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're in a unique position to recognize, treat, and advocate for patients who've experienced abuse. Patient should be ushered to a private, quiet, comfortable area. The patient's consent should be obtained before beginning the history and during each phase of the physical examination and collection of evidence. The nurse should explain each step of the examination process to Alissa and Daisy, because it allows the patient some control over her situation. The patient should be reassured of her safety; if at all possible, she should not be left alone. Take general information about the victim, a description of the incident, and a description of the actions the victim has taken since the incident. Ask Alissa if this is their first time reporting the incident. If yes, ask her why it took long to report it. Is there a history of violence and battery in the family? (The home situation; has the child a secure place to return to; How the rape/abuse was discovered; the number of incidents and the date of the last incident.) The questions asked while the history is being taken should not be judgmental, moralistic or opinionated. Be patient, go at the child’s pace, don’t interrupt his/her train of thought. The dynamics of the sexual abuse in children is generally different from adult abuse. Never restrain or force a frightened, resistant child to complete an exam. Restraint and force are often part of sexual abuse; and if used by those attempting to help, will only heighten the child’s fear and anxiety, and worsen the psychological impact of the abuse. They need to be reassured that they are victims and that what has happened was not their fault. Confidentiality should be stressed. All information is carefully recorded in the patient's medical record and/or in a rape evaluation flow sheet (enclosed in rape kits). Because the determination of rape is made in a court of law, the wording of the history should reflect only the patient's report of the incident. The nurse should do everything possible to treat immediate injuries and STIs and prevent HIV transmission, tetanus and Hepatitis B and C. Since Daisy is only three years old, pregnancy is ruled out. Nurses are expected to perform in accordance with nurse practice acts, standards of care, and agency policies. Doing so provides the best prevention of or defense against malpractice claims. Support the client’s right to make a decision and to act on their choice.
Legal Responsibility The nurse needs to cooperate with law enforcement officials, gathering evidence that can be used in the prosecution of the rapist.
Complete documentation is the best evidence that the standard of care received by a client was met. and the date and time of the examination. either her own or foreign.The Anti-Violence Against Women Act. The Republic Act 9262 . Alissa would be the one to receive the information and sign the consent.an act providing assistance and protection for rape victims. Her mother. understand that information. All evidence should be documented on a standardized form that can be provided to the survivor and/or transferred to law enforcement with the consent of the survivor. Rape Victim Assistance and Protection Act of 1998 . and for other purposes. To give informed consent. Hair: Hair can be taken from the victim. Clothing: Items of clothing that are torn or that may contain spermatozoa or other bodily fluids. establishing for the purpose a rape crisis center in every province and city. authorizing the appropriation of funds therefore. Protection from Violence Section 42. Foreign material: Any organic material. mandated the DSWD to provide support services to rape victims and their families such as residential service and community-based service and establish linkage with the academe and all NGOs for the necessary support services to rape victims/survivors and their families. Therefore nurses must ensure their documentation accurately reflects the care given. Evidence of injury: Trauma to the genital area or other parts of the body should be documented in pictograms or photographs. the certificate should include the name and signature of the examiner. However. Anti-Rape and Rape Victim Assistance and Protection. the nurse should fully respect the wishes of those who do not want to be photographed. Anti-Trafficking in Persons. known as the Special Protection of Children against Child Abuser exploitation and Discrimination Act and for other purposes mandated the Department of Social Welfare and Development to formulate a comprehensive program against abuse and exploitation. Anti-Violence against Women and Children with Women’s and Children’s Desks and Services. like leaves or grass. Daisy is only 4 years old. receive full information. Philippines has enacted several laws protecting women from violence – Anti-Sexual Harassment. At a minimum. anus. using established terminology and objective methods. and consent voluntarily. RA 8505. Cameras may be used to photograph physical injuries on the body. the client must be competent. Protection of Girl-Children . on the body or genital region. the victim’s name. Evidence should be collected by the nurse in a systematic way. and mouth). Replacement clothing should be provided to the survivor. Sperm and seminal fluid: Swabs should be taken from anywhere on the body where penetration occurred (includes vagina. 9710 AN ACT PROVIDING FOR THE MAGNA CARTA OF WOMEN Section 9. Since. RA 7610. Republic Act No.
As a multi-sectoral team. etc. act as both the adviser and counsellor for the victim and her family. follow-up of required interventions. and the relevant national policies and procedures relating to rape (standard treatment protocols. laboratory possibilities). abortion laws. Depending on services available in your setting. therapist. Develop a situation-specific medical care protocol (rape kits.Collaboration and Teamwork As a nurse. Refer Alissa and Daisy to the Women's Crisis Center (WCC). legal procedures. case or services and evaluations of Daisy’s status or family’s problem or situation. and follow-up strategies. materials. protection). .. Home for Girls in Cabatuan. Identify available resources in the country you are working (drugs. Identifying a team of professionals and volunteers either within or outside the affected community to work with the victim. recreation activities or skills training. Quality Improvement Identify a team of professionals and community members who are involved in caring for survivors of rape. Create a referral network between the different sectors involved in caring for rape survivors (community. security. Convene meeting(s) with medical staff and community members. National Commission on the Role of Filipino Women (NCRFW). Department of Social Welfare and Development (DSWD). Inter-agency and inter-sectoral co-ordination should be established to ensure comprehensive care for survivors of sexual violence. coordination mechanisms. (Bathaluman Crisis Centre Foundation Inc. Contributing to decision making regarding her needs and concern. education programs. etc. (Psychiatrist/Psychologist. communication systems. others may need to be included. and Civil Service Commission (CSC). Two-way referral system ensures monitoring of the situation. and security. police/legal justice system. health. Coordination/networking with other agency for the conduct of home visitation to families and relatives for their reintegration. Department of Justice (DOJ). forensic systematic gathering of data) Train providers on the use of the protocol including what must be documented during an exam for legal purposes.) Identifying safe shelters and witness protection programs for victims and potential victims and family members in need of protection and security. Be sure to include representatives from social/community services. provides a supportive and affirming environment in which women who have survived violence can interact with other survivors through group counselling. establish referral networks. protection.).
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