Every year, hundreds of people arrive in UVA’s ED who have experienced the trauma of sexual abuse, child abuse, intimate partner and dating violence, and elder abuse. They are infants, teenagers, and elderly people.
1 in 4One-quarter of women will experience violence over the course of their lifetime (Source: www.NVADV.org)
“People often assume most of our patients are college students,” said Kathryn Laughon (BSN ’98, MSN ’01). “But what we know from the research, and what I see in my clinical work, is that violence is common in every age group and community.”
With one full-time and three part-time forensic nurses, the team provides the specialized care these complex patients require, from HIV prevention to evidence collection to interacting with law enforcement and testifying in court. As a veteran forensic nurse, Laughon had, for years, reimagined how the care flow and structure might improve.
Currently, UVA Health’s forensic team “operates like most forensic teams around the country,” she explained. “It’s not full-time nurses devoted to these issues. What we’re proposing is something that will truly be unique in the nation: a comprehensive center with its own unique geography where we can provide substantial follow-up care, educate clinicians, provide a space for research, and teach students. Under one roof.”
“We care for assaulted patients for the long term,” added Laughon, “and now want to take a leap forward to create a national model with this academic medical center partnership.”
To build the new forensic center, Laughon—with strong support from Kathy Baker, UVA Health’s chief nursing officer, Karin Skeen (PhD ’22), associate chief of women’s and children’s services at UVA Children’s, and ED leaders—will hire dedicated forensic staff trained to identify and treat non-accidental trauma and violence across the lifespan, including child and elder abuse, strangulation, and rape. Using a trauma-informed care model, the new center will also offer teaching space for nursing and medical students on clinical rotation, hold continuing education workshops and webinars for practicing clinicians, allow workers to collaborate on research, and “think deeply about how we can make forensic nursing practice even more scientifically rigorous,” Laughon said.
“We care for assaulted patients for the long term, and now want to take a leap forward to create a national model with this academic medical center partnership.”Kathryn Laughon, professor, PhD program director, and director of a new UVA Health emergency forensic center in the ED
It will also be a place for Laughon to conduct her current research, including a study to buttress understanding of strangulation injuries and how to document them, a pilot to map brain injuries in abused women who are strangled, and an analysis of abused women’s social networks. It will also help her recruit and mentor PhD students seeking to study in the same space.
Longer term, Laughon envisions the forensic center will be a distinct, within-the-ED clinic (“a smaller, separate, quieter place,” she explained) where patients also receive non-emergency follow-up care, sexually transmitted infection and pregnancy tests, prescriptions, access time with a social worker, and resource connections outside the hospital.
If the center offers a new geography for Laughon’s more than 25 years of nursing practice, she insists the work isn’t new. “Teaching, research, and service: that’s what faculty do,” she said. “Maybe what’s really shifted is the world, as there’s a lot more recognition of the kinds of public health spaces we need, and that the way to be engaged in a community is a principle we should recognize.”
Excerpted from the fall 2023 Virginia Nursing Legacy magazine.