Jess Davidson is a Senior Clinical Forensic Charge Nurse with the South East Scotland Police Custody Healthcare and Forensic Examination Service and Lecturer and Programme Lead in Advanced Forensic Practice at Queen Margaret University, Edinburgh. On 10th December 2020 the Forensic Medical Services Bill passed unanimously at Stage 3. Victims of sexual offences can now request a forensic medical examination without having to report a crime under the new legislation. Jess describes the importance of this Bill and the new Law and the difference this will make to the victims of sexual trauma.
I wanted to write something about the Forensic Medical Services Bill that has recently been passed into Law by the Scottish Parliament. Since achieving the Queen’s Nurse title in 2017, I have been committed to a programme of work that has taken me well and truly outside of my comfort zone as a registrant nurse and into a place previously unknown, a place of purposeful activism, change and recognised success.
The trouble with engaging in successful advocacy is that you must then deliver on it. Pointing out flaws in laws and society or questioning the way a nation responds to various causes, that’s the easy bit. It’s how you address those flaws that’s the challenge. How do you, in an already progressive nation such as Scotland, move the agenda to be yet more inclusive of marginalised people? Better yet, how do you do it with full inclusion of stakeholders and without unintended consequences?
Being embedded as a senior clinical forensic charge nurse for NHS Lothian, in a hugely progressive police custody and forensic examination service covering the south east of Scotland, we had worked hard to develop nursing roles, leadership and innovation.
Addressing subjects such as rape, the grooming of teenagers and the devastation suffered by victims of sexual crime, is fraught with difficulty. It wasn’t lost on me that shining a light on those topics considered taboo or devastatingly painful would open me up to scrutiny as much as support. It’s not an exaggeration to say I have felt totally overwhelmed at times, but I have been inspired by those I have met along the way, those who shared their pain and strength with me. Those brave enough to make me brave.
During my career I have come to the realisation that sex crime is a volume crime, with the sheer quantity of cases having a detrimental impact on local communities. The prosecution of sexual crime is extremely complex. One aspect which I wanted to, and knew I could, influence was the response to those people in the acute phases of trauma following rape. I knew that a dedicated specialist course for nurses who were forensically trained, would help to provide trauma-informed and person-centred care for those in need.
Being embedded as a senior clinical forensic charge nurse for NHS Lothian, in a hugely progressive police custody and forensic examination service covering the south east of Scotland, we had worked hard to develop nursing roles, leadership and innovation. Clinical forensic nurses and trainee advanced nurse practitioners working alongside forensic physicians during forensic examinations has been one of the most significant changes and improvements to sexual offences examination in many years. This reflects our commitment in NHS Lothian to embed the HIS standards in our trauma-informed and person-centred practice.
More than providing specialist care, we have a duty to be sensitive to those affected. I have seen the wrenching loss felt by a survivor the instant they feel disbelieved or let down. There is a loneliness surrounding sexual violence which can take its toll on communication. Many times, I have been overtaken by my own emotions on the way home from work, a feeling of frustration seeing disappointment in the eyes of someone who no longer trusts the system. But we are a system they should trust, and I believe in my own, and my colleagues’ responsibility and skill in making that known.
I find that rape and sexual violence are often spoken about in hushed and fearful tones, it reinforces the notion that sexual trauma is something experienced and not recovered from. However, people do recover. These crimes carry an extremely low conviction rate according to overall reports. Many survivors already know this when explaining what has happened to them. But justice is only one part of recovery. Let us not leave it to the Police and Courts, systems that can be adversarial in nature, to deal with trauma. We can all affect change. We can open our eyes, hearts (yes, however cliché it may sound) and personhood to the trauma caused by rape. As nurses we can use our professional skills and uniquely trusted place within society to help begin the recovery.
Those who have experienced complex sexual trauma want to be treated by mature, kind, experienced, compassionate professionals. Staff who listen, make them feel safe but who can also deliver on promises made with integrity and skill. Nurses who demonstrate powerful ability to support, deliver healthcare and reflexive practice, as well as finely honed, solid technical skills. This would create a service that people would engage with and recommend confidently if they had to.
This Bill, now law, allows self-referral to sexual assault referral centres (SARC) and the development of a nursing role specific to rape and sexual trauma. I believe that by providing a welcoming and supportive experience, in a place you would feel comfortable visiting with family or friends, we can influence the development of trauma-informed communities. Communities that find strength and connection through common suffering and connected recovery. These SARC facilities as they exist, already acknowledge the reality of pain caused by sexual offences in our communities. We now have the green light to promote specialist responses to this pain. No more shame, no more hidden pain and no isolation.
As I see it, these new clinics will be places to go and talk, to disclose. To get your forensic exam and know that you can take your time before reporting to Police should you choose to at all. But also somewhere that meets your general and sexual healthcare needs, where you can get your morning-after pill, inoculations, maybe even have a coil fitted. You will also have full access to the Law when you are ready and until then you can feel the safety of being in a place where you are not alone.
You know, I truly believe when these clinics open, people will wonder how they ever did without them, how they ever did without us, the nurses.
Read more about Jess Davidson under her Queen’s Nurse profile.