“I think there is a socialization that goes where violence becomes acceptable. You have to change that and say, No, that’s not acceptable, rape is not acceptable’ … We must not be ambiguous about violence. The greatest war is fought inside our own hearts, a war of anger and resentment and greed. So we start within ourselves and then with our families and our communities.”
-Mairead Maguire, Nobel Peace Laureate
KEY POINTS IN THIS CHAPTER
Anyone can be a victim of sexual violence.
Sexual violence often occurs in conjunction with other perpetrator-initiated crimes and risk behaviors (e.g., burglary, intimate partner violence, substance use, prostitution/trafficking).
Sexual assault nurse examiners (SANEs) fulfill a key role in the care of victims of sexual violence.
Care includes health assessment and treatment as well as forensic assessment, specimen collection, and documentation to maintain the proper legal chain of custody processes.
Collaborative care, including advocates, law enforcement, and other healthcare/social work providers, strengthens the potential for healthy outcomes.
Legislation exists to support victims of sexual violence, along with numerous national resources.
Sexual violence is one of the most difficult experiences endured by a human being. Victims of sexual violence describe the shame, the pain, the vulnerability, the fear, and the lack of control. Nurses and other healthcare professionals frequently provide care to victims of sexual violence and oftentimes have no awareness of their history of trauma. Sexual assault forensic examiners (SAFEs), also referred to as sexual assault nurse examiners (SANEs), provide medical and forensic care in the initial hours and days following an act of sexual violence, if the victim seeks care (Ledray, Faugno, & Speck, 2001). These nurses are prepared to treat and care for victims of sexual violence, with an understanding of the complexity of emotional, physical, and psychosocial needs that may result.
The purpose of this chapter is to orient the non-forensic nurse to sexual violence and related crimes such as stalking and strangulation. Aspects of perpetration, although not a focus of this chapter, will be discussed to increase the nurse’s awareness of how types of perpetration affect victim response and subsequent care that is offered. Current evidence-based nursing responses and interventions will be presented, as well as resources useful to nurses and to victims of sexual violence and their families, friends, and other sources of social support.
OVERVIEW OF SEXUAL VIOLENCE
According to the Centers for Disease Control and Prevention (CDC), “sexual violence (SV) is any sexual act that is perpetrated against someone’s will. [Sexual violence] encompasses a range of offenses, including a completed nonconsensual sex act (i.e., rape), an attempted nonconsensual sex act, abusive sexual contact (i.e., unwanted touching), and non-contact sexual abuse (e.g., threatened sexual violence, exhibitionism, verbal sexual harassment)” (CDC, 2014a, p. 1.) The following sections describe in detail these four types ...