The Life of a SAFE Nurse

Gayriel Lester, RN, SAFE

In 2005, I realized a dream and became a Sexual Assault Forensic Examiner (SAFE).  I could now be there for victims of sexual assault and help them tell their story through pictures, written reports and evidence collection.  Sexual assault is not limited to females only.  It has no limits - young or old, male or female, rich or poor - you get the picture. 

Let me paint the picture for you.  A person comes to the emergency room with a chief complaint (as we must call it) of alleged sexual assault at 6:30am.  The triage nurse starts the person's chart, notifies the charge nurse and the receiving physician.  The doctor speaks with the patient and determines if there are injuries or a medical condition that requires immediate attention.  Bruises and small scrapes are attended to by the doctor.  A page goes out to the SAFE nurse.  She returns the call to the emergency room and receives the report - 6:55am.  Yes, she will go in because it is less than 72 hours since the time of the alleged assault.  She asks if the Crime Victims Council has been called to support the patient and if the police were called to the scene of the alleged assault.

Upon arrival at 7:40am, I introduce myself to the victim and explain the role I will play in the exam and collection of evidence and assure the person that any time they do not want to continue or do not want a particular part of the examination to occur, I will respect their wishes and continue with the remainder of the examination or stop at that point.  A copy of the written report and interview, with photographs and collected evidence, goes to the crime lab for processing.  The police from the jurisdiction of the alleged assault also receive a copy of the written report and interview.  The victim is not mandated to speak to the police.  However, if they want an investigation, they must speak to the police.  After the examination, prophylactic medications are offered to the victim to prevent pregnancy and STDs.

The process can take up to four hours.  I do not hurry the interview, examination or collection of evidence because I want to do the best job I can for the victim.  The sexual assault evidence collection kit has many steps and each one has a purpose.  If they are wearing the same clothing, which I hope they are for evidence purposes, the clothing is collected in paper bags and given to the police.  They are either provided clothing or someone gets clothing for them from their residence.  When the person is discharged from the emergency room they are given follow up instructions for their health and well being.  They also receive a follow up phone call from me to see how they are doing and inquire if they have seen their family doctor of if they have any questions.

My hope is that I have helped this person take their first step toward healing.

Gayriel Lester is a SAFE nurse at Lehigh Valley Health Network and an adjunct instructor with Northampton Community College.  Ms. Lester will also be a presenter at the Forensic Healthcare seminar in November. 

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