Selected Podcast
Forensic Nursing Program at UPMC in the Central Pa.
Nicole Baselj (Unit director of forensic nursing) talks about the Forensic Nursing Program at UPMC in Central PA. Ms. Baselj explains what is the SANE program, what a forensic nurse examiner do, and the services offered to support people who are victims of sexual assault and domestic violence at UPMC.
Featuring:
Nicole Baselj, MSN, RN, SANE-A, SANE-P
Nicole Baselj, MSN, RN, SANE-A, SANE-P is the Unit Director, Forensic Nursing. Transcription:
Bill Klaproth (host): For victims of sexual assault and other abuses. A forensic nurse examiner plays a very important role. So what does a forensic nurse examiner do? Well, we're going to find out and learn more about the forensic nursing program at UPMC with Nicole Baselj unit director of forensic nursing at UPMC . This is Healthier You, a podcast from UPMC, I am Bill Klaproth. Nicole, thank you so much for your time. It's great to talk with you on a really important topic. So first off, what is the forensic nursing program department at UPMC in Central PA?
Nicole Baseji: We're known by a couple of names. We use that terminology because it's more of a broad term. We use that to care for more than just sexual assault patients. So in addition, to education and clinical training. We provide care to all patients who were a victim of a crime. So we provide trauma formed victim centered care to patients of any age. Any gender who may have experienced sexual, physical, or emotional violence. The forensic nursing services we offer completely confidential, non-judgemental care for victims of that sexual assault, child abuse and neglect, vulnerable adults, elder abuse and intimate partner violence. We also see patients who report strangulation and potential human trafficking victims.
Bill Klaproth (host): Well this sounds like a really valuable Valuable program Nicole. So is it just offered in the hospital Do you offer mobile services at all ?
Nicole Baseji: We are a specialized department. . We care for patients 24/7. We are a mobile unit, which means that we traveled to the seven UPMC hospitals in the central PA region. We see majority of our patients within the emergency department, but we can see patients anywhere in the hospital that report any abuse that they encounter.
Bill Klaproth (host): Wow. It sounds like you cover a lot of ground, not only with the services that you offer with literally covering ground too, with the mobile services that you offer. So, Nicole, what does a forensic nurse examiner do? What things are you looking for?
Nicole Baseji: There can be some misconceptions about forensic nursing as we're often portrayed as what's seen on television. Like CSI. Which is just unrealistic. Some people that may view us as nurses who just collect evidence. But there's so much more than we do. Our main goal for our patients is that trauma informed care that we provide. That healing process begins. As soon as they walk through the emergency department doors. When that patient enters those doors. We want to strive to be that first contact within the healthcare system. In order to provide that safe environment for these patients.
When a victim of violence is forced into a situation where there may not be able to have any control over what happened to their body. We want to have that opportunity to provide. Appropriate care and help them move forward. Mainly for a positive healing process. We want to empower them to recover. That gives them that chance to kind of take back control of their lives. So our medical forensic examination includes first obtaining informed consent from the patient that patient can agree or decline all or parts of that examination. We want to collect history of the assault carefully and accurately to document all data that was collected.
The medical forensic exam also includes completing that head to toe assessment. Collecting and preserving physical and maternal evidence. We want to collect swabs. For possible DNA from that perpetrator and any other trace evidence that we can obtain. That forensic evidence includes photography. We do use some equipment, like a digital camera to collect that real time photo. And we use an alternative light source to capture injuries.
Bill Klaproth (host): So Nicole, this is a really interesting, the things that you do in your description of one, someone comes in, you mentioned an alternative light source. What is an alternative light source?
Nicole Baseji: It's a light that we use to identify many forms of evidence, such as semen or urine, or even saliva on the patient's These fluids can be identified through natural light it's like a UV light like that blue light. And we have orange glasses that we put on we can't see with the naked eyes. so that semen you're in a saliva, we can also see possibly soft tissue injury is not visible fingerprints from forceful contact with strangulation cases, we can see around the neck.
Bill Klaproth (host): So I can see where this alternative light source is very, very valuable I'm wondering if people then ask. Are there medications that you give someone? And then of course, people probably are wondering about sexually transmitted infections. How do you deal with all of that, Nicole?
Nicole Baseji: Our program provides that laboratory testing, we offer prophylactic sexually transmitted infection, medications. There's three major STIs, chlamydia gonorrhea and trichomonas that we offer. Medications for them to take it's a one-time dose. That our patients can take. and we also offer emergency contraceptive to our patients. Along with all that information and support that we provide. We provide that throughout the whole exam. We tailor our exam to meet the needs of the patient.
Bill Klaproth (host): Well, that is really good to know. And as you said earlier, your one of your jobs is to try to put that person at ease as much as possible. So if someone has been sexually assaulted, what should they do? What is the timeframe a person should come into the emergency department to ensure a forensic exam can be done?
Nicole Baseji: Well first, if somebody who's been a victim of sexual assault. Please get to a safe place. And then call 911. Or go to your nearest emergency department. They should not take a shower as this can wash away any potential evidence. Try not to eat, drink, brush your teeth, or use the bathroom. Is this out occurred in your home or on the bedrooms sheets, do not clean the area or wash the sheet. even call a friend or family member, a rape crisis center is available 24 7 t/at you can reach out to and obtain guidance from.
Then once a victim comes into the emergency department. We go over the medical forensic exam Obtain that consent from our patient. We start collecting those forensic samples. There's timeframes when there are possibilities of biological or trace evidence on the patient's body. So that patient's body is our crime scene. Over time that evidence decreases over time. So we want that patient really to come in sooner than later. That forensic evidence can be lost from the patient's body clothing through numerous mechanisms.
Seminole fluid can drain from the vagina or wash from the mouth. Body fluid can be wiped off. Dry secretions or foreign material can fall from the body or clothing. So it's really pertinent to obtain evidence sooner than later. And that sexual abuse assault forensic collection can be taken up to five days. At 120 hours for patients, 14 years of age or older. Usually with pediatric patients, children, 13 years of age and younger, it's usually about three days, 72 hours that we can obtain that forensic evidence collection. The child sexual abuse cases, different from sexual assault, from an adult or adolescent. The difference in response to child sexual abuse is that it's completely tailored for children.
Bill Klaproth (host): Well, Nicole, it really is comprehensive. What you do is you do the exam on adults and children. Question, is the assailant usually someone the victim knows?
Nicole Baseji: The research has shown it is a missing assumption that most perpetrators were strangers. That eight out of 10 sexual assaults are committed by someone that the victim knows believe it or not. According to the rape abuse and incest national network. Approximately 30% of sexual assaults are committed by a current or former spouse, boyfriend, or even girlfriend with juvenile sexual abuse cases, 93% of victims knew their perpetrators. So shows majority of victims know their perpetrators.
Bill Klaproth (host): Wow, that that is astonishing statistics there. I didn't realize that. That is kind of eye opening. So thank you for sharing that with us. So if the person uses the safe program, forensic nursing department, do they have to press charges against the assailant if they come to see you?
Nicole Baseji: No, not necessarily. The victim does have the right to request the forensic evidence collected and report as an anonymous patient. That means that they don't have to make a report to law enforcement. And their names will not be attached to that specific forensic evidence. So this forensic Evidence will be preserved for the duration of the current statute of limitations. This option gives the victim time to contemplate their next steps.
Or if they may be fearful of further harm or they just don't know what to do at that time, it gives them time to kind of collect their thoughts and decide. However, there are mandatory reporting laws in Pennsylvania that requires us to report. If the patient is a minor. An elder or an a vulnerable adult. We also have to report if that patient is suffering from an injury resulting in a seriously bodily injury. Or inflicted by the means of a deadly weapon. We do have to report. And we talk to our patients about reporting to law enforcement and these incidents.
Bill Klaproth (host): So someone might be thinking, Nicole. I'm not going to go in there. Cause don't have the money. I just had the most traumatic experience in my life. And I'm worried about money. Will they be charged if they come in and see a forensic nurse?
Nicole Baseji: Thankfully, no. That medical forensic examination, including that evidence collection, we do not charge the patient. There may be expenses that proceeds such as medical expenses, loss of earnings. Even relocation expenses. Sometimes you might even have charges for crime scene cleanup. But the patient may be eligible to receive financial assistance for the expenses through it's a victim compensation assistant program that Pennsylvania has for victims of crime. We go over this information with the patient, we provide that paper application and also the website in our discharge folder. We can assist the patient and filling this application out, or even the YWCA advocate can also help as well.
Bill Klaproth (host): Okay, well, that's good information. And then know that you do this initial forensic exam. Ongoing, are there support services that you offer to people who are victims of sexual assault and domestic violence at UPMC? Do you work with community agencies and law enforcement?
Nicole Baseji: Sexual physical and emotional abuse. Assault is such a huge public health issue. Everybody in the community has a different area of expertise that they can offer. A
part of our team is a victim advocate from the wide YWCA. We call them to come and talk to all of our patients who report sexual assault, intimate partner violence, and even potential human trafficking victims. At the time of discharging the patient, we provide information and also assist in contacting some of these community agencies that offer. The forensic nursing practice combines that nursing science, forensic science, and the criminal justice system. So we play that important role in joining that gap between medicine and law. It's that field of nursing that requires that extensive training. And the medical legal evaluation of patients who were victim and perpetrator of a crime.
Bill Klaproth (host): Yeah, this is a really an intensive program. And thank you for the work that you do in helping these people that have been victims of abuse. So this is really important work you're doing. And Nicole, thank you for explaining all this to us. We really appreciate your time. Thanks again.
Nicole Baseji: Thank you for having me.
Bill Klaproth (host): And once again, that's Nicole Baselj. And for more information, visit upmc.com/centralPAforensicnursing. That's upmc.com/centralPAforensicnursing. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth (host): For victims of sexual assault and other abuses. A forensic nurse examiner plays a very important role. So what does a forensic nurse examiner do? Well, we're going to find out and learn more about the forensic nursing program at UPMC with Nicole Baselj unit director of forensic nursing at UPMC . This is Healthier You, a podcast from UPMC, I am Bill Klaproth. Nicole, thank you so much for your time. It's great to talk with you on a really important topic. So first off, what is the forensic nursing program department at UPMC in Central PA?
Nicole Baseji: We're known by a couple of names. We use that terminology because it's more of a broad term. We use that to care for more than just sexual assault patients. So in addition, to education and clinical training. We provide care to all patients who were a victim of a crime. So we provide trauma formed victim centered care to patients of any age. Any gender who may have experienced sexual, physical, or emotional violence. The forensic nursing services we offer completely confidential, non-judgemental care for victims of that sexual assault, child abuse and neglect, vulnerable adults, elder abuse and intimate partner violence. We also see patients who report strangulation and potential human trafficking victims.
Bill Klaproth (host): Well this sounds like a really valuable Valuable program Nicole. So is it just offered in the hospital Do you offer mobile services at all ?
Nicole Baseji: We are a specialized department. . We care for patients 24/7. We are a mobile unit, which means that we traveled to the seven UPMC hospitals in the central PA region. We see majority of our patients within the emergency department, but we can see patients anywhere in the hospital that report any abuse that they encounter.
Bill Klaproth (host): Wow. It sounds like you cover a lot of ground, not only with the services that you offer with literally covering ground too, with the mobile services that you offer. So, Nicole, what does a forensic nurse examiner do? What things are you looking for?
Nicole Baseji: There can be some misconceptions about forensic nursing as we're often portrayed as what's seen on television. Like CSI. Which is just unrealistic. Some people that may view us as nurses who just collect evidence. But there's so much more than we do. Our main goal for our patients is that trauma informed care that we provide. That healing process begins. As soon as they walk through the emergency department doors. When that patient enters those doors. We want to strive to be that first contact within the healthcare system. In order to provide that safe environment for these patients.
When a victim of violence is forced into a situation where there may not be able to have any control over what happened to their body. We want to have that opportunity to provide. Appropriate care and help them move forward. Mainly for a positive healing process. We want to empower them to recover. That gives them that chance to kind of take back control of their lives. So our medical forensic examination includes first obtaining informed consent from the patient that patient can agree or decline all or parts of that examination. We want to collect history of the assault carefully and accurately to document all data that was collected.
The medical forensic exam also includes completing that head to toe assessment. Collecting and preserving physical and maternal evidence. We want to collect swabs. For possible DNA from that perpetrator and any other trace evidence that we can obtain. That forensic evidence includes photography. We do use some equipment, like a digital camera to collect that real time photo. And we use an alternative light source to capture injuries.
Bill Klaproth (host): So Nicole, this is a really interesting, the things that you do in your description of one, someone comes in, you mentioned an alternative light source. What is an alternative light source?
Nicole Baseji: It's a light that we use to identify many forms of evidence, such as semen or urine, or even saliva on the patient's These fluids can be identified through natural light it's like a UV light like that blue light. And we have orange glasses that we put on we can't see with the naked eyes. so that semen you're in a saliva, we can also see possibly soft tissue injury is not visible fingerprints from forceful contact with strangulation cases, we can see around the neck.
Bill Klaproth (host): So I can see where this alternative light source is very, very valuable I'm wondering if people then ask. Are there medications that you give someone? And then of course, people probably are wondering about sexually transmitted infections. How do you deal with all of that, Nicole?
Nicole Baseji: Our program provides that laboratory testing, we offer prophylactic sexually transmitted infection, medications. There's three major STIs, chlamydia gonorrhea and trichomonas that we offer. Medications for them to take it's a one-time dose. That our patients can take. and we also offer emergency contraceptive to our patients. Along with all that information and support that we provide. We provide that throughout the whole exam. We tailor our exam to meet the needs of the patient.
Bill Klaproth (host): Well, that is really good to know. And as you said earlier, your one of your jobs is to try to put that person at ease as much as possible. So if someone has been sexually assaulted, what should they do? What is the timeframe a person should come into the emergency department to ensure a forensic exam can be done?
Nicole Baseji: Well first, if somebody who's been a victim of sexual assault. Please get to a safe place. And then call 911. Or go to your nearest emergency department. They should not take a shower as this can wash away any potential evidence. Try not to eat, drink, brush your teeth, or use the bathroom. Is this out occurred in your home or on the bedrooms sheets, do not clean the area or wash the sheet. even call a friend or family member, a rape crisis center is available 24 7 t/at you can reach out to and obtain guidance from.
Then once a victim comes into the emergency department. We go over the medical forensic exam Obtain that consent from our patient. We start collecting those forensic samples. There's timeframes when there are possibilities of biological or trace evidence on the patient's body. So that patient's body is our crime scene. Over time that evidence decreases over time. So we want that patient really to come in sooner than later. That forensic evidence can be lost from the patient's body clothing through numerous mechanisms.
Seminole fluid can drain from the vagina or wash from the mouth. Body fluid can be wiped off. Dry secretions or foreign material can fall from the body or clothing. So it's really pertinent to obtain evidence sooner than later. And that sexual abuse assault forensic collection can be taken up to five days. At 120 hours for patients, 14 years of age or older. Usually with pediatric patients, children, 13 years of age and younger, it's usually about three days, 72 hours that we can obtain that forensic evidence collection. The child sexual abuse cases, different from sexual assault, from an adult or adolescent. The difference in response to child sexual abuse is that it's completely tailored for children.
Bill Klaproth (host): Well, Nicole, it really is comprehensive. What you do is you do the exam on adults and children. Question, is the assailant usually someone the victim knows?
Nicole Baseji: The research has shown it is a missing assumption that most perpetrators were strangers. That eight out of 10 sexual assaults are committed by someone that the victim knows believe it or not. According to the rape abuse and incest national network. Approximately 30% of sexual assaults are committed by a current or former spouse, boyfriend, or even girlfriend with juvenile sexual abuse cases, 93% of victims knew their perpetrators. So shows majority of victims know their perpetrators.
Bill Klaproth (host): Wow, that that is astonishing statistics there. I didn't realize that. That is kind of eye opening. So thank you for sharing that with us. So if the person uses the safe program, forensic nursing department, do they have to press charges against the assailant if they come to see you?
Nicole Baseji: No, not necessarily. The victim does have the right to request the forensic evidence collected and report as an anonymous patient. That means that they don't have to make a report to law enforcement. And their names will not be attached to that specific forensic evidence. So this forensic Evidence will be preserved for the duration of the current statute of limitations. This option gives the victim time to contemplate their next steps.
Or if they may be fearful of further harm or they just don't know what to do at that time, it gives them time to kind of collect their thoughts and decide. However, there are mandatory reporting laws in Pennsylvania that requires us to report. If the patient is a minor. An elder or an a vulnerable adult. We also have to report if that patient is suffering from an injury resulting in a seriously bodily injury. Or inflicted by the means of a deadly weapon. We do have to report. And we talk to our patients about reporting to law enforcement and these incidents.
Bill Klaproth (host): So someone might be thinking, Nicole. I'm not going to go in there. Cause don't have the money. I just had the most traumatic experience in my life. And I'm worried about money. Will they be charged if they come in and see a forensic nurse?
Nicole Baseji: Thankfully, no. That medical forensic examination, including that evidence collection, we do not charge the patient. There may be expenses that proceeds such as medical expenses, loss of earnings. Even relocation expenses. Sometimes you might even have charges for crime scene cleanup. But the patient may be eligible to receive financial assistance for the expenses through it's a victim compensation assistant program that Pennsylvania has for victims of crime. We go over this information with the patient, we provide that paper application and also the website in our discharge folder. We can assist the patient and filling this application out, or even the YWCA advocate can also help as well.
Bill Klaproth (host): Okay, well, that's good information. And then know that you do this initial forensic exam. Ongoing, are there support services that you offer to people who are victims of sexual assault and domestic violence at UPMC? Do you work with community agencies and law enforcement?
Nicole Baseji: Sexual physical and emotional abuse. Assault is such a huge public health issue. Everybody in the community has a different area of expertise that they can offer. A
part of our team is a victim advocate from the wide YWCA. We call them to come and talk to all of our patients who report sexual assault, intimate partner violence, and even potential human trafficking victims. At the time of discharging the patient, we provide information and also assist in contacting some of these community agencies that offer. The forensic nursing practice combines that nursing science, forensic science, and the criminal justice system. So we play that important role in joining that gap between medicine and law. It's that field of nursing that requires that extensive training. And the medical legal evaluation of patients who were victim and perpetrator of a crime.
Bill Klaproth (host): Yeah, this is a really an intensive program. And thank you for the work that you do in helping these people that have been victims of abuse. So this is really important work you're doing. And Nicole, thank you for explaining all this to us. We really appreciate your time. Thanks again.
Nicole Baseji: Thank you for having me.
Bill Klaproth (host): And once again, that's Nicole Baselj. And for more information, visit upmc.com/centralPAforensicnursing. That's upmc.com/centralPAforensicnursing. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You, a podcast from UPMC. I'm Bill Klaproth. Thanks for listening.