A Providence Alaska Medical Center service providing forensic exams to rape victims in Anchorage will reopen around the clock on Nov. 16, about six weeks after shutting down overnight due to a lack of specially trained nurses, the program manager said Friday.
Women's advocates and prosecutors had said the shutdown was damaging both to criminal investigations and to the victims themselves, who were being told not to shower or change clothes until they could see a nurse. Providence's action was a relief, Amanda Price, executive director of Standing Together Against Rape, or STAR, said Friday.
Jennifer Meyer, clinical nurse manager for Forensic Nursing Services of Providence, said Friday the decision to resume overnight exams was made Tuesday. That's the same day a Daily News story about the gap was published. The hospital had already been looking for a temporary fix but didn't want to publicize that a solution was close in case it didn't pan out, Meyer said.
The temporary staffing solution involves two nurses who work at Providence hospital providing patient care. Both already have experience and necessary training in sexual assault exams, Meyer said. One is already doing the work on-call, and the other did so in the past. Their regular managers had to backfill so that they could shift over to the sexual assault program, which is housed off the hospital campus.
The forensic nursing program used to operate with 16 nurses, most of them on-call, but gradually had shrunk to just eight, and that wasn't enough, Meyer said.
"It's difficult work. It's not work that just anybody can do," she said. Twice-yearly sexual assault nurse examiner trainings in Alaska maybe draw 30 to 40 participants who want to try the work but once they learn what is entailed in detail, most don't sign up, she said. "We're happy if we can get three or four who actually go on to practice."
Most who do the exams also work regular nursing shifts at Providence or elsewhere, including Alaska Native Medical Center, the military bases, the Anchorage School District and the U.S. Public Health Service, Meyer said. They usually commit to one, 12-hour on-call shift a week to perform exams as part of a multi-disciplinary team that also includes advocates and police. They must be available by phone or pager and arrive at the team building, in the University Lake area, within an hour of getting the call.
"It's not predictable. It's not always the easiest to balance with family or home life or other jobs," Meyer said.
In addition to conducting exams, the nurses must be prepared to meet with the team, help prepare cases for court, and testify in criminal proceedings.
Typically nurses only stay in rotation conducting sexual assault exams for about two years even as a part-time position, she said.
"When you're actively engaged in providing patient care to this population, and listening to the stories of what the patients have to tell you of what they've experienced, that takes a toll on everybody on the team," Meyer said.
The stress factor is extremely high, said John Skidmore, director of the state Department of Law criminal division, who oversees prosecutors statewide.
"Just knowing the type of trauma that they have to look at and think about and interact with on a daily basis, we also try to keep track of that," Skidmore said. It's up to supervisors to watch for burnout and help guard against it.
Providence's decision to restart the overnight exams "is tremendous," he said. "I'm pleased that they have found a short-term solution in addition to looking at a long-term solution."
Providence temporarily stopped providing exams on Oct. 1 between 6 p.m. and 7 a.m. because the strain on the small crew of nurses was too much, Meyer said. Some were working more than one extra 12-hour shift in addition to their full-time jobs. She was doing many of the exams herself and covered half of the 12-hour shifts a week at the worst of it.
Five women have made rape reports during the overnight hours since the reduced schedule began, Meyer said. All came in during the day shifts.
Most victims don't report rape immediately, but rather wait 24 or 48 hours, she said. They are often bracing themselves to talk about what is often the worst experience in their lives. They may be checking in with family and friends, or seeing who might have witnessed the assault. As long as their reports are within four days, nurses can collect forensic evidence, she said.
The new additions bring the number of full-time nurses on the team to three, plus six working on-call shifts, she said. By Feb. 1, Providence is aiming to have additional nurses on board and the program fully staffed. Two already hired are undergoing training this month and two more are considering joining the team, Meyer said.
"Like other nurse specialities, forensic nurse examiners are in great demand, and we are actively recruiting for RNs with this training and experience or those seeking this experience," Providence said in a statement posted on its web site this week.
Reach Lisa Demer at firstname.lastname@example.org or 257-4390.