Sexual assault pts & gender of tech

[Ridryder911]

I'm not so sure we should be considering situations like this to be "tough luck" in terms of what the patient wants. I personally would not shy away or ask for another same-gender crew unless the patient specifically seemed to desire such a thing. I certainly would not ignore their request.

It's definitely a cultural thing and there is no way that I can force my ideals on a patient that may have just been sexually assulted and mentally traumatized because of it. I'm a firm believer in the, "do no harm" aspect of the job and forcing things to go your way on a call would be no different than the person who SA the victim forced themselves onto said victim.

If the patient does not care, I do not either, I am there simply to help them. But if the patient does care then I can at least ask them what would make them comfortable. ^_^

That's a nice thought but not realistic. One cannot operate EMS based and dispatched upon what "patients want". I have them want only Native Americans, read and heard of requesting "Blacks, female", etc... Alike any other business, one cannot always get what they want or should the EMS attempt to satisfy. EMS operation is much more complex than just being able to send the unit with what the patient request. When a patient request help, they are asking for medical help and that is what they are going to get.

As a male nurse, many assume that females would automatically want another gender but in reality that has never happened. When a patient is assigned that is who they get.

R/r 911

 

[simpatico]

It's a rough subject, especially because I find myself fully agreeing with you as well Ridryder.

I don't think I'd ever go along with it as far as getting same ethnicity EMTs or anything like that, I think it would be strictly limited to me as far as same gender goes, just because of the local culture where we're brought up to generally be more comfortable with same gender groups when it comes to physically intimiate things - especially trauma.

To be frank, I know of no men that go to their mothers to discuss sexual problems just as I know of no women that go to their fathers to discuss the same thing.

BUT... This is where I find myself agreeing with you, Rid, I can't imagine that I would care who I went to regarding a sexual assult that occurred. I'd probably prefer my nurse friend or doctor friend, regardless of whether or not they were male or female. So, yeah... I do see that trying to keep same gender is not only unrealistic but probably entirely unnecessary for most people.

 

[VentMedic]

As a male nurse, many assume that females would automatically want another gender but in reality that has never happened. When a patient is assigned that is who they get.

R/r 911

Disagree here. We do try to accommodate patients, both male and female, especially where there are cultural issues. Oklahoma may only have white, all American English speaking people, since it seems the Native Americans take a very distant back seat there, with just one religion but other parts of the country we have several different nationalities and many different cultures. Thus, we have specialized training classes for health care providers to help recognize, understand or at least respect people for their beliefs.

simpatico

I'd probably prefer my nurse friend or doctor friend, regardless of whether or not they were male or female. So, yeah... I do see that trying to keep same gender is not only unrealistic but probably entirely unnecessary for most people.

It will depend on the nature of the rape as well as the age, gender, culture etc. Some believe it is just a little sex act without the woman's permission and that might be the only type some here have seen. Some may even think of it just as a prom date gone alittle too far. In other places, the assault may be extremely violent to where the man or woman is no longer rational due to the emotional or physical stress. They may see people only as male or female or a uniform which may or may not be a good thing. This is why our PD also dispatches their own from a Victim's Services unit. The person doesn't even have to be sexually assaulted to require special consideration. If your community does not provide some type of service that considers the victims of these crimes then I would say the people are not being appropriately provided for. Some just believe the things worth money or what you can see is of more value than that what isn't which is the emotional.

Again, it depends on the attitude of the healthcare provider. Some do not understand rape and do have their own personal views as to why it occured. If these providers don't see any phyicial injuries, some may have the attitude the woman should just get over it. No harm, no foul. This same attitude was the norm about domestic violence for many years until laws were passed. However, many involved in domestic violence, male or female, still do not get prosecuted nor do the parties involved get help due to the attitudes of their first responders.

Recognizing the needs of your patient should be part of your initial assessment. From there you should adjust your attitude to provide what is needed to get this patient to the hospital safely. Granted, in some areas that do not provide services for victims, the choice of personnel may be limited. One, however, shouldn't do the "tough luck" attitude as that will show in the care you attempt to provide. And, any remarks made to other responders on scene within hearing range of the victim as to saying "tough luck I'm what he/she is getting" should be avoided even though it sounds as if they happen. Also in the case with the OP, I would seriously not want the victim to feel she/he is "inconveniencing" those in EMS by having the misfortune to get raped. No conversation as to "why" someone was called "just" for a rape should be happening at scene...although we know it must in some areas just by the comments in this thread.

There should be other considerations for the patient. In some areas the response will be at least two LEOs who may be male and 8 EMS providers who may also be male. Now imagine a naked woman (or man) lying in a vulnerable position possibly in a public area, depending on the location of the assault, looking at this crowd of uniforms standing over her/him. Some don't think before they rush in and then stand and stare. Sometimes the lead Paramedic, especially if male, allows them to gawk at his patient because privacy is not something that is learned in school since everything is an emergency to where privacy is not an issue to be considered of importance.

 

[VentMedic]

Here's more reading for you Epi-do.

It looks like I didn't even begin to list all the factors covered by those who specialize in forensic medicine dealing with assaults.

Sexual Assault Medical Forensic Examinations
http://samfe.dna.gov/overarching_issues/victim_centered_care/

National Protocol
http://www.ncjrs.gov/pdffiles1/ovw/206554.pdf

Here's one we deal with occasionally and the patient presents to us in many different ways. It might also be a good read for the parents of teen-agers.

Cross-Cultural and Social Context of Adolescent Partner Violence.

http://www.hms.harvard.edu/coewh/ViolencePrevention/SocialandCultural.ppt

 

[Epi-do]

Does your PD not have a victim's service unit or one that provides advocates? If so, they can help you with the guidelines.

It depends upon which department we are running with. If it is our PD, it is a pretty small department and I do not believe that they have the resources. However, we do occassionally run with Indy Metro PD, and I know from past experience that they do have this sort of thing.

I really appreciate your help with the resources. Hopefully, I can help to better educate the rest of my department regarding these types of runs.

 

[VentMedic]

I've got more links for you.

http://www.aardvarc.org/victim/states/indvic.shtml

http://www.aardvarc.org/rape/states/indrp.shtml

In Florida, healthcare professionals are required to update on Domestic Violence with each renewal. During that time various information about sexual assault may also be discussed.

 

[willbeflight]

That it based on the foolish assumption that the patient is an idiot and can't tell the difference between their attacker and the rest of the world.

Ok, if a guy just raped a girl, why would they want a guy looking at them in places that may need some tending to, depending on the type of attack? I wouldn't want that. It has nothing to do with telling the difference. It's just a very emotional time

 

[NolaRabbit]

It will depend on the nature of the rape as well as the age, gender, culture etc. Some believe it is just a little sex act without the woman's permission and that might be the only type some here have seen. Some may even think of it just as a prom date gone alittle too far. In other places, the assault may be extremely violent to where the man or woman is no longer rational due to the emotional or physical stress. They may see people only as male or female or a uniform which may or may not be a good thing. This is why our PD also dispatches their own from a Victim's Services unit. The person doesn't even have to be sexually assaulted to require special consideration. If your community does not provide some type of service that considers the victims of these crimes then I would say the people are not being appropriately provided for. Some just believe the things worth money or what you can see is of more value than that what isn't which is the emotional.

Again, it depends on the attitude of the healthcare provider. Some do not understand rape and do have their own personal views as to why it occured. If these providers don't see any phyicial injuries, some may have the attitude the woman should just get over it. No harm, no foul. This same attitude was the norm about domestic violence for many years until laws were passed. However, many involved in domestic violence, male or female, still do not get prosecuted nor do the parties involved get help due to the attitudes of their first responders.

Recognizing the needs of your patient should be part of your initial assessment. From there you should adjust your attitude to provide what is needed to get this patient to the hospital safely. Granted, in some areas that do not provide services for victims, the choice of personnel may be limited. One, however, shouldn't do the "tough luck" attitude as that will show in the care you attempt to provide. And, any remarks made to other responders on scene within hearing range of the victim as to saying "tough luck I'm what he/she is getting" should be avoided even though it sounds as if they happen. Also in the case with the OP, I would seriously not want the victim to feel she/he is "inconveniencing" those in EMS by having the misfortune to get raped. No conversation as to "why" someone was called "just" for a rape should be happening at scene...although we know it must in some areas just by the comments in this thread.

There should be other considerations for the patient. In some areas the response will be at least two LEOs who may be male and 8 EMS providers who may also be male. Now imagine a naked woman (or man) lying in a vulnerable position possibly in a public area, depending on the location of the assault, looking at this crowd of uniforms standing over her/him. Some don't think before they rush in and then stand and stare. Sometimes the lead Paramedic, especially if male, allows them to gawk at his patient because privacy is not something that is learned in school since everything is an emergency to where privacy is not an issue to be considered of importance.

Salient points and very educational. Thank you so much for posting this, Vent, and for the added links. I hope that some will come away with an enlightened POV after reading this.

 

[Ridryder911]

Ok, if a guy just raped a girl, why would they want a guy looking at them in places that may need some tending to, depending on the type of attack? I wouldn't want that. It has nothing to do with telling the difference. It's just a very emotional time

The attack is just more than the sexual assault, and at the time such crisis mode the sexuality of the provider is a mute point. The attitude and professionalism of the provider is the main emphasis. As well, some research has discussed that many of those which are females feelthey are being judged by those of the same sex although it may be due to the circumstances.

Ironically, many always assume it is always a female that gets rape and or sexually assaulted. Many sexual assaults of males, are never reported as it still has a stigma that surrounds it.

R/r 911

 

[VentMedic]

Rid,

What is the incidence of unreported domestic violence or the chances charges are not filed in these male dominated EMS and PD services in your area? I would probably say very high and that may go for both male and female victims.

As far as research goes, what is the gender of the authors and what is their intent? If you were doing the study I believe I know which way you would want it to go. Are the studies from any particular region, age, culture etc? Are all the women 20 y/o white middle class from Oklahoma?
Do they all share the same opinions of marriage and the role of the male figure? Do they do things in their normal life just to please the males and is it expected of them? Are they always dependent on the men in their lives and is this dependency an expectation?

There are too many human factors involved to make a blanket statement of preference. While I do agree that a large part of it is determined by the professionalism of the health care provider, I still feel you have so notions that a man takes care of all problems which could just be part of your male dominated work force and childhood. You have expressed strong opinions about religion, marriage, homosexuality, culture and language which makes me think you may also not be that easy to approach about some issues regardless of your professionalism. There will always be patients that will test our limits and if there are other options, it might be for the good of the patient if one of those options be taken.

 

[willbeflight]

The attack is just more than the sexual assault, and at the time such crisis mode the sexuality of the provider is a mute point. The attitude and professionalism of the provider is the main emphasis. As well, some research has discussed that many of those which are females feelthey are being judged by those of the same sex although it may be due to the circumstances.

Ironically, many always assume it is always a female that gets rape and or sexually assaulted. Many sexual assaults of males, are never reported as it still has a stigma that surrounds it.

R/r 911

Good point!

 

[Aidey]

Like Vent said, there is no way to make a blanket statement about victims because people are going to have such varied reactions. I also think that trying to anticipate what is going to make the patient more comfortable (as far as gender of the tech, race etc) isn't going to get us anywhere.

I think the best thing we can do (pre hospital) is be as calm and professional as possible. If the patient states they are more comfortable with a specific person treating them, then I think we should facilitate that if possible.*** However, without a stated preference I don't think we should be trying to anticipate (again pre-hospital).


*** Example: All male EMS crew arrives, the FD is also on scene with a female paramedic. Female patient asks if female paramedic can be in the back with her. Where I work there wouldn't be a problem with that.

 

[VentMedic]

Here's an interesting news item that I thought would fit nicely in this thread. Some aren't always aware of the services in their community or what happens to the patient after they get to the ED.

http://www.emsresponder.com/features/article.jsp?id=9715&siteSection=24

Kansas Facility Aims to Help Assault Victims

Tuesday, June 16, 2009

Stormont-Vail Regional Health Center's new emergency and trauma center will offer sexual assault victims more space and privacy, said Joy Thomas, a sexual assault nurse examiner.

The space is three times larger than where Thomas conducts examinations and offers a bathroom, shower, lobby area and separate exam room.

As a sexual assault nurse examiner, Thomas has examined male and female victims of all ages, shapes and ethnic backgrounds.

"You just never know what you are going to get. You think you have seen everything, then something else comes in," Thomas said. "Some of the victims are crying and upset and you have to calm them down. Some sit very quietly. Some will be jabbering away. There's no normal reaction to being assaulted."

 

[emt1994]

I think there should always be a woman on board for a sa if a man did what he did to you would you want an all male emt crew to take you to the hospital I sure wouldnt and your right im sure she was not comfortable with you either but prob. felt safer.

 

[akflightmedic]

I think there should always be a woman on board for a sa if a man did what he did to you would you want an all male emt crew to take you to the hospital I sure wouldnt and your right im sure she was not comfortable with you either but prob. felt safer.

Just an honest question...did you read any of the posts before responding, click on any links or do any of your own internet research?