As an emergency medicine locum tenens physician, you’re caring for patients in emergency departments across the country who arrive with all sorts of injuries and stories. Some of them most likely pass through quickly and uneventfully, while there are others that you probably think about long after your shift is over. For example, the young girl who arrived after a violent sexual assault and needs medical attention but does not want to report a crime. You may go home after your shift wondering why sexual assault goes unreported and what your role as a physician is in this situation. It’s hard not to get emotionally wrapped up in the stories of patients who arrive as victims, and your obligation to report sexual assault crime is different depending on the state that you’re working in. Luckily, there are resources available for locum tenens who are caring for sexual assault victims, as well as plenty of studies that explain why sexual assault goes unreported.
Why Sexual Assault Goes Unreported
An estimated 80 percent of sexual assaults go unreported. There are many reasons why sexual assault goes unreported such as victim-blaming, and stigma or fear of their attacker. Since so many sexual assaults go unreported, some professionals, such as The American College of Obstetricians and Gynecologists, recommend that healthcare providers screen all patients for sexual assault, especially those who complain of pain or sexual dysfunction. These patients may be too afraid to say what has happened to them. Sexual assault can happen to anyone, and many times people are attacked by someone they know. Sexual assault is also a growing issue for many people addicted to opioid pain pills or heroin, so much so that it’s becoming a normal and overlooked part of the opioid epidemic. If an assault victim comes into the emergency room, they’re one of the few who chooses to report the crime. As an ER doctor, if someone does decide to report a sexual assault they will most likely see you first. How can you help?
Caring for Sexual Assault Victims as a Locum Tenens Doctor
The most important thing to keep in mind when caring for sexual assault victims as a locum tenens emergency medicine doctor is that they not only need immediate medical care, but they have psychological needs that must be met in a timely fashion too. Here are some steps you can take, no matter where you’re working, to help sexual assault victims.
Know state laws
There is most likely a community plan in place between law enforcement and the hospital in which you are working. Make sure to familiarize yourself with this plan so that you know what is expected of you as the ER doctor. There are lots of arguments for and against ER doctors and emergency medical service workers being required to report rape, but it will all come down to the law in your state.
Know hospital protocol
The hospital should have a specific protocol for caring for sexual assault victims, which most likely includes offering the patient medical, technical, and psychological support. It may also include calling in specially trained personnel to collect evidence. It’s best to know this ahead of time so as not to compromise any part of the process.
Stabilize the patient
First and foremost, try to stabilize the patient and reassure them. Your patient just went through a very traumatic experience. You and your team members in the emergency department should focus on getting the victim’s basic needs met first before delving into the medical procedures.
Perform a physical exam
When it’s time for the physical exam, be sure to offer the patient testing for pregnancy and sexually transmitted diseases. There could be minor injuries, such as bruises, but there could also be more serious injuries, like fractures. The patient will most likely need care beyond what you can give to cope emotionally with the assault, so connect them with additional resources.
Know what to say
If an assault victim calls into the emergency department with questions, encourage them to come into a medical facility immediately. Make sure they know not to bathe, change their clothes, go to the bathroom or clean anything so that there’s as much evidence available as possible. There is typically a time cut-off, like 72-hours, for collecting evidence in a sexual assault.
If you have experience or expertise in this field, feel free to share your thoughts or tips in the comments below!