Being a forensic nurse means being a source of strength and comfort to some community members who need healing most.
For Cheryl Wier, a sexual assault nurse examiner in Bradford, she sees some of the most vulnerable children in the region. But over the 8 ½ years since she received training, she’s grown passionate about her lifework.
Wier and other forensic nurses were honored for their service this past week, Nov. 7-11, during Forensic Nurses Week. The recognition coincides with the six-month anniversary of the First Step Medical Clinic, the facility at Bradford Regional Medical Center where she sees children who have been victims of sexual abuse. The clinic opened May 19.
In those six months, Wier has seen 25 patients under the age of 18.
Other forensic trained nurses at BRMC are Julie McCord, who is adult/adolescent and pediatric trained, and Nicole Steinhauser, who is adult/adolescent trained and hopes to receive pediatric training in the spring. McCord and Steinhauser work in the emergency room, and one of the three is available 24 hours a day.
Wier said she does case reviews with Dr. Jill Owens as the case director.
Wier, who has been a nurse for 10 years, hadn’t planned on working with victims of sexual abuse. In 2008, “They asked me if I would take the training. I had no idea that it would be something that would become my passion and be so gratifying.”
She explained that forensic nurses “are trained to assess and intervene and get services for patients who have been victims” of a number of violations including domestic violence, sexual assault, child abuse, human trafficking, child sexual abuse and elder abuse. They offer trauma-focused, patient-centered care, and perform tasks such as collect a medical history, perform a physical exam, document injuries, collect evidence and develop a safety and discharge plan.
“It is very purposeful work, to work with someone when they are at their worst,” said Wier, who noted, “I get way more out of it than (the patients) get.”
It has been an eye-opening experience for Wier. She explained that she wasn’t aware of just how unfortunate some of these children’s home lives were, which sometimes included poverty and drug use in their families — “and just not having what I was fortunate to have.”
Wier stressed, “This is a team approach. We are all working together to have the best outcomes for our patients,” not just during the course of a case, “but for the whole lifespan.”
In McKean County, Wier works with a multidisciplinary team that includes different agencies including the McKean County Children’s Advocacy Center, police officers and the district attorney, Children & Youth Services and more.
The McKean County Children’s Advocacy Center in Smethport is an agency dedicated to bringing services to victims of child abuse in the community.
The reach of child abuse services in McKean County goes well beyond its own borders.
“Our Children’s Advocacy Center has memorandums of understanding from surrounding counties, and we’re starting to see patients from other counties,” Wier explained. “It’s more of a regional resource.”
The more she talks to people in the field from across the state, the more she realizes how unique the services for sexual abuse victims in McKean County are.
“The doctor that I did my mentorship with retired in Erie.” Consequently, “There’s been a lot of counties in the west that are struggling to find services.” To the south of Bradford, the closest place that provides similar services is Jefferson County. “We have seen patients in Elk, Cameron, Potter and Warren counties.”
One important aspect locally, according to Wier, is the level of dedication of team members from various agencies, who can be reached even in the middle of the night if that’s when a trauma victim needs assistance.
“Everybody is committed to the same goal of having safe patient care for us, and that’s unique,” she said.
With what she’s learned about helping victims, she wants to use that knowledge to help the community as a whole become better at identifying victims.
“That’s a goal of mine is to do more community awareness,” she said, which includes teaching “how to assess a situation and how to report it” — and to get services to children more quickly.
“We all, as a team and as a community, need to tighten up our response to all of those things and intervene earlier.”
She would like to get a system in place to bring interventions to children in difficult circumstances by looking for signs that something isn’t right, such as sleeping through class or declining schoolwork. Help would could come faster “if we as a community just asked a few questions about their home life.” This can be done not just in schools, but through churches and other community groups, too.
Wier mentioned the Adverse Childhood Experiences (ACE) study from the 1990s, which looked at the impact traumatic experiences related to issues such as violence and drugs in childhood had on a person’s physical and mental health throughout their lifespan.
The study identified a list of factors that have shown to make an impact on a child’s future health.
“I was so grateful and fortunate to have such a great life growing up,” while there may have been children in class next to her who were dealing with family issues she couldn’t imagine, such as poverty and drug use.
Wier does have opportunities now to help agencies develop protocols and responses when facing suspicions of abuse.
She said she’s collaborated with groups including the University of Pittsburgh at Bradford, Federal Correctional Institute-McKean, the McKean County Jail and places in other counties sharing information. “I’ve done first responder training for fire departments and law enforcement about how to recognize forensic patients and how to intervene at that time to get the best outcomes,” she added.
