Forensic Nurse Examiner Care After an Assault

It’s hard to know what to do after an assault. Confidential, compassionate, specially trained help is available at CHI Health emergency departments through our Forensic Nurse Examiner program. 

Our Forensic Nurse Examiners are specially trained in crisis intervention. They do not work for law enforcement. They advocate for victims by providing sensitive and timely medical examinations. They also collaborate with community response teams to connect victims with the resources they may need after being seen in the emergency department. An FNE provides:

• Injury detection and treatment
• Health care pertaining to sexual assaults (sexually transmitted infection screening, pregnancy testing, emergency contraception)
• Forensic medical evidence collection
• Domestic violence crisis intervention
• Testimony in judicial proceedings
• Community resource connection

The wraparound care provided by the FNE is designed to help the victim of violence feel fully supported and educated. We help the patients we see make informed decisions about how to proceed after an assault – and ultimately heal physically, emotionally and psychologically. 

What makes a Forensic Nurse Examiner different? The FNE’s role is specially designed to reduce the physical and psychological trauma experienced with sexual assault, human trafficking and domestic violence. FNEs complete a minimum of 40 hours of classroom training followed by an average of 40 hours of clinical training specifically for all kinds of assault.

FAQs on What to Do if You're Assaulted

How long does an FNE exam take?

Two hours is a good benchmark, but the amount of time depends on the patient and amount of injuries. An FNE exam is completely patient-led. That means each step is explained in full and the victim of violence is asked for consent before proceeding. You will never be rushed or required to do anything you don’t want to do. 

What if I don’t want to report the assault to law enforcement?

The FNE is completely transparent about mandatory reporting, which means what we are required to tell law enforcement. Whether mandatory reporting applies depends on how old you are, whether you were seriously injured, if a weapon was used in the assault or if children are involved. 

Important: The patient does not have to disclose information about the assault to law enforcement if they do not want to. The FNE or care provider may be required to report an assault due to mandatory reporting laws, but the patient is not required to disclose any information. 

Mandatory reporting guidelines

These guidelines are for sexual assault. We also have to do a mandatory report for all other assaults, including domestic or intimate partner violence. 

Younger than 18 – FNEs are required to report the assault to law enforcement.

18 years and older – If the victim of violence is seriously injured and/or a weapon is used in the assault, FNEs are required to report the assault to law enforcement.

18 years and older – If the victim of violence is not seriously injured and no weapons were used in the assault, the victim of violence can anonymously report the assault, make a partial report or make a full law enforcement report.  

Children younger than 18 in the home – If children are at risk of abuse or being assaulted, this is a mandatory Child Protective Services report. We are transparent about what we will disclose to CPS. This does not automatically result in children being taken from the home.  

What happens during an FNE exam?

• When you come into the emergency room, you will be triaged by a triage nurse, and an FNE will be called in to see you.
• FNE will explain your rights and reporting options (see Mandatory Reporting).
• FNE will contact a community advocate (agency). 
  • These agencies provide supportive services for follow-up and safety planning. This is for nonmedical issues and does not include law enforcement. 
  • These agencies help you understand what happens next and provide support after you leave the emergency department.
• FNE will complete your History and Physical. This includes: 
  • Narrative of assault (your description of what happened)
  • Documentation of injuries (including photos)
  • Sexual assault kit (this includes collecting any physical evidence including swabbing for body fluids) Not everyone needs a sexual assault kit. This is not done automatically. 
  • Prophylactic medications (for sexually transmitted diseases, if needed)
  • Follow-up care 
• An emergency room physician will see you to assess/treat any injuries.
  • You can request a female physician and we will do our best to accommodate this request. 
  • The length of assessment and treatment depends on the extent of your injuries. 

Where does the FNE exam happen?

Many CHI Health hospitals have designated spaces for FNE exams. These quiet, secure and private rooms are located away from the busy ER. If dedicated FNE rooms are not available, please know that your privacy will be ensured at all times. 

How soon do I need to come in?

There is no time limit for disclosure. You do need to be seen within 120 hours of the assault to collect physical evidence. It’s important to know that you can come in any time. You can quit any time. You can leave and come back later. We are not going to pressure you. 

Can I have someone with me?

We allow anyone to accompany you other than the abuser. A friend or family member can provide emotional support but should not answer questions for you or try to influence your decisions. 

I don’t want my abuser to know I’m at the emergency room.

When domestic violence or intimate partner violence is involved, we immediately make you a “no information” patient. This means no information will be given to anyone – including family members – asking about your presence or condition. This is for your safety and for the safety of our staff.

I can’t afford to pay.

State and Federal laws prevent billing when a sexual assault has occurred, but there are no State or Federal laws regarding billing for intimate partner violence. That means if it is not an intimate partner assault, you will not be charged for an FNE exam, sexual assault/rape kit or any prophylactic medications. For intimate partner violence, you may be billed but there are resources for assisting you with the cost and these bills take high priority for charity care. 

Is this service only for women victims?

Males are victims too, and are increasingly coming forward for care. Please be assured you will receive the same level of care regardless of your gender, and your dignity will be respected. 

What if I don’t want to continue with the exam?

You can stop at any time. Your wishes will be respected at all times. You can also come back at any time. 

What if I’m not sure an assault occurred?

This is more common than you might think. An FNE can walk you through the reporting process, provide documentation if needed, and connect you with resources which can help you recover physically and emotionally, regardless of whether an assault occurred.

I’m afraid I won’t be believed.

We believe every patient who comes in. We document the facts presented by the patient without judgment. Our role is to treat patients so they know their rights and have choices about what happens next.

What if I was drunk or on drugs when the assault occurred?

It doesn’t make any difference what happened prior to the assault. Consent is everything, and a lack of saying “no” does not mean “yes.” 

How do I ask to see an FNE?

Go to a CHI Health emergency room and say you are the victim of violence. If you don’t want to say that, you can come in for an injury or even a headache, and ask the triage nurse to see an FNE.