
From Forensic Nurse to Forensic Patient
By Christine Vecchi, MSN, RN, DABFN
It was not supposed to happen to me. I had always been so careful. My job was to look after victims, not become one. "It happened so quickly" ... how many times had I heard that before?
I have been a clinical forensic nurse for six years and have completed hundreds of sexual assault examinations and taken thousands of photographs. Since coming back from the U.S., I have spent the last two years getting settled and looking into the field of forensic nursing in Western Australia. After my brush with being a forensic patient, my desire to contribute once again to this field as a clinical forensic nurse has now become even more important.
I had been at work for about 5 minutes when the attack took place. I had just received report on the few patients still left in the emergency department. One of the nurses looking after the patient I will call John, asked me to hand her his notes so she could record his blood pressure. The report I had received was that John was acting weird and had admitted to taking heroin.
Drug ingestion is a common issue in the emergency department so I did not really think of this patient as out of the ordinary, nor the situation extraordinary, as most nurses working in emergency departments know. We see many patients who act weird with a history of taking drugs.
I was standing at John's right side near the head of the bed. He was agitated and looking at the ceiling, grabbing at something that was not there. I told him to try to relax, that we were going to take his blood pressure, and that we were not going to hurt him. Then everything changed. He looked at me and with a deep, possessed-like voice, said, "You!" I backed away to the curtain that was less than a foot from my back. I knew I was in trouble in that split second. I ran out of the cubicle and down the hallway. I saw out of the corner of my eye John had pulled off the monitoring equipment and jumped over the bed rails. I knew he was coming after me. I could not believe this could be happening in the middle of the ED. I looked over my shoulder to see where he was and his fist made contact with my right cheek and nose. He grabbed me around the neck, so I could only get out a partial scream. I could not get free. I knew I was close to a wall and was thinking, "Please do not throw me into the wall or hurt my neck."
He had tackled me to the ground and was lying on top of me. He had my head between his hands and I remember my head hitting the floor two or three times.
Then it was over. My colleagues were all over him, trying to pull him off of me. It took six people, I was told, to remove him. He was yelling and I was lying on the floor face down. At first I could not move. I slowly rolled over and reality hit. I had been attacked. I saw John's girlfriend standing to my left, crying.
I knew what needed to be done and yet at that moment I was not the forensic nurse. I was the victim and I had a difficult time trying to be in both roles. I was trying to remain calm but my insides were not cooperating. My colleagues were great. The coordinator of the shift was by my side. The police were called; however, I never spoke to them that day. A female police officer stood in a doorway as I told my story to the hospital manager and then she was gone. I knew I was supposed to talk to the police, but I was sent home before that conversation took place.
What I really needed was a forensic nurse. I kept thinking that the police would call, but they didn't. I went home and two days later decided I needed to contact the police and act like a forensic nurse on my own behalf. When I went to the police they had no record of my assault. I was told, after 45 minutes of looking for the complaint, that the call-out was listed as an "unruly patient in the ED."
I thought the police were supposed to be there to help. I did nothing wrong. I could at that moment see why people get so angry at the system. I told the officer the policewoman stood in the doorway and heard my story. She did not document my story nor did anything to help me. So I made the report by myself for myself.
In the past it was my job to make sure the victim was taken care of -- that their story was down on paper, police were informed and that appropriate medical care was provided. After being in the position of the victim, I now know why the victims I looked after in the past were so grateful for my work.
I sat in the chair by myself and was asked all of these questions that should have been taken care of two days ago. Nobody photographed my injuries. I was asked if I knew if I was entitled to compensation. (I am sure most victims are not up to date on such issues.) I expected a bit more help and was very disappointed that I received very little. The entire incident has given me a greater awareness of the gap in services provided to victims in Western Australia. They need to be looked after in a more efficient manner.
Internationally, the role of the forensic nurse has been rapidly expanding in the last 20 years. In Australia, however, the field of forensic nursing has its primary focus on issues within the mental health field and the prison system. Violence and victims of violence have become important issues nurses confront in their everyday practice. This type of trauma is seen daily in EDs throughout Australia. Emergency departments need trained clinical forensic nurses to coordinate a multi-disciplinary team so that all forensic patients receive comprehensive care that addresses their individual forensic needs.
A systematic approach is needed to improve patient outcomes and enable our acute care departments to run more effectively and efficiently. Forensic nurses reduce the delay in responding to the health and forensic needs of their patients, decrease the workload of forensic medical officers and police, and improve the exchange of information between the healthcare team and other agencies.
My proposed PhD research will consist of investigating the current forensic nursing practice in Western Australia and comparing it with international models. Effective and appropriate care of medico-legal patient issues require the nurses in Western Australia to have new knowledge. The need for role development of the clinical forensic nurse specialist in Australia is now. This nurse specialist would provide a significant contribution to the healthcare field while moving forward with the community's needs.
As I have found out, most of us will know a victim or unfortunately become a victim of violence at some stage in our lives. No other individual should have the experience I did. It is so important for this patient population to feel safe and well cared for. I realize now how important it is for every hospital to have a clinical forensic nurse among its staff and understand more fully the valuable service forensic nurses provide their patients every day.
Christine Vecchi, MSN, RN, DABFN, is a clinical forensic nurse and a forensic photographer in Western Australia.
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