When the world is at its worst, forensic nurses must be at their best.
Bon Secours has a forensic nursing program, in which nurses who staff emergency rooms and other areas are trained to spot and work with people of all ages who have been abused or are in danger. They work with cases of child and elder abuse, spousal or domestic partner violence, and people who have been caught up in sex trafficking.
Forensic nurses have been on the job at Bon Secours since the program began in 1993, and each year they log about 2,500 calls. After shelter-in-place orders were enacted in early spring in response to the COVID-19 pandemic, there was a drop in calls to hotlines nationally, and fewer people being seen for abuse.
Locally, a decline in calls for help was noted by the Richmond YWCA domestic violence hotline, which reported 317 calls in March and April, compared with 640 calls logged in March and April 2019.
That continued into May, but in that time, among the people the Bon Secours workers were seeing, there were more significant injuries, and there also was an uptick in fatalities, according to Bonnie Price, director of the forensic nursing program at the health system.
People were spending long hours with their abusers, unable to call for help and cut off from their usual supports. Children in abusive situations were at home, out of contact with teachers, care-givers and others who otherwise may have seen signs of abuse and gotten help for them.
That dramatic drop in child abuse cases nationally at the height of the initial shelter orders haunts these workers when they get together to chat. “[We’re] pretty sure the kids are getting abused, it’s just that the safety net was gone,” says Price.
As pandemic restrictions eased, abuse cases soared. The first 11 days of July saw these nurses dealing with 100 calls for service in dealing with sexual assault, child abuse and domestic violence. They usually work with six or seven cases a day, Price says. There was a notable increase in human trafficking and child abuse incidents. “It absolutely was an impact of COVID,” she adds.
Price speculates that the increase in child abuse cases is because kids returned to outside activities and had more opportunities to disclose what was going on. Also advocates, police and health care workers stepped up their involvement.
Many of the people who were abused by their spouses or partners were in vulnerable situations to begin with and then had to contend with additional stressors such as the loss of a job, according to Price.
The women who were being abused were stuck. They were fearful and didn’t know where to turn or where to go. They decided that though it was bad, they would stick it out in the situation that they knew, Price says, but some situations escalated a great deal over a short period of time, and the violence accelerated accordingly, resulting in severe injury or even death.
“It just tipped the edge and became physical,” she says.
Some people who were caught up in sex trafficking have found themselves homeless because of a decrease in demand during the pandemic. “Pimps and traffickers are basically kind of discarding them because they can’t make them any money,” Price says.
Many of those who were exploited don’t realize they were taken advantage of; they simply say, “I was a sex worker, and now I’m homeless,” Price explains. She says she’s considering ways to contact groups that work with the homeless to reach these people who were trafficked “and hope we can pull them in.”
Forensic nurses are available around the clock to take care of patients of all ages who report that they were subject to any type of violence. The forensic program is available in Bon Secours facilities in metro Richmond, including Southside Regional Medical Center in Petersburg, which was officially acquired in January by Bon Secours Mercy Health. The forensic program began there in March.
In May, the forensic nursing program was supplemented with state money that paid for advocates to work with the nurses at two Bon Secours facilities to connect victims with community resources including housing and shelter, help with protective orders, and access to food. They’d already been providing the services, but the grant enhances their abilities. “That grant program has allowed us to expand the care from just what the forensic nurses can do while they are in the hospital,” Price says.
The state grant-funded Hospital Violence Intervention Program supplements the forensic nursing at Memorial Regional Medical Center in Mechanicsville and at St. Mary’s Hospital. The grant also funds programs at VCU Health, Chesapeake Regional Medical Center in Chesapeake, Riverside Regional Medical Center in Newport News, Sentara Norfolk General Hospital and Sentara CarePlex Hospital in Hampton.
According to Price, the forensic nurses don’t know whether to be happy or sad when they are busy. There are fears and concerns that the people they serve need help, but there is also some satisfaction that the care providers have the tools available to provide help, she says. “It’s been something, but it’s been something good in that if [these patients] had experienced violence, we have the resources that are needed.”