GBMC Fights Back against Sexual Assault and Domestic Violence

A 32-year-old female came to the Greater Baltimore Medical Center (GBMC) Emergency Department, reporting an arm injury. She was accompanied by her husband. GBMC routinely screens every patient for signs of domestic violence, and even though the patient did not disclose abuse, the nurse suspected there was something the patient could not say in her husband’s presence. The nurse initiated support from GBMC’s Sexual Assault Forensic Examination (SAFE) and Domestic Violence (DV) Program. Members of the SAFE/DV team took the patient to a safe place in the hospital, where she revealed the physical and emotional abuse she endured from her spouse. The team helped her file a police report and secure a protective order. They also referred her to counseling services, and helped to place the woman and her three minor children in a shelter.

This recent example is just one of many that illustrates GBMC’s efforts on the front lines of combating domestic violence and sexual assault.

“This hospital-based program at GBMC gives us the ability to reach hundreds of victims and prevent countless injuries each year,” says Valerie Weir, BSN, RN, FNE-A/P, Coordinator of GBMC’s DV Program, which is part of the healthcare system’s long-standing SAFE Program. “It heightens our ability to contact high-risk victims and underserved populations including the elderly, victims with disabilities, those who are pregnant, and those who are under-insured or uninsured,” she explains.

The SAFE Program is staffed by registered nurses who are trained and certified by the Maryland Board of Nursing to work with sexual assault victims across the lifespan in a compassionate and respectful manner. These patients are cared for in a private, secure suite separate from the hospital’s Emergency Department.

The SAFE Program was established to address the unique concerns of sexual assault victims. Its expert forensic nurse examiners evaluate victims, collect evidence that can be vital in prosecuting a sexual assault, use the latest technology to document sexual and domestic violence injuries, and provide emergency contraception and antibiotics if needed. The GBMC SAFE Program has eliminated the long waiting time that many victims endure, only to have the rape kit administered by an untrained medical professional. GBMC is also the only hospital in Baltimore County to provide expert medical-forensic exams to patients who have been victim to a strangulation assault.

Additionally, the SAFE Program provides outreach and educational programs about safe dating, recognizing potential violence, and dealing with current violence in a relationship. In the 2017-2018 school year, the SAFE Program made presentations to approximately 2,000 students and community members in the Baltimore area. Among the lessons imparted:

• Roughly two-thirds of GBMC forensic exams are conducted on victims between 13 and 24 years old
• Alcohol was involved in nearly half of all those sexual assaults
• More than 70% of the alleged assailants were known to the victim

In 2011, GBMC established the DV Program, which identifies victims and links them to shelters and other services in the community, provides information on the steps and resources in helping them secure legal protections, and puts them in touch with community advocates and counselors.

“Studies have shown that only 4% of domestic violence victims will reach out to traditional domestic violence service providers; whereas approximately 42% of those victims will seek medical care at some point,” Weir says. “Having a hospital-based program gives us the opportunity to connect patients with the services available in the community.”

The program doesn’t wait for victims to reach out to them. Virtually every patient who comes to GBMC hospital – whether they are initially seen in the Emergency Department, Labor and Delivery, arriving for surgery, or admitted to any unit in the hospital – are screened for signs of abuse. If the screening indicates possible abuse, crisis interventionists are notified. DV Interventionists are on-call 24/7, available to meet with patients in a confidential setting to assess the danger and discuss the options. Interventionists will assist victims with crisis counseling, documentation, shelter placement, locating legal assistance, identifying follow-up counseling, and other services, including photo-documentation of injuries of domestic violence cases that do not involve forensics.

Since its inception, the DV Program has provided crisis counseling and advocacy to over 2,000 abuse/assault victims, recently averaging more than 30 referrals a month, but assisting as many as 45 in a month.

All services are free and confidential.

Weir notes that domestic violence comes in many forms, including physical violence, sexual violence, emotional abuse, and economic abuse. The Centers for Disease Control and Prevention (CDC) reports 1,200 deaths and 2 million injuries to women from domestic violence each year. According to FBI statistics, domestic violence is the leading cause of injury to women between the ages of 15 and 44 in the United States, more common than automobile accidents, muggings, and rapes combined.

“Intimate partner violence is a public health concern,” Weir says. “The CDC estimates that one in three women and one in four men will be abused in their lifetimes. In addition to injuries sustained during violent episodes, physical and psychological abuse are linked to adverse health effects including depression, alcohol and substance abuse, chronic pain, migraines and other frequent headaches, and stomach ulcers. We are very fortunate that GBMC takes abuse so seriously and has committed to being the community leader in responding to this critical health issue.”