Maryland's forensic nurse examiners carry 'worst type' of workloads

Laura Clary admits her job is not for everyone.

Clary is a forensic nurse examiner at GBMC, and when she sees a patient, it is almost always on the worst day of their life. Clary often represents the first person a victim of sexual abuse or domestic violence comes in contact with when they seek help at a hospital.

“Every day can be unpredictable and hard emotionally, but it is also a very rewarding field of work,” Clary said. “You are helping people at a time when they need it more than at any point in their lives.”

Clary is one of the relatively few certified forensic nurse examiners in Maryland.  Such nurses must complete a course approved by Maryland Board of Nursing and have a minimum of 18 months continuous experience in a clinical setting.

Those who work in this field, Clary said, are required to tread very carefully to ensure evidence is properly collected while also helping victims navigate through the proper channels to receive the help they need whether it be from law enforcement, social services, medical care or psychiatric help.

THURSDAY @ 11 p.m. | ABC2 will reveal a Maryland policy that often forces rape victims into further trauma.

Along with patient assessment, Clary said, a forensic nurse examiner is also responsible for everything from working with the victim to collect evidence to dealing with emergency contraceptive and potential sexually transmitted diseases to referrals to crisis counseling and other support services.

“You really have to hold their hand through the whole process,” said Clary, who also works in the emergency room at Franklin Square. “It’s important to let the victims know that we will move at their pace and will do what we can to make them comfortable. The average patient is with us for anywhere from three to five hours.” 

Clary said GBMC could see anywhere from one to four patients over a 24-hour period. The Towson hospital is also the only hospital in Baltimore County certified to administer rape kits for adults. Those 12 and under are referred to Medstar Franklin Square Medical Center.

Between 2011 and 2013, GBMC administered 334 rape kits, according to the state Department of Health and Mental Hygiene’s Sexual Assault Reimbursement Unit. The Towson hospital has 10 forensic nurse examiners on staff, with one on call at all times.

Each jurisdiction in the Baltimore metropolitan area has one hospital with a designated Sexual Assault Forensic Exam (SAFE) program. In each case, the hospital has certified nurses who conduct exams in a designated area away from the general patient population.

This includes Mercy Medical Center in Baltimore City. The hospital, which launched its SAFE program 20 years ago, has 31 forensic nurse examiners on staff with up to two on call at all times. According to state figures, Mercy administered 1,275 rape kits between 2011 and 2013.

“In this field, we never see a happy case,” said Debra Holbrook, Mercy’s director of forensic nursing, who has worked in the field for 20 years. “These are the worst of the worst types of crimes. We just try to make their lives a little easier moving forward. “

Holbrook said nursing is just one part of her job. Those in forensic nursing are also part counselor, social worker and law enforcement assistant. Forensic nurses are taught, she added, to understand the chain of custody when it comes to evidence while also working in conjunction with the police and state’s attorney’s office.

“You are on the front line of helping these victims,” Holbrook said. “In most cases, the victim knows their abuser which makes it even more difficult. You just try to do whatever they need to guide them through the process.”

Clary said along with dealing with patients, it is important for nurses in her field to be able to leave their work at work especially since due to privacy issues they can’t really discuss any difficult issues that may arise.

“I live an hour away so I’m able to listen to music and decompress on the drive home,” Clary said. “While this job is rewarding, it is not ideal for everybody. It can take an emotional toll for some. For me, knowing we are helping so many people allows me to keep moving forward.”

Here is a breakdown of which hospitals in the Baltimore area have a SAFE program and how they are staffed:

Anne Arundel County: Anne Arundel Medical Center (3 forensic nurse examiners for ages 13 and up; not on call 24/7); Baltimore Washington Medical Center (4 forensic nurse examiners for both pediatrics through adults)

Baltimore City: Mercy Medical Center (31 forensic nurse examiners for ages 13 and up; 1-2 on call 24/7); University of Maryland Medical Center handles cases for children 12 and under

Baltimore County: GBMC (10 forensic nurse examiners; 1 on call 24/7); Medstar Franklin Square Medical Center handles cases for children 12 and under

Carroll County: Carroll Hospital Center

Harford County: Harford Memorial Hospital (6 forensic nurse examiners; staffed 24/7)

Howard County: Howard County General (7

forensic nurse examiners; 1 on call 24/7)



Also, University of Maryland Pediatric Emergency Department in Baltimore City cares for sexually assaulted patients ages 12 and under. Mercy Medical Center sees all sexual assault patients ages 13 years and up. These are the two hospitals for Baltimore City. BWMC sends our patients to these two locations when we do not have coverage, and when AAMC does not have coverage either.

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