Fifteen years ago, Karen D. Carroll, RN, SANE-A, NY-SAFE, was raped by her then-husband and had to show an ED physician how to collect the evidence.

Today, the Yonkers, NY, resident is associate director of the Sexual Assault Response Team (SART) at North Central Bronx Hospital (NCBH), providing trained forensic examiners to NCBH and two other public hospitals in the Bronx: Lincoln Medical and Mental Health Center and Jacobi Medical Center, all part of the New York City Health and Hospital Corp. SART sees approximately 200 cases a year.

SARTs combine medicine, law enforcement and victim advocacy to ensure sexual assault victims receive appropriate medical attention, evidentiary examinations, emotional support and referral information.

In 1994 when Carroll was raped, she chose not to go to the ED where she was head nurse.

"I wasn't comfortable asking the staff to do a rape kit on the boss," she said. But when the physician avoided eye contact with her and starting reading the instructions on the kit, Carroll ended up showing him "how to do my own evidence collection."

Diverse Options

An RN for almost 35 years, Carroll has held management positions in the emergency department, pediatrics and med/surg. Her career path, paved by personal experience and charted "by accident or chance," illustrates the diversity of nursing options.

"The field of nursing is so broad," Carroll said. "When nurses want to advance their careers, they should be open-minded because there are so many ways nurses can impact the lives of women and patients in general. I'm a forensic nurse, and the bulk of my work takes place in the emergency department, but it doesn't end there."

Nurses can help people in the community, she said, understand some of the issues in healthcare reform and affect public policy by working with legislators to change healthcare laws.

Carroll has made her mark in forensic nursing, a fairly new and broad branch in nursing.

"Most people think of CSI on TV, but we know the word 'forensic' means pertaining to the law," Carroll said, "so forensic nurses are everything from legal nurse consultants, to investigators who help determine the cause of death at crime scenes, to psychiatric nurses who determine whether someone is fit to stand trail, and more.

"Forensic nursing is a bridge between the criminal justice system and the healthcare system."

Carroll contends virtually anyone "who has ever taken care of a patient does forensic nursing because we all know any case could end up in court," and every nurse "who has ever taken care of female patients has taken care of sexual assault victims, but may not have known it."

Vagina Warrior Award

Training for sexual assault examiners teaches "how to ask questions sensitively and how to listen," Carroll said, "and whether or not you ever do a formal rape exam, it will change the way you look at nursing."

Carroll takes many creative avenues to raise awareness of sexual violence against women, including performing several times in The Vagina Monologues in Westchester County when she worked at a rape crisis center.

She earned an intriguing "Vagina Warrior Award" for her work from the Pace Women's Justice Center and SUNY Purchase. The award was a beautiful red Movado vase with a heart.

Recently, Carroll helped host a group of Japanese professionals from the Department of Crime Victim Studies at the Tokiwa University in Tokyo eager to learn more about the Bronx Sexual Assault Response Team, celebrating its fifth anniversary.

"As much as we have a long way to go in this country," Carroll said, "you really appreciate how far we've come when you learn what other countries are dealing with."

Last month, Carroll visited Nairobi, Kenya, to help staff at Kenyatta National Hospital establish a forensic examiner program.

"That's what so great about the field of forensic nursing," Carroll said. "You're not only changing the life of every rape victim you see personally, but you can be involved in protocol, policy and training and impact lives.

"It's the ultimate realization of why I became a nurse in the first place. I can help people I may not ever meet."

It took the nurse 10 years to "figure out what happened to me [the rape] wasn't because of anything I did," she said. "It happened to me because of everything I will do."

Carroll turned "something awful into something positive," and is a fierce warrior for victims of sexual assault and rape.

Kathleen A. Waton is a frequent contributor to ADVANCE.