Compassionate champions: forensic nurse examiners

In 2023, ChristianaCare emergency departments treated more than 2,000 patients who were victims of violent crimes. In those sensitive situations, a specially trained team of nurses called forensic nurse examiners provide compassionate, trauma-informed care.

For their innovative, dedicated approach to care, this full-time team of 25 nurses received the Compassionate Champion Award in Healthcare from Delaware Governor John Carney on May 17. The recognition is given by the Family Services Cabinet Council, Trauma Matters Delaware and the Governor’s Office. It is the latest recognition for this unique team in the region.

Christiana Care’s internationally respected forensic nurse examiners are available 24 hours a day, seven days a week. Coordinator Amy Stier, BSN, RN, FNE, CEN, SANE-A, and Sarah Peluso, BSN RN CEN CPEN SANE-A, explain the critical role of forensic nurse examiners and how ChristianaCare is setting the gold standard in the field.

What is the role of a forensic nurse examiner in a hospital setting?

Forensic nurses look a little different in every hospital. At ChristianaCare, our forensic nurses are also emergency room nurses and we have additional training in caring for adult and child victims of violence.

We take a health history, perform a safety assessment, identify and document injuries, and collect possible evidence along with photographs and written documentation.

What does the national landscape look like for forensic nurse examiners?

There is a shortage of forensic nurses across the US. In the 200 hospitals in our region, 80% have no forensic nurse or a forensic nurse who is only on call. Especially in rural areas, some patients have to drive for hours to find a hospital with a sexual assault nurse or forensic nurse.

What makes ChristianaCare’s forensic nurse program exceptional?

Victims of crime are present 24 hours a day and we are there for them every hour of the day. We are the only forensic nurse examiners in our region who are on site 24 hours a day, 7 days a week, 365 days a year.

I want people who need us to know that we are ready every moment of every day to provide one-on-one compassionate, personalized, trauma-informed care.

We have made it our mission to never allow a shift to come to light. We all work as a team and everyone does their part to ensure that someone is there if someone is sick or an emergency occurs.

In our training, we initially follow a 40-hour course through the International Association of Forensic Nurses, specifically for the care of victims of sexual violence. We have expert training in strangulation, gunshot wounds and ballistics. We have approximately 125 hours of training specific to the wide variety of patients we care for, plus hands-on training. We have mandatory further training requirements twice a year.

We are part of the Emergency Nurses Association and the International Association of Forensic Nurses. We have helped train nurses from as far away as Malta, the United Arab Emirates and Australia.

How did the program start?

We started as sexual assault examiners in 1997. Now we are a forensic team of 25 people between our campuses in Newark and Wilmington. We care for victims of sexual assault, and we care for patients who are victims of intimate partner violence, elder abuse, or child abuse, or who have suffered any form of traumatic injury, such as a gunshot wound or stabbing or strangulation.

In addition to treating patients in the emergency department, we also receive consults from all Christiana and Wilmington hospitals, and respond to all admitting floors, the Center for Women’s & Children’s Health, and the Pediatric Care Center. Patients come to us from Union Hospital and from across the region.

What is trauma-oriented care?

Because we are located in the emergency department, we can quickly greet victims of sexual assault at triage and return them to a quiet, isolated area, away from the hustle and bustle of the emergency department. From the moment we are notified that the patient has arrived to the moment we contact him or her personally is less than 10 minutes.

ChristianaCare’s forensic nurse examiners provide education to healthcare professionals, community organizations, government offices, law enforcement agencies, schools and universities. To make a request, please contact fnecoordinator@christianacare.org.

And we practice trauma-informed care in a safe, inclusive environment. This care model shifts the focus “What is wrong with you?” Unpleasant “What happened to you?” We work with our patients to gain a complete picture of their life situation – past and present – ​​so that we can provide them with the most effective and healing healthcare.

Trauma-informed care has been proven to improve patient engagement, treatment adherence, and health outcomes, as well as the well-being of providers and staff.

It is a model that also helps us in our role. We see traumatic things and we need support from each other. We have a close-knit team: we debrief each other and offer each other support. This way we can continue to help our patients.

What happens after a patient leaves the hospital?

This is more than just treating in the moment. This is ongoing care to help them through the situation they have faced. They don’t begin that healing process and road to recovery until we discharge them.

Upon discharge, we work with them on safety planning to ensure they have a safe place to go. We provide referrals to the domestic violence hotline, shelter placement, counseling services, law enforcement, victim advocates – basically anything they need. We want to make sure they have access to all the different resources available because not every patient realizes there are so many different options.

Sometimes we can follow a patient full circle through the legal system. We can testify on behalf of the patient. We can see them getting protection from abuse or the restraining order they need.

Patients are extremely grateful. Knowing that we could provide that one-on-one care and help them in that moment is so important. When a patient says, “You changed the entire feeling of that visit” or “You made me feel safe and protected,” that feedback energizes us.