Legal mobilization in medicine: Nurses, rape kits, and the emergence of forensic nursing in the United States since the 1970s

When Sexual Violence Goes Viral: A Literature Review and Synthesis on How the Popularization of the #MeToo Movement Contributed to the Recent Evolution of Nursing Practice With the Student Population in Quebec (Canada)

ABSTRACT

Since the popularization of the #MeToo movement, the prevention and management of sexual violence (SV) has become prominent in North American public discourse, including in the province of Québec (Canada). Despite such an important visibility in the public sphere, there is little scientific evidence of how nursing practice has adapted to the popularization of the #MeToo movement, led by victims of SV. Drawing on critical feminist theories, we describe the results from a literature review on nursing practice in the context of SV on college and university campuses since the #MeToo movement. A literature search was performed in five databases using keywords targeting nursing practice in the context of SV. In total, 45 articles were selected for analysis. Eight studies were added for their relevance (obtained outside the databases). Next, a reflexive thematic analysis inspired by Braun and Clarke (2006) was conducted. The literature review was then used to compare current practices in Québec. The results identify the persistence of numerous myths and stereotypes that contribute negatively to the credibility of persons experiencing SV. The results also describe the difficulty of public institutions to change structures aimed at preventing and managing SV in response to the popularization of the #MeToo movement. The results indicate the relevance of using an intersectional feminist theoretical framework to better understand the complexities of SV. Through our analysis, we show that, more than ever, the evolution of forensic nursing practice must be informed by political and testimonial activism driven by persons experiencing SV.

Assistance to victims of violence in Emergency services from the Forensic Nursing perspective

OBJECTIVE

to analyze nurses' role in collecting, identifying and preserving traces in Emergency care for victims of violence, from the perspective of these professionals.

METHOD

a qualitative study with an exploratory and descriptive approach. It was developed through semi-structured interviews with 21 nurses from hospitals that are part of the intersectoral flow to assist victims of violence from two reference hospitals in this type of care, in a capital city from southern Brazil. Nurses that are members of the multiprofessional team working in the Emergency areas at the respective hospitals were included; in turn, the exclusion criteria corresponded to professionals relocated in Emergency areas during the pandemic. Data analysis was performed according to Thematic Content Analysis.

RESULTS

the data were discussed in five categories: 1) Professional qualification; 2) Institutional protocol and materials; 3) The professionals' perceptions; 4) The professionals' actions; and 5) Team structure.

CONCLUSION

Nursing professionals' skills in collecting, identifying and preserving traces in Emergency assistance provided to victims of violence need to be better organized, structured and standardized. The presence of Nursing professionals in the care of victims of violence in Emergency services is undeniable, but their importance is still underestimated and their potential contribution to the forensic approach is underused.

Variation in rates of sexual assault crisis counsellor usage during forensic examination in California: an observational study

OBJECTIVES

A critical asset to post-assault care of survivors is support from sexual assault crisis counsellors (SACCs). We sought to elucidate variation in implementation between California counties in SACC accompaniment during Sexual Assault Forensic Examination (SAFE).

METHODS

SACC attendance data from 2019 was obtained from the California Governor's Office of Emergency Services (CalOES). To assess SACC attendance rates during SAFEs, we requested SAFE quantity data from sheriffs and public health departments, the State Forensic Bureau, and the California Department of Justice (DOJ), but all requests were unanswered or denied. We also sought SAFE data from District Attorneys (DAs) in each county, and received responses from Marin and Contra Costa Counties. To estimate numbers of SAFEs per county, we gathered crime statistics from the Federal Bureau of Investigation's (FBI's) Uniform Crime Reporting Program and OpenJustice, a transparency initiative by the California DOJ. For each data source, we compared SACC attendance to SAFE quantities and incidences of sexual assault statewide.

RESULTS

At the state level, data on SACC attendance per CalOES and DOJ archival data on sexual assault were used to approximate relative rates of SACC accompaniment at SAFEs; 83% (30 of 36) of counties had values <50%. The joint sexual assault crisis centre for Contra Costa and Marin Counties reported that 140 SACCs were dispatched in 2019, while DAs in Contra Costa and Marin reported completion of 87 SAFEs in 2019, for a calculated SACC accompaniment rate of 161%. Proxy data sourced from FBI and DOJ crime statistics displayed significant inconsistencies, and DOJ data was internally inconsistent.

CONCLUSIONS

SACC accompaniment at SAFEs appears to be low in most California counties, however, limited data accessibility and data discrepancies and inaccuracies (e.g., rates over 100%) prevented reliable determination of SACC accompaniment rates during SAFEs. Substantial improvements in data accuracy and transparency are needed to ensure survivors' adequate access to resources.

Forensic Nursing competencies in disasters situations: scoping review

OBJECTIVE

To map sources of technical-scientific information on Forensic Nursing competencies in disasters situations.

METHOD

Scoping review developed in accordance with the JBI methodology, carried out in three stages by two reviewers independently on selected databases and gray literature, using keywords and descriptors. After reading them in full, we proceeded with data extraction and content analysis of 28 publications.

RESULTS

Identified 24 publications in English, 20 of which were produced in the United States of America. 24 competencies of forensic nurses in disasters situations were mapped, including: training; resource management; link with the justice service; direct care; psycho-emotional care; collection and preservation of traces; registration and documentation with photography; body management; maintenance of the chain of custody; and epidemiological surveillance.

CONCLUSION

The forensic nurse acts in all phases of disasters with the affected people, families and communities, under an interdisciplinary perspective. The development of competencies aimed at the practice of Forensic Nursing in disasters should be incorporated into the training strategies of these professionals, in order to obtain better response standards.

A critical ethnographic perspective on risk and dangerousness in forensic psychiatry

In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health-care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing.

Dropdown rights: Categorizing transgender discrimination in healthcare technologies

This study analyzes how U.S. healthcare organizations implemented legal requirements to treat patients in a manner consistent with their gender identity under Section 1557 of the Affordable Care Act. The ways that healthcare organizations determine gender and track complaints constitute socio-technical systems for compliance, and they shape what discrimination protections look like on the ground. We interviewed grievance handlers about how they use information technologies to process possible civil rights claims from patients and argue that their work demobilizes and erases civil rights, especially claims such as transgender harassment. Mobilized physician-led implementation groups, by contrast, enacted a version of gender identity recognition by tracking identities and bodies in electronic medical records and material objects such as specimen labels. Default structures-the dropdown menus of healthcare software-both shape and are shaped by professional norms, financial incentives, and conceptions of justice and deservingness. These socio-technical structures allow conflicting stories of transgender rights to continue on in different parts of the healthcare organization, making it difficult for law to transform healthcare delivery.

The Forensic Nurse's Evolving Role in Addressing Elder Maltreatment in the United States

U.S. forensic nurses' specialization in elder maltreatment has evolved over the last 30 years. Significant progress in research has led to the ability to define and respond to elder abuse. This article describes the foundation for a specialization in nursing that led to inter vention in abuse and neglect, historical milestones as steps to elder justice, and the evolution of forensic nurse practice with senior victims of abuse.

Investigation in forensic nursing: trajectories and possibilities of action

To theorize and reflect on the possibilities of the forensic nurse's performance, emphasizing the work as a civil and criminal expert, based on the Brazilian legislation, ethical principles, and comprehensive care for human beings. This is a theoretical study of exploratory nature with reflective and critical characteristics. It was based on the history of the national and international development of the forensic nursing specialty. It is organized into four categories, namely: areas of practice of forensic nurses in North American countries; state-of-the-art North American forensic nursing and the Brazilian reality, and nursing action in the face of violence. This way, international history, national panorama, and in-depth theoretical study were concatenated. Evidence of the contribution of forensic nursing to criminal and civil areas points to the emerging need for implementation and recognition of this practice within the scope of forensic investigation in Brazil with the inclusion of the topic in undergraduate courses.

From Medicine to Health: The Proliferation and Diversification of Cultural Authority

In his account of the medical profession's ascent, Paul Starr drew a distinction between the social authority of physicians and the cultural authority of medicine-between doctors' capacity to direct others' behavior and the ability of medical institutions and discourses to shape meanings of illness, health, wellness, and treatment. Subsequently, scholars have reflected on the social-structural transformations challenging physicians' social authority but neglected shifts in cultural authority. Focusing on the United States, we find a proliferation and diversification of cultural authority, reflecting a partial movement from the domain of medicine into new terrains of health. This shift is apparent in the resurgence of alternative healing, the advent of new forms of self-care and self-monitoring, the rise of health social movements, and the spread of health information online. We advance a research agenda to understand how the mechanisms and dynamics of cultural authority shape contests to speak in the name of health.

Planning and implementation of the Sexual Assault Nurse Examiner course to assist victims of sexual violence: an experience report

OBJECTIVE

To describe the authors' experiences in planning and implementing a training course based on the Sexual Assault Nurse Examiner.

METHOD

This is an experience report with qualitative characteristics of a descriptive nature and cross-sectional cut. In 2019, nurses were trained to care for victims of sexual violence through a course known in the United States as Sexual Assault Nurse Examiner. The course lasted 40 hours and was offered to nurses. The didactic strategies used were dialogued exposure, group dynamics and realistic simulation for clinical-gynecological examination with volunteers.

RESULTS

For five days, 20 nurses underwent training. The contents covered Brazilian legislation, protocols for assisting victims, anamnesis, physical examination, collection and preservation of forensic remains. The practical classes took place in the last two days of training. At the end of the course, a written assessment was applied.

CONCLUSION

The course provided the opportunity for the consolidation of important knowledge for nurses to care for victims of sexual violence, collection and preservation of traces and participation in the chain of custody.