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Sexual Assault Exams

Having a forensic exam can seem a little intimidating. That’s understandable. Knowing a little bit about what to expect can help you feel more comfortable with the process.

  • You can have a forensic exam up to 5 days after the assault. The Forensic Nurse Examiner program offers medical forensic examinations for patients who have been sexually assaulted in the last 120 hours (5 days). This type of exam is offered to patients ages 13 and older. If you or someone you care about is under the age of 13, please call 911 to be directed to the appropriate location near you for a pediatric examination.
  • Your exam will be performed by a specially trained nurse. The nurses who perform medical forensic exams at Mercy have been specially trained to work with patients who have recently been sexually assaulted. Part of their training includes learning how to collect and preserve evidence from your body and clothes that may be used later if an investigation occurs.
  • You do NOT need to report the assault to police to have an exam. If you have been assaulted and you do not wish to speak to the police for whatever reason, you may still have a confidential exam done. If you have this exam at Mercy Medical Center’s Forensic Nurse Examiner Program, we are able to store any evidence collected for up to 18 months. If at any point during that time you decide to report your assault to the police, you can have the evidence released to them.
  • You can stop at any time. If at any point you wish to stop, slow down, or take a break—you can. Having an exam is your choice, and we will respect your wishes.
  • Try not to pee. If you think that you were given a drug, try to avoid urinating until the exam. A forensic nurse can test your urine for traces of drugs that may be in your system. It’s understandable to feel the need to go to the bathroom after an experience like sexual assault. If you really need to go, please collect your urine in a clean container and save the toilet tissue from wiping in a paper/plastic bag. Bring both with you to your exam. The toilet tissue might contain evidence that can be collected by the forensic nurse.
  • Try not to eat, drink, or brush your teeth. During the exam, the nurse may be collecting evidence from your mouth. The forensic nurses make every attempt to get the exam done in a timely manner so you can get back to your routine as soon as possible.
  • Try not to shower or change your clothes. There could be hair, fluids, or other substances in your clothing that could be collected for evidence. If you have already changed, please bring the clothes you were wearing at the time the assault happened, including your underwear, with you to the hospital.
  • You will have support from trained professionals. You will be screened in the Emergency Department and taken to a private room to wait to be seen. A doctor will see you to address any immediate injuries or concerns. A patient advocate will also be called; they can speak with you about your safety and emotional concerns. They can also help provide access to other community services and resources for victims of sexual violence.
  • A forensic nurse will perform the exam and collect evidence. Your nurse will talk with you to understand what happened and complete a physical examination. The nurse will also collect evidence from your body and clothes. Some of these steps will depend on your experience and what happened to you. The exam may include:
    • Asking questions about your medical history as well as what happened to you during the assault
    • Taking pictures of any injuries you may have
    • Collecting your clothing for evidence
    • Collecting swabs for areas on your body that might have evidence on them
    • Testing for sexually transmitted infections (STIs), pregnancy, and signs of drug-facilitated assault (“date rape drugs”)
    • Providing medications to prevent pregnancy and STIs
  • You can find support in your local community. The forensic nurse or advocate can walk you through different forms of support in your local area such as affordable mental health care, support groups, and books or websites you can read through.
  • The evidence kit may not be tested right away. When you are finished with the exam, the forensic nurse will submit the evidence to the investigating police department for it to be tested and analyzed. This process doesn’t always happen quickly. If you have questions about the status of your kit, you can call the investigating police department. If you choose not to report to police, Mercy will store the kit in our secure evidence locker for 18 months. If you choose this option, the kit won’t be released to police unless you give us written permission to do so.
  • You are not alone. Check out our resources page for a list of local and national resources including 24 hours telephone and online hotlines for sexual assault survivors.

Interpersonal Violence Exams

If you have been assaulted by a partner, spouse, caregiver, friend or family member, it can be challenging to come forward. It’s important to treat any injuries you may have so that you can continue to care for yourself and your loved ones. Mercy Medical Center offers medical forensic examinations to identify, treat, and document injuries.

  • Your exam will be performed by a specially trained nurse. The nurses who perform medical forensic exams at Mercy have been specially trained to work with patients who have experienced violence. The forensic nurse and medical team work together to address both any emergent medical needs and provide written and photographic documentation of any injuries
  • You do NOT need to report the assault to police to have an exam. If you have been assaulted and you do not wish to speak to the police for whatever reason, you may still have a confidential exam done. Mercy’s nurses can still provide a medical forensic examination including photography and documentation of injuries.
  • You can stop at any time. If at any point you wish to stop, slow down, or take a break - you can. Having an exam is your choice, and we will respect your wishes.
  • You will have support from trained professionals. You will be screened in the Emergency Department and taken to a private room to wait to be seen. A doctor will see you to address any immediate injuries or concerns. A patient advocate will also be called; they can speak with you about your safety and emotional concerns. They can also help provide access to other community services and resources for victims of violence.
  • A forensic nurse will take a history and perform the exam. Your nurse will talk with you to understand what happened and complete a physical examination. The nurse may also take photographs and collect evidence from your body and clothes. Some of these steps will depend on your experience and what happened to you. The exam may include:
    • Asking questions about your medical history as well as what happened to you during the assault
    • Taking pictures of any injuries you may have
    • Collecting your clothing for evidence
    • Collecting swabs for areas on your body that might have evidence on them
  • You can find support in your local community. The forensic nurse or advocate can walk you through different forms of support in your local area such as affordable mental health care, support groups, and books or websites you can read through.
  • You are not alone. Check out our resources page for a list of local and national resources including 24-hour telephone and online hotlines for survivors.

Staff

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Deb Holbrook, BSN, RN, FNE-A/P, SANE-A
Forensic Nursing Coordinator

Mrs. Holbrook is a graduate of The Union Memorial Hospital School of Nursing and Wilmington University. After working in the field of critical care, Mrs. Holbrook founded a Forensic Nurse Examiner Program in Delaware that became a model in the Unites States (US Senate, 2002). In 2002 she testified on Capitol Hill before a Senate Judiciary Committee on Crime and Drugs on behalf of the Bill that was signed into law in 2005 as the DNA Justice Act. She is the recipient of numerous international awards, including the ANCC Magnet Nurse of the Year, the Delaware Nurse of the Year, the International Association of Forensic Nurses Pioneer Award, and the 2014 Most Influential Marylanders in Healthcare. Mrs. Holbrook has authored grants totaling over 7 million dollars to benefit victims of major person’s crimes and lectures nationally for the Office of Victims of Crime in Washington. She has conducted over 200 pediatric and adult educational offerings, educating medical professionals across the country and has conducted over 5,000 forensic medical examinations. Mrs. Holbrook has integrated comprehensive forensic practice into the SANE model and her programs have cared for all patients of interpersonal violence including domestic, elder, child, institutional, vulnerable populations, gunshots, stabbings, non-accidental poisonings and burns. She has pioneered the use of alternate light source technology in strangulation cases and set precedence in Maryland Court systems.

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M. Christine Jackson, MD
Medical Director

Dr. Jackson is a graduate of University of California, San Diego Medical School and is Board Certified in Emergency Medicine. She is an Assistant Professor of Emergency Medicine at the University of Maryland School of Medicine. Dr. Jackson has been the Medical Director of the program Forensic Nurse Examiner Program at Mercy Medical Center since 1993. Dr. Jackson led the first Sexual Assault Nurse Examiner training program in Maryland and has continued to secure grant funding for training Forensic Nurses across Maryland. Her training efforts have also included working with police, patient advocates, and attorneys in providing comprehensive care to victims of violence. Dr. Jackson was part of the initial 1998 committee that requested and worked with the Maryland Board of Nursing (MBON) to include Forensic Nursing as a regulated specialty area in the Nurse Practice Act and has continued to serve on the MBON committee that updates these regulations. In addition to several research papers in the field of sexual assault and forensic medical care, she has written and published two books on Forensic Medicine in the Emergency Department. Dr. Jackson also continues to ensure quality medical and forensic care for patients experiencing violence by serving as a member of the Baltimore City Sexual Assault Response Team and the governor appointed Maryland State Taskforce for Improving Coverage of Forensic Evidence Examinations to Victims of Sexual Assault.

Projects

Featured
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Illuminating the Way: Alternate Light Source Research

Pollitt et al. (2016). Journal of Forensic Nursing.

Mercy’s Forensic Nurse Examiner Program continues to lead in the advancement of forensic examinations with alternate light source (ALS) research. They first used this specialized forensic light for victims of interpersonal violence to assist in examining injuries which may otherwise have remained invisible to the naked eye. The team then took on addressing the question of how common hair and skin products used by patients may influence ALS findings. The team found that numerous products fluoresce, or glow, when viewed under various ALS wavelengths, while a smaller number of the examined products appeared dark. These discoveries about the influence of common hair and skin products on ALS findings has allowed Mercy’s Forensic Nurses to use ALS in an even more succinct and focused way in order to provide the highest quality evidence based examinations and treatment possible for our patients.

Read more
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Providing Care for Baltimore’s Diverse Populations

  • On June 1, 2016, the FNE Outreach Committee hosted an event at Mercy Medical Center: "An Open House for Immigrant & Refugee Survivors' Empowerment, Response & Protection." Over 40 guests from local health, legal, and social service agencies united to discuss methods of addressing violence against immigrant and refugee survivors in Baltimore City. The event included networking, presentations by FNE staff members Jennifer Breads and Debra Holbrook, and a virtual tour of the forensic unit.
  • In an effort to assess service utilization and community awareness of the Mercy Medical Center FNE Program, a retrospective chart review of 2,322 women who were seen by the program between 2010-2013 was conducted and found that only 2.5% of the women were identified as Hispanic, which is about half of what Baltimore City demographic data would predict. This work was recently published in the Journal of Forensic Nursing.
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2016 End Violence Against Women International (EVAWI) conference

Members of the Community Outreach team received 1st place prize at the 2016 End Violence Against Women International (EVAWI) conference for the poster "Addressing the Unique Needs of Immigrant and Refugee Survivors in Baltimore City."

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Use of an Alternative Light Source to Assess Strangulation Victims

Holbrook, D. & Jackson, M.C. (2013). Journal of Forensic Nursing.

Alternate light source technology is utilized during many patient examinations at Mercy Medical Center and the Forensic Nurse Examiner staff have worked to learn more about how this technology can be used to identify potential evidence during medical forensic examinations.

Read more
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bMoreSafe App

Campus Outreach

The bMoreSafe app was developed by the Mercy Medical Center Forensic Nurse Examiner staff to provide quick and easy access (“Help at the Touch of a Button”) to those in the community who are in need of forensic nursing services. The app provides information regarding where to go, who to call and what steps can be taken to preserve evidence prior to a medical forensic exam.

Download the App
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Immigrant Outreach

Addressing the unique needs of immigrant and refugee survivors of sexual assault and domestic violence in Baltimore City

Sexual and intimate partner violence is a major public health problem with substantial impacts on the mental health, physical health, and social wellbeing of victims, and connecting survivors to health care services is critical.

Despite recent population booms among immigrant and refugee populations in Baltimore, utilization rates of important post-assault clinical services in this community remain staggeringly low. With funding support from the Johns Hopkins Neighborhood Fund, the FNE Program is leading the City's first community outreach initiative committed to understanding and responding to this emerging disparity.

The goals of the program are to increase awareness of FNE Program services to local service providers and community members; increase the FNE Program's knowledge base around the target community members' unique perceptions, needs, and barriers surrounding post-assault clinical care; and to improve the cultural adaptability of the FNE Program to best respond to immigrant and refugee survivors' identified concerns. A major focus of this initiative is to support the establishment and strengthening of sustainable partnerships between health, legal and social service providers working with immigrant and refugee survivors across the City.

Events & Trainings

Our schedule of events and trainings.

2017
  • Forensic Nurse Examiner (Adult/Adolescent) Training
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    • November 6 - 7, 2017 8:00am-6:30pm EDT
    • Map Weinberg Center at Mercy Medical Center
      Truman Semans Conference Room
      Mercy Medical Center
      227 Saint Paul Place,Baltimore MD 21202
    • Cost
      $350
    • Notes
      In addition to 20 hours of in person content, each training will include 20 hours of online content that students will be responsible for completing prior to beginning the clinical components of the FNE-A curriculum as indicated by the Maryland Board of Nursing. More information on accessing and completing the online training will be available to registered participants.
    More Information
  • Forensic Nurse Examiner (Adult/Adolescent) Training
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    • August 14 - 15, 2017 8:00am-6:30pm EDT
    • Map Weinberg Center at Mercy Medical Center
      Truman Semans Conference Room
      Mercy Medical Center
      227 Saint Paul Place,Baltimore MD 21202
    • Cost
      $350
    • Notes
      In addition to 20 hours of in person content, each training will include 20 hours of online content that students will be responsible for completing prior to beginning the clinical components of the FNE-A curriculum as indicated by the Maryland Board of Nursing. More information on accessing and completing the online training will be available to registered participants.
    More Information
  • Mercy's FNE's 4th Annual Bull & Oyster Roast
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    • Saturday March 25, 2017 7:00pm EDT
    • Map Columbus Gardens
      4301 Klosterman Ave, Nottingham, Maryland 21236
    • Save the date
      More information to follow
    Sponsors For 3rd Annual
  • Forensic Nurse Examiner (Adult/Adolescent) Training
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    • March 6 - 7, 2017 8:00am-6:30pm EDT
    • Map Weinberg Center at Mercy Medical Center
      Truman Semans Conference Room
      Mercy Medical Center
      227 Saint Paul Place,Baltimore MD 21202
    • Cost
      $350
    • Notes
      In addition to 20 hours of in person content, each training will include 20 hours of online content that students will be responsible for completing prior to beginning the clinical components of the FNE-A curriculum as indicated by the Maryland Board of Nursing. More information on accessing and completing the online training will be available to registered participants.
    Register
2016
  • Forensic Nurse Examiner (Adult/Adolescent) Training
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    • Wednesday, August 15, 2016 8:00am-5:00pm EDT
    • Map Weinberg Center at Mercy Medical Center
      Truman Semans Conference Room
      Mercy Medical Center
      227 Saint Paul Place,Baltimore MD 21202
    • Cost
      $300
    Register See more
  • An Open House for Immigrant and Refugee Survivors’ Empowerment, Response & Protection
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    • Wednesday June 1, 2016 10:00am-1:00pm EDT
    • Map Truman Semans Conference Room
      Weinberg Center for Women’s Health & Medicine
      Mercy Medical Center
      227 Saint Paul Place,Baltimore MD 21202
    • Cost
      Free. Lunch will be provided.
    RSVP See Flyer
  • Mercy's FNE's 3rd Annual Bull & Oyster Roast
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    • Saturday April 30, 2016 7:00pm EDT
    • Map Columbus Gardens
      4301 Klosterman Ave, Nottingham, Maryland 21236
    • Cost
      $50. Tickets can be purchased directly from any nurse on the team, questions can be directed to bmoresafe@mdmercy.com
    RSVP See more Sponsors
  • Community Peer Review - Hosted by the MD/DC Chapter of the International Association of Forensic Nurses
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    • Wednesday April 20, 2016 1:00pm-3:00pm EDT
    • Map Mercy Medical Center
      McAuley Conference Center
      301 St. Paul Place Baltimore MD 21202
    • Cost
      Free to forensic nurses and attendees of the morning strangulation training.
    Register See Flyer
  • Dynamics of Strangulation and Use of Alternate Light Source in Forensic Exams
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    • Wednesday April 20th, 2016 8:00am-12:00pm EDT
    • Map Mercy Medical Center
      McAuley Conference Center
      301 St. Paul Place Baltimore MD 21202
    • Cost
      $99
    Register See Flyer
  • Forensic Nurse Examiner (Adult/Adolescent) Training
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    • Monday March 7, 2016 8:00am-5:00pm EDT
    • Cost
      Free
    See more
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