Nurse Takes On The Sexual Assault Beast

IU Health Arnett Hospital nurse Megan Shupe takes sexual assault personally. That’s why she’s working diligently to implement a forensic nursing program focused on specialized care for victims.

She stands at just over four feet tall. But Megan Shupe’s passion for her cause can overpower the most influential audiences in her presence.

Fire fighters, prosecutors, police officers, paramedics, nurses, and doctors – they’ve all witnessed Shupe’s plea. It isn’t a plea for all emergency room patients; it’s a plea for those who come in bruised and battered – the victims of abuse and assault. For months she’s been canvasing Lafayette, Tippecanoe County and beyond, gathering support and resources for her cause. She’s also been doing a whole lot of educating.

“There is not a sexual assault response team in Tippecanoe County – no group that comes together to provide support for victims,” said Shupe, who sat in on two rape trials and a mock trial orchestrated by the prosecutor’s office to help her learn more about the needs of victims and the support in place at the court level. “I start by telling people ‘you may not be the first person to come into contact with a victim but you are likely the one they will remember. Keep an open mind. Don’t give them an eye roll when they tell you their story. A person who has suffered trauma may not behave the way you behave but it doesn’t mean their story is false.’”

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Sadly, Shupe knows about those stories intimately.

“For me, my story happened years ago during childhood but I remember thinking at that time ‘if one person would have reached out to help me how much different that situation would have been.’ The resources weren’t available, so I’m committed to making sure every patient who comes to this hospital gets the very best support we have to offer,” said Shupe.

For 12 years, she watched helplessly as her single mom struggled in a relationship with a man who changed from the nicest person she’d ever met to what Shupe calls “a monster.”  The physical and sexual abuse were both reasons to leave and reasons to stay.

“I watched her struggle through ‘how can I leave?’ and ‘how can I afford to stay?’ A lot of people stay in the situation because they don’t know how to get out. They take their kids down that path with them because they are scared and they don’t know any other way,” said Shupe.

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The sexual assault picture is big and scary – like a beast. But Shupe is focusing on each piece as if it is her only patient.

To help her with her efforts the Indiana Criminal Justice Institute recently awarded a two-year grant to develop and strengthen care, education and outreach to victims of assault through the Victims of Crime Act, Federal Assistance Fund. Specifically, Shupe is heading up the West Central Region’s Sexual Assault Nurse Examiner (SANE) program. The program will be headquartered at Arnett but will also serve surrounding areas including IU Health White Memorial, and Frankfort hospitals. She has also met with leaders in nearby Clinton County. She estimates there are 400 sexual assaults a year in the Lafayette area including the Purdue University campus.

“Since July, I’ve really hit the ground running, knocking down barriers to get the program in place,” said Shupe. What does that look like for IU Health Arnett Hospital?

“Now when someone comes in and they’ve been sexually abused they are basically treated like any other ER patient,” said Shupe. “They sit in a waiting room and don’t have a private place to go. After they wait for the medical clearance, they are told we don’t offer those exams and they are referred to another hospital. The other hospital is so overwhelmed that they have to turn patients away. If it’s sexual assault, you have a traumatized patient who has worked up the courage to come in and there is also a window of opportunity to collect evidence. We can’t afford to lose time.”

By mid-November, Shupe hopes that will be completely transformed. With the backing of Brian Weinrich, Chief of Nursing, and Brad Jordan, Director of Emergency Room and Trauma Services, Shupe’s plan has been unanimously supported by the hospital’s executive leadership team. That plan includes two emergency rooms – one will be with a single entry point to protect the victim from the public eye. The first room will be designed more like a home setting with furniture rather than medical equipment. That area will serve as a consult room to collect patient information. The second room will serve as an exam room that will include a private shower.

Patient care will begin with a medical legal examination that includes an interview where the patient recalls as much detail as possible from the incident and the perpetrator.  The interview is followed by a thorough exam that includes body mapping and swabbing, identifying lacerations, bruises and areas that may provide forensic evidence – such as particles of skin from beneath the fingernails, a possible sign of the victim scratching the perpetrator during defense. A special camera has been ordered to photograph the victim’s injuries.

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Thirteen nurses will be trained in forensic nursing and will rotate through an “on call” schedule. “I think everybody has a story – something that led them down a path. I can’t speak for every nurse in forensics, but at some point if you are willing to make the sacrifices involved in this level of patient care, you almost have to have a personal experience, a passion for the victims,” said Shupe. She started her career in ER medicine in a small critical access hospital where she first learned about forensic nursing. She completed the training and joined IU Health in 2011 working in ER. She will continue splitting her time between administrative duties for the SANE program, and bedside care.

“My goal is to get them while they are here. Whether they are a victim of sexual assault, domestic violence, child abuse, stabbings, gunshot wounds, elder abuse -– anything where emergency medicine brushes with the legal system – I want us to be available to handle those situations,” said Shupe. “When we say we offer patient support we want the entire community to recognize what resources are needed and what resources exist. When we discharge a patient we want to send them out with everything available from access to 24-hour hotlines, to legal aid, to victim advocacy and safe shelters. It’s the only way to help them.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
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 T.J. Banes or on Twitter @tjbanes.