Nurses at junction of medicine, law

BY EMILY MELVOLD | MAY 13, 2009 7:30 AM

Solving crimes isn’t just the job of police or investigators — nurses play a major role in the justice system, too.

The field of nursing forensics has people in the medical field collecting evidence instead of taking temperatures.

“Forensic nursing is whenever the medical field intersects with the law,” death investigator Darleen Olshansky said.

There are several jobs in the forensic-nursing field, including disaster-planning consultants, correctional nurses, and death investigators. Locally, two groups are involved with nursing forensics.

The Johnson County Sexual Assault Response Team is affiliated with the International Association of Forensic Nurses, which has more than 3,000 members in 24 countries, according to the group’s website.

The UI Hospitals and Clinics sexual-assault nurse examiner team — made up of nine nurses in the Iowa City area — works with police officials, the county attorney’s office, the Rape Victim Advocacy Program, and emergency-room teams at both Mercy Hospital and the UIHC. They are on call 24 hours a day.

A rape victim can call in a report to the police, RVAP, the crisis line, or the emergency room. After receiving a call, a forensic nurse responds to the patient. A RVAP advocate is always present to help the patient through the process.

“We want to give them back control after they’ve had their control taken away from them,” said Pamela Terrill, the coordinator of the sexual-assault nurse examiner program.

The nurses are trained to offer a physical exam to check for injuries, medications to prevent STDs and HIV/AIDS, the Plan B emergency contraception, and an exam to collect evidence in case the patient decides to file a police report.

The patient has the option to receive or deny any of these services.

Funding from the state through the Crime Victim Assistance Division pays for all of the exam and medication expenses. As of Jan. 1, all states are required to pay for these services, but Iowa was already doing so, Terrill said.

“I’m really proud of our state for being so forward thinking,” she said.

Terrill, also a member of the UI nursing staff, said nurses with the UIHC’s program recommend having an exam and collecting evidence right away; evidence only remains usable in the body for three to four days after the incident.

“People who have gone through a traumatic experience are not always thinking about all of their options,” she said. “They need more time to process everything sometimes.”

Police are required to hold evidence for up to 10 years if a victim wants to file a report later.

“We give them the facts, but they make all of the decisions,” Terrill said.

An exam can take between two to four hours. The forensic nurses said most people have the exam, but not many report the incident to police, Terrill said.

Reports of sexual assaults have increased by 50 percent since the program’s initiation in 1992, said forensic nurse Nancy Downing.

A 40-hour course is required to be a sexual-assault forensic nurse. It’s offered one to two times a year in Iowa City.

In the weeklong training, students ride along with a police officer and practice testifying in court and performing speculum exams, Downing said.

While the UI does not have a program in the School of Nursing specializing in forensics, she said, a handful of colleges in the United States do.

“Rape and sexual assault is an emergency, and that is why we do what we do,” Terrill said.

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