Methodist Jennie Edmundson Hospital has rebuilt its team of forensic nurses by providing trauma-informed training to a new group of employees.
Jennie Edmundson established a trained and active team of sexual assault nurse examiners in about 2009, but employee movement and turnover caused it to lapse from October 2021 to March 2023, said Nicole Brunow, BSN, RN, the sexual assault nurse examiner/sexual assault response team coordinator at Jennie.
“We had nurses that transferred out of the emergency room; we had nurses that left,” she said.
In addition, the ER manager left, Brunow said. Now, the hospital has three nurses trained to be SANEs.
The Methodist Heidi Wilke SANE/SART Survivor Program, which provides specialized, compassionate care to survivors of sexual assault, domestic violence, human trafficking and elder abuse, is already in place at Methodist Hospital and Methodist Women’s Hospital in Omaha.
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“Every survivor deserves timely care close to home,” Brunow said. “Although our doors have always been open to survivors, we owed our community more. Now, Jennie has the ability to provide survivors specialized treatment, resources, safety plans and assistance in reporting to the appropriate agencies if they so choose. It’s all right here for them. We’re here for them.”
Named after Heidi Wilke, who was assaulted following a business meeting in downtown Omaha, Methodist’s SANE/SART program is made up of specially trained sexual assault nurse examiners — also known as forensic nurses — physicians, victim advocates and law enforcement agencies. Together, this sexual assault response team employs collaboration and cutting-edge technology to ensure the safety and well-being of adult and teen survivors.
Jennie Edmundson’s SANE/SART services — which include thorough assessments, screenings, treatment of injuries, evidence collection, preventive care and emotional support in a comfortable, private exam space — are available 24/7 at the hospital’s Emergency Department, where staff are well-versed on Iowa’s mandatory reporting laws and a variety of next steps for survivors. The team’s forensic nurses work closely with the Catholic Charities Phoenix House, Council Bluffs Police Department and Pottawattamie County Sheriff’s Office while using a trauma-informed approach. This enables them to recognize the signs and symptoms of trauma and respond appropriately without further traumatizing survivors.
The forensic nurse explains options available to the patient. Options include treatment for injuries, collection of an evidence kit (remaining anonymous, if desired) and reporting the incident to law enforcement.
“The patient has the right to do the kit or not do the kit,” Brunow said.
As in the past, Jennie nurses notify Catholic Charities so they can send an advocate.
“The patient can discuss all kinds of stuff with the advocate,” Brunow said.
Advocates aren’t usually asked to testify, if a case goes to trial, she said.
If the patient wants evidence collected, the nurse swabs any area where there was sexual contact, Brunow said. The nurse will also get a sample that contains the patient’s DNA — usually by pricking their finger — so they can distinguish between the attacker’s DNA and the patient’s. Evidence needs to be gathered within 120 hours of the assault, but a medical report can be done later.
“We try to get as much as we can,” she said.
If there are visible wounds, the nurse will take photographs.
The kit can be labeled with the patient’s name or given a number that corresponds with their name in a confidential database, Brunow said. It can be stored by law enforcement for up to 10 years.
“The patient has several years to decide whether they want to pursue charges,” she said. “We definitely don’t push patients either way. We just give them information on the options.”
If the victim is younger than 12, the nurse is required to report the incident, she said. Likewise, if the patient has special needs, reporting is mandatory. If the patient is 16 or older, reporting is only mandatory if the assailant was a family member. Reporting is not required if the victim is 18 or older (19 or older in Nebraska).
Nurses look for signs that a patient may be a sex trafficking victim, Brunow said.
“We always look for injuries that don’t fit the story, and then we will look for any kind of tattoo or branding,” she said.
If a victim enters the hospital within 120 hours of the assault, they can be treated for three different kinds of sexually transmitted infections — two with oral medications and one with an injection, Brunow said. The nurse can also provide patient education materials, which are funded by the Iowa Victims Fund.
Forensic nurses go through extensive training, Brunow said. That includes both online instruction and hands-on training.
“We go through several months of inpatient training,” she said. “One of the big things is trauma-informed care. We are trained to speak to our patients and ask questions of our patients in a specific manner. We know when to stop questioning them. It’s a little bit delicate.”
And, of course, forensic nurses are also trained on how to gather evidence.
Brunow hopes Jennie can add to its team.
“Recruitment to be a forensic nurse is pretty much always open,” she said.
