NURS 4433 case study 5
NURS 4433 case study 5
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It’s a sad pattern that is all too familiar to multiple organizations that try to help survivors of sexual assault: a reluctance on the part of most survivors to seek help afterward. They may call for immediate help, such as police intervention (but sometimes not, depending on their relation to their assailant), but even then only a small percentage seek help in the form of proper physical health care, mental health care, forensic evidence collection, survivors’ services, and help from the courts.
We understand why in many cases (fear, guilt, embarrassment, or misplaced concerns for the assailant if it’s someone they know and care about).
But do we always know?
And even when we do know, what can we do to break down some of those barriers?
A researcher out of the University of Michigan’s School of Nursing in Ann Arbor did a comprehensive review of the literature to identify barriers by extracting data from four national surveys and 12 empirical studies and reviewing results that related to the research question to identify common themes. The themes that emerged described barriers to care in terms of either personal or environmental factors.
| Personal Factors | Environmental Factors |
| Fear of external exposure, including bad treatment by the criminal justice system, not being believed, lack of confidentiality, the trial experience, fear of the assailant (retaliation), fear for the assailant (i.e., fear of jail time if the assailant has some sort of relationship with the survivor or the survivor’s family), and public exposure (most strongly affected members of minority groups, homosexuals, immigrants, and persons with disabilities—fear related to greater stigma and unfair treatment) | Structural or organizational barriers
|
| Lack of knowledge regarding post-assault services (unaware of where to go or how to access assistance; lack of knowledge about how to pay for them) | Societal rape myths, including prejudicial views related to race, gender, disability, class, and sexual orientation—included social stigma attached to naming the event and belief that the assault was “not serious enough” |
| Emotional states—shame, embarrassment, humiliation, guilt, and self-blame |
Recommendations: Implications for nurse practitioners included helping clients identify by including questions about childhood and adult sexual trauma; increased awareness of both physical and emotional-psychological evidence of past assaults; a practiced awareness of barriers; availability of easy-to-read print materials from advocacy organizations; advocacy for and promotion of specially trained sexual assault nurse examiners (SANEs) in all emergency departments (EDs); and actively seeking partnerships with community members and agencies in the areas of prevention, advocacy support, and legal advocacy availability and funding.
Source:
Munro ML. Barriers to care for sexual assault survivors of childbearing age: An integrative review. Women’s Healthcare (Doylestown, Pa.) 2014;2(4):19-29. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4316731/. Accessed February 17, 2015.
Questions:
- This article advocated for more SANEs in Emergency Departments. What other roles can forensic nursing take on?
- How does forensic nursing provide specific care within the community?
- Describe at least three specific actions to practice in gathering forensic evidence from a patient who has been injured, raped, or otherwise assaulted.
- Identify an interprofessional collaboration practice core competency that applies to this topic with rationale (Support with cited reference)
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