged with carnal knowledge of an inmate and Alexandria's sheriff says he "betrayed his duty to this Office."  May 15 was the deadline for states and territories to adopt federal standards to reduce sexual assault in prisons under the Prison Rape Elimination Act. It is estimated that 4% of state and federal prisoners and 3.2% of jail inmates experience sexual assault.Montgomery County establishes a human trafficking task force.

Celebrating National Nurses Week!

Happy National Nurses Week! This year's theme is Nurses: Leading the Way and we're proud to be leading the way for survivors of sexual assault and intimate partner violence in the District. Forensic nurses play an important role in the community by providing victim-centered medical care while also collecting evidence and working with the judicial system to bring perpetrators to justice.

This year we joined with other victim services groups in DC to ensure that survivors of intimate partner violence (IPV) have access to comprehensive care and services. Our nurses provide exams to survivors of IPV and they are specially trained on the nuances of strangulation and other injuries commonly seen with IPV patients, and they know how to collect evidence and offer testimony in court. Learn more here. We also continued to provide exams and medical care for sexual assault survivors in the city. Check back for more information as our program continues to grow and offer new services!

Read more about forensic nurses and National Nurses Week here.