Essential services

Last government shutdown threatened care of D.C. forensic nurses

 
October 11, 2013 -- Today the Huffington Post reported that the partial federal government shutdown was threatening to stop forensic nurse examiners from helping sexual assault victims in the District of Columbia. The blog post explained that the relevant programs rely on federal funding, and it focused on the worrisome funding outlook. But it also explained that the nurses do rape kits that are critical to the criminal justice system. And it suggested that they act as advocates for victims, helping them through the various aspects of the process. The piece might have done more to educate the public about what the forensic nurses do, particularly their skilled physical and psychosocial care and their forensic testimony in court. But the post did at least signal the importance of having the nurses on call 24-7 to come to hospitals and care for victims. We thank the Huffington Post and political bloggers Amanda Terkel and Jason Cherkis.

The item was headlined "Rape Kits May Stop In D.C. If Government Shutdown Continues." The first few paragraphs describe the basic situation. Rape victims in D.C. generally "receive a forensic exam when they arrive at the hospital so that DNA evidence can be quickly collected to help obtain justice." And the victims "can also expect to receive the services of an advocate who will be at their side through the entire process, helping them with any administrative, employment or housing issues that may arise." Presumably that is all done by the same people. However, the post notes, that system could end if the shutdown goes on. The piece quotes Nikki Charles, co-executive director of the Network for Victim Recovery of DC (NVRDC), who worries that victims will go without the services of her "case managers, who help the victims with anything they need, [and] are available 24 hours a day, seven days a week."

Only then does the post make clear that these are nurses. It notes that NVRDC is "one of two groups that makes up D.C.'s Sexual Assault Nurse Examiner Program," the other being D.C. Forensic Nurse Examiners (DCFNE). Both groups depend on federal and local funds. The post includes good quotes from DCFNE executive director Heather Devore:

If we don't have funds, no rape kits get done, there's no medical forensic exam. It would be back to the days of prior to SANE's existence, where it's essentially an evaluation by a physician and you lose evidence. It's especially important because we know that DNA degrades quickly; we only have a short time in order to obtain this evidence. It's not like we can schedule and tell them to come back in a month when we have funding, because all that evidence is gone at that point.

The rest of the piece is mainly about how long SANE's current funds will last and contingencies if it does not get more. Devore says that if the government remains closed, she would look to private funds, or "the other alternative is asking my nurses to be on call in the middle of the night and coming in and performing their duties without pay, and without anticipation of being paid anytime in the future." Of course, the nurses are on call 24/7 regardless; it's the never-getting-paid part that would be a problem (unlike federal employees, government-funded non-profit workers cannot expect back pay). The piece ends with a short passage describing how the shutdown has already undermined domestic violence programs in more general ways.

This report includes several helpful pieces of information about SAFE nurses. (The better term is probably "sexual assault forensic examiner," or "SAFE," rather than "sexual assault nurse examiner," which creates an acronym inviting people to consider the practitioners' mental health). The piece makes clear that the nurses are essential for obtaining the forensic evidence that would otherwise be lost--including with the traditional scenario of physicians doing an evaluation. The piece also briefly describes the far broader range of services that victims can expect to receive from "advocates" and "case managers," and to the extent readers understand those to be the SAFE nurses, those elements are helpful.

However, the piece is vague about whether those last services come from the nurses. More broadly, it would have been helpful to get more detail about what the SAFE nurses do and why. What special training and focus do the nurses have that enables them to do more than physicians would? And it would have been great to hear more specifics about how the nurses help sexual assault victims, both as part of the criminal justice process--like testifying in court--and in providing skilled physical and psychosocial care.

Still, despite these limitations, the report does briefly highlight the critical work of forensic nurses for an audience that may not be familiar with it, particularly given the entertainment media's overall failure to recognize that work. We thank those responsible.
 

See the article "Rape Kits May Stop In D.C. If Government Shutdown Continues," by Amanda Terkel and Jason Cherkis, posted October 11, 2013 on the Huffington Post. This piece is archived in pdf format.

See the International Forensic Nurses Association's website.