Forensic nurse examiners provide critical healing care to patients who have survived the most horrific trauma and violence: from sexual assaults to human trafficking to being intentionally set on fire.
Now, in the first program of its kind in Colorado, survivors of violence can return to the hospital for follow-up care with their specially-trained forensic nurse examiners.
Nurses at UCHealth University of Colorado Hospital have launched Colorado’s first comprehensive forensic outpatient program that serves both teens and adults who are survivors of violence.
The patients have endured the full range of violence from rape to physical and sexual assault to intimate partner violence, shootings, stabbings, burnings and vehicular assaults.
Among patients who need hospital care for violence, women outnumber men by about two to one. But men also can suffer violent attacks.
New help for survivors of trauma and violence
During initial visits, forensic nurse examiners may gather physical evidence to help prosecutors successfully hold perpetrators accountable in the criminal justice system. But, the nurses do far more than gather evidence for trials. They typically spend several hours with each patient, tending to a full range of needs from medical care to mental health needs and referrals to violence prevention and social service programs.
“These are very traumatized patients. In most hospitals, forensic examiners only have specialized training to care for sexual assault survivors, but we have the training to care for all patients affected by violence,” said Christine Foote-Lucero, nurse manager for the forensic nurse examiner programs at UCHealth University of Colorado and Highlands Ranch Hospital.
“A comprehensive forensic program is a necessity as violence is incredibly pervasive and all patients deserve specialized care,” she said.
That’s why she has been working hard on this vision for over a year with the forensic program medical director, Dr. Christina Yannetsos. Survivors of violence can return within 7-10 days after their initial hospital visit and receive follow up care. The forensic examiners started seeing patients in late April.
After a crime, patients are often overwhelmed. Now survivors of violence can return for additional TLC
Survivors of violence often are in shock and in such poor condition physically in the immediate aftermath of a violent attack that it’s difficult for some of them to absorb all of the information and support that forensic nurse examiners can provide. That’s why a follow-up visit in the new outpatient clinic is so valuable.
“We are truly helping these patients heal both mentally and physically. Our goal is to provide a comprehensive medical forensic exam that starts them on the road to healing and recovery. While we provide medical care first and foremost, we also provide psychological support and resources including long-term safety planning,” said Foote-Lucero, who has been a nurse for nearly 20 years, a forensic nurse examiner for 10 years. She also has special training as an ER nurse.
“We work with survivors of violence on what safety looks like beyond tonight,” she said.
Doctors in emergency departments greatly appreciate the comprehensive support from forensic nurse examiners, both for the initial hours-long care they provide in ERs, and now, for the follow-up support. The nurse examiners can spend time probing the causes of violence and trying to prevent patients from suffering repeated attacks. They also testify in court.
“We are able to supplement what the ER can do. It’s a busy environment, where these patients can fall through the cracks,” Foote Lucero said.
Many crime victims don’t have regular access to health care. So, the nurse examiners tend to the full spectrum of needs.
“It’s a comprehensive approach, addressing their medical needs, updating immunizations, connecting them with victims’ advocates, counseling services and primary care,” Foote-Lucero said. “We can connect them to resources for domestic violence, human trafficking, safety planning and education on health and dating violence.
“The primary focus is making sure wounds are healing properly and reinforcing mental wellbeing,” Foote-Lucero said.
Some survivors can improve dramatically a week to 10 days following a violent attack.
One patient who returned for care at the follow-up clinic had been strangled, assaulted and suffered a concussion and wounds to the head. During the second visit, the forensic nurse examiners were pleased to see how well the patient was doing.
Others, however, can decline.
Seeing patients for follow-up care either in person — or via a virtual visit if the patient prefers — can serve as a lifesaving touchpoint.
“We screen all patients for concussions. We can re-screen them. We start them on medications to prevent HIV. We can see if they are tolerating their medications and make sure everything is healing properly. There are multiple benefits to bringing them back,” Foote-Lucero said.
Specially trained nurses help survivors of violence heal physically and mentally
The increased care at UCHealth hospitals comes at a time when some other hospitals are eliminating services provided by forensic nurse examiners. The programs are expensive, but UCHealth bills insurance or covers the costs of care as a community benefit. In some cases, survivors of violence can receive funds to cover their care through crime victims’ compensation funds.
While the work that the forensic nurse examiners do can be very challenging, Foote-Lucero said seeing patients a second time has been incredibly rewarding.
“When these patients first come in, they’re completely overwhelmed. When we bring them back seven to 10 days later, some of the dust has settled and we can help them be sure that everything has healed,” Foote Lucero said. “This new clinic is amazing for the patients and really good for the nurses too.”