Fairbanks

With caseload up, Fairbanks hospital struggles with sexual assault staffing

Fairbanks' only civilian hospital says its forensic nurses have been overwhelmed by a jump in sexual assault cases in 2016, and that it will be cutting back on those services in the new year.

Starting Jan. 1, forensic nurses will no longer be on call from 10 p.m. to 8 a.m. Monday through Friday, or from 6 p.m. to 8 a.m. on the weekends, said Mike Julius, director of emergency room services for Fairbanks Memorial Hospital.

Forensic nurses — who are trained in evidence collection and documentation in sexual assault cases — will also no longer be involved in domestic violence or strangulation cases, Julius said.

There will be exceptions for "acute," or severe, cases, Julius said. In a severe sexual assault case reported after hours, or a severe domestic violence case, emergency room doctors will call the forensic nurse manager, who will ensure that a forensic nurse sees the victim at the time of the report, instead of the next morning, Julius said.

About 40 sexual assault cases were reported after hours from Jan. 1 to Oct. 15 of 2016, according to Julius.

Julius called the cutbacks a "short-term solution to a long-term problem," and said partnering agencies would be seeking out solutions in coming months.

Currently, when a report comes in, a Sexual Assault Response Team is assembled to respond, regardless of the time of day. That team includes a forensic nurse, a victim advocate from the Interior Alaska Center for Nonviolent Living and, if the victim wants to file a police report, a law enforcement official.

But starting in January, the forensic nurse will no longer join the advocate at the time of the report — only if a doctor makes the call that it's "acute."

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Brenda Stanfill, executive director at the Interior Alaska Center for Nonviolent Living, said "there's going to be a lot of back and forth," about what constitutes an "acute" case.

"We feel that anytime that you are ready to report a sexual assault, it should be considered acute," Stanfill said.

Stanfill also worried about moving backward in what she called a "stellar system" of response for sexual assault victims.

"We won't be actively working as a team anymore," she said.

When forensic nurses aren't automatically called in, victims may also need to repeat their story, which means re-living trauma unnecessarily, Stanfill said.

One of the biggest questions is where victims who are not deemed to be "acute" will reside in the hours between when they make the report and when they are seen by a forensic nurse, said Alaska State Troopers Cmdr. Ronald Wall.

"We don't necessarily have a facility to put a victim in for four hours," Wall said of the trooper station.

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The hospital says that it is struggling with staffing and budgetary concerns in handling the sexual assault cases.

Forensic nurses require extensive training and are difficult to recruit, Julius said. And while the budget for forensic nursing is staying even in 2017, the cases have increased past what staff can handle.

In both 2014 and 2015, Fairbanks Memorial Hospital staff handled around 450-500 sexual assault cases. But in 2016, the caseload jumped.

"This year we're right at 600," Julius said.

With only four forensic nurses on staff, they are being overwhelmed by the daily workload and scheduled on-call hours, said Kelly Atlee, director of public relations for the hospital.

Given that a relatively small number of sexual assaults are reported after hours, Julius said the hospital had to weigh the cost of hiring more full-time staff to serve a small number of patients. A better solution for the hospital, Julius said, may be to partner with other local nurses who would be available to undergo training and be scheduled on call.

About 65 percent of all sexual assault cases are victims under the age of 18, according to Julius.

"The vast majority of what we see are children," Julius said.

Underage sexual assault victims won't be affected by the reduced hours, Stanfill said, as Fairbanks' Child Advocacy Center has a regularly scheduled system for reporting sexual assaults.

Likewise, sexual assault victims flying in from communities off the road system, who are generally brought in by Alaska State Troopers during the day, won't be affected by the cutbacks, Stanfill said.

Stanfill called the cutbacks temporary, as the agencies work toward a long-term solution.

State trooper Wall hopes that in the long run, the response program may be strengthened by collaboration with various agencies.

"No matter what happens we're going to provide the best possible service and I have to say not just law enforcement is committed to that but the hospital and our advocates," Wall said.

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