NEWARK, Del. -- An emergency room nurse named Anita
Symonds has an eye for details. She can distinguish between an accident and an
intentional injury. She can discern when color, shape, or pattern of a bruise
hints something occurred to a patient that is unlike the story being said.
She realizes the value of utilizing photos to preserve
details, of swabbing for bodily fluids, and distinguishing gunshot matter, all
without hindering with a patient?s care. Most importantly, she knows her work
needs a sensitive touch, looking at patients? emotional trauma can be just as dreadful
as their physical injuries.
Symonds is not constantly certain where the data she collect
will lead, however as a forensic nurse, it is her duty to make certain crucial
details about a patient?s injuries and condition are recorded. When required, she takes the stand in court ?
helping the prosecutors or the defense, depending on the case.
Symonds is also a coordinator of the forensic nurse examiner
program at Christiana Care Health
System, and she is searching for other similar nurses to join her in this
flourishing, more and more technical specialty
"Literally,
I'm looking at a patient completely different than someone else," Symonds reveals.
"I'm noticing what their clothes look like while another nurse is focusing
on their shortness of breath. We encompass all this other stuff, being
detailed. You're doing something beyond emergency room nursing."
When someone
surmises a crime may have been committed against the patient, forensic nurses
get involved.
A forensic
nurse may be part of the team that charges into exam rooms, in trauma cases
like gunshot victims. At the same time the trauma staff checks vitals and looks after the patient's needs, the
forensic nurse is also functioning but in a different way. Forensic nurses
collect and label clothing and belongings, record injury patterns, and listen
for statements the patient uttered in an excited tone that may suggest who the
offender is.
Symonds
explains that as forensic nurse they gather evidences, take pictures of
injuries, however they leave the medical treatment to the trauma team. "We
can get in and out without getting in the way. You can't have your staff who is
giving the care and addressing their physical needs also be able to collect
evidence."
Although in
other cases, a crime may not be instantly apparent, for instance an
elderly person who comes in wearing dirty clothes and having multiple bedsores
that - with additional tests - may show signs of elderly abuse. The state Division of Family Services, on the other
hand, must be notified by the hospital staff in cases that involve abused
children under the age of 18. Delaware
does not demand reporting situations of domestic violence or adult sexual
assault, which means evidence, is handed to police only if the patient agrees
to file charges.
Dawn Culp, a
forensic nurse coordinator who is regarded an expert witness for sexual
violence cases, said, "We still offer to them safety planning with all the
different options a patient has."
Majority of the hospitals in Delaware have someone on staff trained to carry
out tasks for cases that involve abuse or assault.
Culp reveals, Bayhealth Medical Center,
which includes Kent General and Milford Memorial hospitals, keeps nine nurses
trained as sexual assault examiners, with another 14 presently in training. Other
nurses went through training on handling cases of abuse and violence, and,
frequently, she explained, a forensic nurse is available at the hospitals no
matter the hour to care for patient.
There are seven
forensic nurses on staff assisting in assault and abuse cases in Beebe Medical Center, while Nanticoke Memorial Hospital has eight at
their disposal.
In 1996,
Christiana Care began its forensic nursing program, initially, with ten nurses.
Now, it has 19 forensic nurses -- with someone available 24/7 in the
emergency department ? qualified to handle cases of sexual assault, domestic
violence, child and elder abuse, and trauma injuries such as gunshot and stab
wounds. In 2010, just below 1,500
patients were attended to by a forensic nurse, however not every
patient was established to be a crime victim.
Symonds said, with
the help of a $10,000 appropriation from Verizon, forensic nurses from
Christiana Care will be able to attend an eight-hour training session on
identifying entrance and exit wounds for living gunshot victims.
Culp revealed
she was attracted to forensics because, as an emergency room nurse, she has seen
firsthand the effects of violence within the community. She has begun as a
sexual assault nurse examiner, awakened by the memory of a sexual abuse victim
who had to wait eight hours for treatment.
Later on, Culp
returned to school to study how to utilize forensics in abuse and assault cases. Her
know-how on the field are applied in treating victims of beatings, stabbings, gunshots, and
in cases of abuse against a child or an elderly. Having the opportunity to advocate for the patients,
keeps her positive about her job.
She narrated
that people come to the emergency room with gunshot or stab wounds. However,
she said, there might be a patient who is a direction admission, perhaps
someone with pneumonia, and later on you?d find out they?re actually being
abused by a caregiver. "There are all different entities here."