WEBVTT - External Exam - Forensic Nursing with Lyndsey Cotton 0:00:04.720 --> 0:00:12.879 Mother Knows Death presents External Exams with Nicole and Jimmy. 0:00:16.680 --> 0:00:19.799 Hi, guys, today, I want to introduce Her name is 0:00:19.840 --> 0:00:23.599 Lindsay Cotton and she is a sexual assault nurse examiner 0:00:23.720 --> 0:00:27.040 and medical legal death investigator. Did I get that correct? 0:00:27.280 --> 0:00:27.680 You did? 0:00:28.280 --> 0:00:31.680 Okay? Awesome? So I have a bunch of questions to 0:00:31.800 --> 0:00:35.720 ask you, obviously, but maybe it would be better if 0:00:35.760 --> 0:00:38.960 you just started by telling us a little bit about 0:00:38.960 --> 0:00:40.040 what you do for a living. 0:00:40.800 --> 0:00:44.440 Okay, Well, first of all, I'm a registered nurse. I've 0:00:44.440 --> 0:00:46.800 got my VSN and I've been a nurse for about 0:00:46.800 --> 0:00:51.040 eleven years. I'm in Nurse practitioner school right now to 0:00:51.080 --> 0:00:55.720 further my education. My background primarily has been working in 0:00:55.760 --> 0:00:59.320 the emergency room, and during that time I became a 0:00:59.440 --> 0:01:04.040 Saint nurse, which is sexual assault nurse examiner, and what 0:01:04.080 --> 0:01:06.280 that means is I'm taking care of victims of sexual 0:01:06.280 --> 0:01:10.880 assault that present to the emergency room, and in that capacity, 0:01:10.880 --> 0:01:14.679 I'm considered a forensic nurse. But within the last year 0:01:14.720 --> 0:01:17.280 and a half I've broad into that and the county 0:01:17.280 --> 0:01:21.199 that I live in created a forensic nurse position and 0:01:21.640 --> 0:01:24.720 I had to get my MDI, which is medical legal 0:01:24.760 --> 0:01:29.440 death investigator. Certification as well. So I'm under the umbrella 0:01:29.520 --> 0:01:32.800 of the District Attorney's office, and I work for the county, 0:01:32.959 --> 0:01:35.480 and I work with all of our law enforcement agencies, 0:01:37.080 --> 0:01:40.720 and so I kind of wear two hats. So broadly speaking, 0:01:40.760 --> 0:01:43.280 the forendic nurse could mean a lot depending on where 0:01:43.280 --> 0:01:45.520 you live and work, but for me, it means I 0:01:45.560 --> 0:01:47.960 work both as a saying and an MDI. 0:01:49.400 --> 0:01:52.600 Okay, this is so exciting for me to hear about 0:01:52.640 --> 0:01:55.440 this because well, as of right now, I don't think 0:01:55.520 --> 0:01:59.360 Philadelphia has a position like that, and I think it's 0:01:59.400 --> 0:02:03.480 cool that they're deciding to bring in other health professionals 0:02:03.520 --> 0:02:07.320 besides just doctors. So that's cool. So one of the 0:02:07.400 --> 0:02:10.720 questions I had for you was what education you needed 0:02:10.760 --> 0:02:15.560 for this job? And obviously you're already You're a bsn 0:02:15.680 --> 0:02:20.600 correct you said. Okay, So basically, if anybody was a 0:02:20.680 --> 0:02:24.040 nurse right now and they wanted to do this, they could. 0:02:24.160 --> 0:02:27.000 They already have their degree. You have to just take 0:02:27.040 --> 0:02:30.760 an additional certification exam to be a saint that that's 0:02:30.760 --> 0:02:31.400 what you're saying. 0:02:32.320 --> 0:02:35.080 So it depends on the state. Every state is different, 0:02:35.160 --> 0:02:37.440 and in my state you have to take a forty 0:02:37.440 --> 0:02:40.800 hour course to become a saane and they divide it 0:02:40.880 --> 0:02:46.440 up between adult and adolescent and pediatric, so you could 0:02:46.440 --> 0:02:49.800 do both, or you could just do one because some 0:02:49.800 --> 0:02:52.480 people don't like peds or some people love peds and 0:02:52.480 --> 0:02:55.639 that's all they want to do. So I started out 0:02:55.639 --> 0:02:58.400 with that training and at the time, my hospital that 0:02:58.480 --> 0:03:02.280 I worked for paid for that, and from there you 0:03:02.320 --> 0:03:09.079 can become certified through your state and internationally for the 0:03:09.240 --> 0:03:12.600 NDI portion the death investigator. You don't have to be 0:03:12.639 --> 0:03:15.200 a nurse for that. They actually use a lot of 0:03:16.240 --> 0:03:19.600 it's cross training for law enforcement officers, so a lot 0:03:19.600 --> 0:03:23.720 of them will be cops and death investigators. And so 0:03:23.840 --> 0:03:26.640 that is also another forty hour course put on through 0:03:26.720 --> 0:03:30.000 our state. And then you're appointed by your district attorney 0:03:30.120 --> 0:03:33.799 to be the medical legal death investigator. You're also appointed 0:03:33.840 --> 0:03:36.840 by the medical examiner, so it's a little bit more 0:03:36.880 --> 0:03:40.440 formal process, and then at that point you can work 0:03:40.640 --> 0:03:43.560 and the state that I live in, every county is 0:03:43.680 --> 0:03:47.320 totally different. I'm one of just a handful of urns 0:03:47.400 --> 0:03:51.040 that do this job. So I think it makes sense 0:03:51.160 --> 0:03:54.320 that a nurse or a medical person would work this job. 0:03:55.520 --> 0:04:00.440 In terms of death investigation, there's so much complimentary knowledge 0:04:00.480 --> 0:04:03.200 that you have as a nurse and a death investigator 0:04:03.240 --> 0:04:05.680 that law enforcement just won't have. They'll look at it 0:04:06.040 --> 0:04:08.600 more from a criminal lens, whereas we're looking at it 0:04:09.080 --> 0:04:12.280 from a death lens or medical, like what caused this 0:04:12.320 --> 0:04:15.720 person to die? And so we just asked totally different questions. 0:04:15.880 --> 0:04:20.279 And I think that the trend should be that nurses 0:04:20.360 --> 0:04:23.520 get to do this job more and more than traditionally have. 0:04:24.240 --> 0:04:26.240 I agree with you. I used to feel the same 0:04:26.279 --> 0:04:30.920 way because we as a pathology pathologists assistant students rotated 0:04:30.920 --> 0:04:34.880 through the m's office, but they didn't actually employ pathologists 0:04:34.880 --> 0:04:38.760 assistant and I thought that that was really interesting because 0:04:38.800 --> 0:04:41.599 all of the people that were forensic texts there were 0:04:41.680 --> 0:04:45.760 just high school educated and didn't really have any knowledge 0:04:45.760 --> 0:04:48.359 of medicine. And I thought, how awesome it would be 0:04:48.440 --> 0:04:52.400 to have a medical person cutting the bodies and finding 0:04:52.440 --> 0:04:54.360 things along the way to help the doctors because they 0:04:54.360 --> 0:04:59.280 seem so overwhelmed with all the cases and everything. So, yeah, 0:04:59.320 --> 0:05:03.200 I totally with you. So one of the things there 0:05:03.200 --> 0:05:05.919 are questions I like to ask because this was a 0:05:05.920 --> 0:05:09.480 big thing when I went to PA School. When when 0:05:09.520 --> 0:05:11.960 I went to PA School, you graduate and you get 0:05:12.000 --> 0:05:15.159 a job and then there's no jobs, right because there's 0:05:15.200 --> 0:05:18.719 not that many pas in the world compared to like nurses. Right, 0:05:19.200 --> 0:05:23.400 So are there a lot of opportunities for forensic nurses? 0:05:23.440 --> 0:05:26.960 Do you do you know if they're available or have 0:05:27.080 --> 0:05:28.520 you heard of jobs opening? 0:05:29.720 --> 0:05:36.839 I I think the answer, unfortunately is no. In my state, 0:05:37.720 --> 0:05:40.480 it's so unique. The job that I have, I just 0:05:40.640 --> 0:05:44.560 happened to come across it and was the most qualified applicant. 0:05:45.279 --> 0:05:51.279 I really created the death investigation programs from nothing. Before me, 0:05:51.600 --> 0:05:56.440 there was a death investigator that again was more law 0:05:56.520 --> 0:06:01.720 enforcement trained, and so he just did things totally different, 0:06:01.800 --> 0:06:04.480 and I just saw a lot of opportunity to create 0:06:04.520 --> 0:06:07.840 something new. So I think that if somebody's interested, they 0:06:07.880 --> 0:06:12.800 might have to just be entrepreneurial and very persistent with 0:06:13.120 --> 0:06:19.760 their EM's office or their DA's office and voice why 0:06:19.800 --> 0:06:22.880 they would be good at creating something like what I 0:06:22.960 --> 0:06:27.240 have here, And if anyone's interested in that, they could 0:06:27.279 --> 0:06:31.120 always reach out to me. I think you need a 0:06:31.120 --> 0:06:34.080 lot of support from various different agencies to do that. 0:06:34.320 --> 0:06:36.760 So if it doesn't already exist, you're going to have 0:06:36.800 --> 0:06:42.159 to get creative. Somebody could apply for the Medical Examiner's office. 0:06:42.240 --> 0:06:44.760 Maybe to get their foot in the door. But I 0:06:44.800 --> 0:06:47.960 think as a saying nurse, that's the biggest area where 0:06:47.960 --> 0:06:52.320 you'd have the most opportunity to get started, because hopefully 0:06:52.320 --> 0:06:55.280 one day every single emergency department's going to have a 0:06:55.320 --> 0:06:59.479 sane program. We're nowhere near that at all right now. 0:07:00.000 --> 0:07:02.520 There's a lot of areas that don't have a forensically 0:07:02.560 --> 0:07:04.400 trained nurse to take care of them if they've been 0:07:04.440 --> 0:07:08.039 sexually assaulted. But I mean, broadly speaking, the area of 0:07:08.080 --> 0:07:11.400 forensics is huge. Like, if you live in a metropolitan 0:07:11.440 --> 0:07:13.920 area and you're a forensic nurse and you have saying 0:07:14.000 --> 0:07:17.560 and MDI training, you could go into every single patient 0:07:17.640 --> 0:07:21.240 that might be a domestic violence victim, go in and 0:07:21.280 --> 0:07:28.640 do an assessment. You could do strangulation assessment, pediatric abuse assessment, 0:07:30.280 --> 0:07:32.960 I mean elderly abuse and neglect. I mean it literally 0:07:33.000 --> 0:07:38.200 spans the lifespan. I've caught a lot of elderly neglect 0:07:38.560 --> 0:07:42.400 death cases where law enforcement thinks, oh, this person's old 0:07:42.400 --> 0:07:45.080 and they just died at home and it's nothing suspicious, 0:07:45.120 --> 0:07:47.920 and I review the scene photos and the report and 0:07:47.960 --> 0:07:51.160 I think, oh, hell no, this is this is suspicious, 0:07:51.200 --> 0:07:53.640 and we died into it, and we see they had, 0:07:54.280 --> 0:07:59.440 you know, coint court appointed caregiver, somebody that's legally responsible 0:07:59.440 --> 0:08:01.440 for them and they're doing their job and this person 0:08:01.520 --> 0:08:06.040 died from hypothermia, for example. And we've had a couple 0:08:06.040 --> 0:08:09.960 of those kind of cases, and it's it's it's a 0:08:10.040 --> 0:08:12.560 huge area that has a lot of potential for growth, 0:08:12.600 --> 0:08:15.000 but we're not quite there yet. 0:08:15.760 --> 0:08:19.280 That's that's really interesting. I think you're really onto something, 0:08:19.320 --> 0:08:21.720 and it makes me really excited to hear that you're 0:08:21.800 --> 0:08:25.040 kind of creating that. I really just from a person 0:08:25.120 --> 0:08:28.800 that was heavily involved with the Emmy's office, I see 0:08:28.840 --> 0:08:32.720 your position as a nurse being so valuable that I 0:08:32.760 --> 0:08:36.080 think you're onto something for sure. So I think that's 0:08:36.120 --> 0:08:39.200 really cool that you're I mean, it sucks that you 0:08:39.280 --> 0:08:43.720 have this job that is so dreamy that everybody can't 0:08:43.760 --> 0:08:47.439 just go get right, but but you're starting it. You're 0:08:47.480 --> 0:08:50.839 starting a movement, and it's really cool. So I guess 0:08:50.920 --> 0:08:52.600 that was one of the questions I had for you 0:08:52.679 --> 0:08:55.600 when you were working in the er. You were just 0:08:55.679 --> 0:08:57.920 working as an er nurse, and then they would call 0:08:57.960 --> 0:09:01.080 you in for those specific cases because obviously you're not 0:09:01.160 --> 0:09:03.880 just sitting around twiddling your thumbs. And waiting for them 0:09:03.880 --> 0:09:04.400 to come in. 0:09:04.520 --> 0:09:08.600 Right. Yeah, I've seen it done two different ways. You 0:09:08.640 --> 0:09:12.160 could either be an er nurse working your normal shift, 0:09:12.240 --> 0:09:15.320 and then if a sane patient comes in, you go 0:09:15.360 --> 0:09:17.360 one to one with that patient for a few hours, 0:09:17.360 --> 0:09:21.240 and another nurse picks up your patients and then you 0:09:21.280 --> 0:09:23.680 know with that you're not there's no perk in terms 0:09:23.720 --> 0:09:26.000 of extra pay, You're just you're already on shift. So 0:09:26.080 --> 0:09:29.679 you've just got a different patient load. But that's difficult 0:09:29.760 --> 0:09:33.199 because if the ear is busy and understaffed, which they 0:09:33.480 --> 0:09:36.840 always are, always are, Yeah, that's gonna be hard. And 0:09:36.920 --> 0:09:40.240 so now a lot of hospital systems are moving towards 0:09:40.760 --> 0:09:44.640 a third party. So there are sane companies that train 0:09:44.720 --> 0:09:48.200 their sane nurses and provide twenty four to seven coverage. 0:09:48.600 --> 0:09:50.240 And that's what I do here. So I work for 0:09:50.400 --> 0:09:53.680 company and I cover two different counties and we all 0:09:53.720 --> 0:09:56.600 share twenty four to seven call. It's a very flexible 0:09:56.600 --> 0:09:58.800 work schedule and I choose when I want to work 0:09:59.320 --> 0:10:02.440 and it's it's either twelve or twenty four hour shifts. 0:10:02.520 --> 0:10:08.240 And I'll just get a call from something called medical Messenger. 0:10:08.280 --> 0:10:11.000 They'll call and say, hey, there's a thirty six year 0:10:11.000 --> 0:10:15.559 old female at the certain hospital and they were assaulted, 0:10:15.960 --> 0:10:19.880 you know, two days ago. And then we go in 0:10:20.000 --> 0:10:22.280 and so we will go in and take over for 0:10:22.400 --> 0:10:27.320 that nurse as the forensic nurse and do our exam, 0:10:27.960 --> 0:10:32.040 make recommendations on medications, share that with the physician, and 0:10:32.080 --> 0:10:35.600 then the doctor will order whatever we decide we'll be 0:10:35.640 --> 0:10:39.520 giving that patient. And then at that point our job 0:10:39.600 --> 0:10:41.720 is done, and then the ear nurse takes over to 0:10:41.760 --> 0:10:44.880 medicate that patient and discharge. So we kind of work 0:10:44.920 --> 0:10:48.280 hand in hand, but it's a lot more I think 0:10:48.360 --> 0:10:52.600 time cost effective and time effective because sometimes you'll get 0:10:53.040 --> 0:10:56.200 two calls, you know, one after the other, and so 0:10:56.280 --> 0:10:58.320 I'll be at a hospital taking care of somebody and 0:10:58.320 --> 0:11:00.760 then there's another patient that's showed upwhere else, and so 0:11:01.360 --> 0:11:04.440 we'll have to decide can it wait until I'm done, 0:11:04.640 --> 0:11:07.000 or we just have a huge pool of nurses we 0:11:07.000 --> 0:11:09.640 can call from and say, hey, is anyone ready to 0:11:09.679 --> 0:11:10.240 pick this up? 0:11:11.080 --> 0:11:14.720 Okay, that's cool. So when you go see these patients 0:11:14.720 --> 0:11:17.680 in the hospital, are you the one that's actually collecting 0:11:17.960 --> 0:11:19.480 the specimens from them? 0:11:20.080 --> 0:11:21.000 Yeah? 0:11:21.520 --> 0:11:26.400 And so what during your training you learn exactly, you know, 0:11:26.440 --> 0:11:30.320 what would you do take fingernail scrapings. Would you do 0:11:30.400 --> 0:11:32.520 that on a person that's live still. 0:11:32.440 --> 0:11:37.400 Or yeah, so again, and that it depends on where 0:11:37.400 --> 0:11:41.760 you live. They'll have different expectations. But so for the 0:11:41.800 --> 0:11:45.000 state that I'm in, I can respond up to one 0:11:45.040 --> 0:11:47.880 hundred and twenty hours after someone's been assaulted. So that's 0:11:47.920 --> 0:11:51.800 five days. That is the number that we use to 0:11:52.760 --> 0:11:55.800 decide if we still have a chance of collecting forensic evidence. 0:11:56.400 --> 0:12:01.000 And I think nationwide that's pretty standard. So five days. 0:12:01.040 --> 0:12:03.319 If somebody is sexually assaulted, they could come into the 0:12:03.640 --> 0:12:07.160 er say hey, I was sexually assaulted, and they may 0:12:07.240 --> 0:12:09.720 or may not want to report to law enforcement. Again, 0:12:09.760 --> 0:12:12.560 that's jurisdictional and it depends. It depends on the age 0:12:12.600 --> 0:12:15.040 and a whole bunch of other factors, but fits your 0:12:15.600 --> 0:12:19.480 average sexual assault patient. Then I would come in and 0:12:19.760 --> 0:12:24.520 do a thorough interview. So I would be asking first 0:12:24.600 --> 0:12:27.480 of all, all the medical questions, like I want to 0:12:27.480 --> 0:12:30.520 know about their medical history just from a nursing perspective, 0:12:30.760 --> 0:12:34.920 the things that are important, And then I'll ask what 0:12:35.080 --> 0:12:38.520 they can remember happen to them. And I'm writing everything down, 0:12:38.559 --> 0:12:43.760 I'm using quotations, I'm being as objective as possible. And 0:12:43.840 --> 0:12:47.640 so there's a chart that we use. It's either paper 0:12:47.840 --> 0:12:50.600 or on the computer. It's about sixteen pages, so it's 0:12:50.640 --> 0:12:52.720 long and it does take a couple of hours. But 0:12:53.240 --> 0:12:56.240 I'm just writing down everything they can remember, and that 0:12:56.760 --> 0:13:02.360 helps dictate the physical exam. If they remember certain things 0:13:02.400 --> 0:13:05.840 like I was pushed down, or I was held down 0:13:05.840 --> 0:13:09.240 by my wrists, or I was choked, those are areas 0:13:09.280 --> 0:13:12.959 where there might be potential DNA, and that will be 0:13:13.040 --> 0:13:17.559 where I swab with sterile Q tips. I will use 0:13:17.600 --> 0:13:21.720 an ultimate light source to look when it's dark with 0:13:21.800 --> 0:13:24.560 this particular light to see if there's body fluids that eliminate. 0:13:26.360 --> 0:13:29.680 I will look at them literally had to toe and 0:13:29.720 --> 0:13:32.880 mark any kind of anything and you kind of bruise 0:13:32.920 --> 0:13:37.480 the area of pain abrasion. I will do a peltic 0:13:37.559 --> 0:13:43.320 exam and same thing. Document anywhere there's pain. If there's 0:13:43.440 --> 0:13:46.200 something that I see, like maybe a hair that doesn't match, 0:13:46.440 --> 0:13:51.680 or one time I saw literally dirt in somebody's vaginal wall, 0:13:52.520 --> 0:13:56.600 I swapped that. And even if they don't remember anything, 0:13:56.760 --> 0:13:59.560 there's pretty much a standard process that all of us 0:13:59.600 --> 0:14:03.760 will use because if you think about a rape, there's 0:14:03.840 --> 0:14:08.000 likely going to be saliva or DNA transfer from aggressive 0:14:08.000 --> 0:14:13.000 handling on somebody's neck or breasts or wrists or thighs 0:14:13.040 --> 0:14:15.240 for example. So there's a lot of swabs that we 0:14:15.280 --> 0:14:19.520 get just no matter what, oral swabs for a DNA 0:14:19.640 --> 0:14:21.920 standard or there might be saliva or seen in there. 0:14:22.640 --> 0:14:25.760 We asked questions like when was the last time you 0:14:25.800 --> 0:14:28.920 had consensual sex? Because maybe that somebody has a partner 0:14:29.120 --> 0:14:31.200 that they just had sex with four days ago and 0:14:31.200 --> 0:14:34.320 that was consensual, but two days ago they were raped, 0:14:34.480 --> 0:14:36.960 and so now there could be different DNA from two 0:14:37.000 --> 0:14:39.640 different people there, and that's important for the forensic lab 0:14:39.720 --> 0:14:39.920 to know. 0:14:41.120 --> 0:14:44.600 Wow, this is so this is really interesting because I 0:14:44.640 --> 0:14:46.960 obviously I don't take care of live patients, so I 0:14:47.080 --> 0:14:49.920 just never I've always been curious about this stuff. So 0:14:51.160 --> 0:14:54.520 on average, and I know it probably varies from place 0:14:54.560 --> 0:14:58.000 to place, but I mean, how many of these types 0:14:58.040 --> 0:15:02.160 of sexual assaults do you see in a week or 0:15:02.680 --> 0:15:04.200 just on average? 0:15:04.480 --> 0:15:07.760 Yeah, well, the area, it's it's so hard to say 0:15:07.800 --> 0:15:12.760 because I share call with about maybe twelve to fourteen 0:15:12.800 --> 0:15:16.000 other nurses, and so I only know what I see. 0:15:15.600 --> 0:15:19.120 I get called a couple of times a month, and 0:15:19.120 --> 0:15:22.920 that's when I see everybody. So I see ages zero 0:15:23.000 --> 0:15:26.600 to one hundred, I mean pedes, adolescents, adults. I'm trained 0:15:26.600 --> 0:15:31.560 for all of that, So definitely a handful of month. 0:15:31.800 --> 0:15:34.080 I don't know what our numbers are for last year. 0:15:34.880 --> 0:15:37.920 That's a great question, and I'm curious. But I live 0:15:37.960 --> 0:15:40.240 in more of a rural area and so it's not 0:15:40.280 --> 0:15:43.080 going to be as high as like Portland, Oregon, for example, 0:15:43.240 --> 0:15:47.600 or me or something like that. So but of the 0:15:47.640 --> 0:15:52.000 ones that we see, I mean, it's just different every 0:15:52.000 --> 0:15:56.080 single time. You always learn something. When you're done. We 0:15:56.160 --> 0:16:00.600 do a lot of peer review and share things that 0:16:00.680 --> 0:16:03.440 are helpful to each other because you know it's hit 0:16:03.480 --> 0:16:06.480 and miss or feast or famine. I always say, it's 0:16:06.480 --> 0:16:08.040 like you could go a couple of months without a 0:16:08.080 --> 0:16:10.960 call and then you start to feel rusty. So we 0:16:11.000 --> 0:16:13.920 do a lot of meetings with the team and share 0:16:14.960 --> 0:16:18.640 forensic photos that are important. And I mean, pediatrics is 0:16:18.640 --> 0:16:21.520 a whole other beast in terms of trying to do 0:16:21.520 --> 0:16:24.760 an exam like that on a toddler, for example, a baby, 0:16:24.920 --> 0:16:30.440 Like it's just it's so hard and then you're dealing 0:16:30.480 --> 0:16:34.720 with the parents and the emotions that come with that. 0:16:35.000 --> 0:16:37.880 So yeah, that was one of my questions. I had 0:16:37.880 --> 0:16:41.920 for you. I was always able to disconnect from the 0:16:41.960 --> 0:16:46.160 pediatric autopsies at Children's Hospital, but when I went to 0:16:46.200 --> 0:16:50.240 the eme's office and saw abuse and kids getting killed 0:16:50.360 --> 0:16:54.000 by for even car accidents, it really kind of fucked 0:16:54.000 --> 0:16:57.400 me up. Yeah, so I was, But I know that 0:16:57.440 --> 0:17:01.360 there's people that are designed to fit every aspect of 0:17:01.400 --> 0:17:04.199 this world. That's what makes it great. Right. Do you 0:17:04.320 --> 0:17:08.480 have what case would bring more emotion to you? Have 0:17:08.560 --> 0:17:11.800 you ever had any kind of emotion because you have 0:17:11.880 --> 0:17:14.000 to be in the room like the squared away one 0:17:14.080 --> 0:17:17.960 that's just that's doing your job and not get distracted 0:17:17.960 --> 0:17:20.560 by that stuff. But have have you ever had any 0:17:20.600 --> 0:17:24.160 cases that make you feel emotional or you think about 0:17:24.160 --> 0:17:26.160 all night when you go home or something like that. 0:17:27.160 --> 0:17:30.240 Yeah, for sure, I do. 0:17:33.600 --> 0:17:35.960 I mean, trust listen, I get it because I'm able 0:17:36.000 --> 0:17:39.600 to turn it off like and have no emotions most 0:17:39.680 --> 0:17:42.240 of the time. But yeah, I could recall a few 0:17:42.320 --> 0:17:46.040 cases that I was that you know, a baby that 0:17:46.080 --> 0:17:48.639 died on Christmas Eve or something, you know, just like 0:17:48.720 --> 0:17:52.199 things like that that I go home and it stays 0:17:52.200 --> 0:17:55.240 in my mind when normally I'm pretty desensitized to it. 0:17:55.400 --> 0:17:58.000 I get that you have to disconnect for your job. 0:17:58.960 --> 0:18:01.520 I know I do have some that come to mind, 0:18:01.680 --> 0:18:06.840 for sure, and I think I compartmentalized pretty well, but 0:18:06.880 --> 0:18:08.960 you just can't help some of those that stick in 0:18:09.000 --> 0:18:13.840 your mind that are just like extra horrifically sad and unnecessary. 0:18:14.040 --> 0:18:18.320 And I think that the ones that are the worst 0:18:18.359 --> 0:18:21.159 are the ones where there's just obvious signs of abuse 0:18:21.200 --> 0:18:24.800 and neglect combined with the sexual abuse, because it's just 0:18:25.200 --> 0:18:28.280 all the things that are so terrible for this kid. 0:18:29.200 --> 0:18:32.000 Yeah, it's so it just sucks that we live in 0:18:32.040 --> 0:18:34.400 a world like this. You just don't want to think 0:18:34.440 --> 0:18:38.560 that anybody would, especially a child. It's just yeah, so gross. 0:18:38.600 --> 0:18:43.880 But how did you So you did you start off 0:18:43.920 --> 0:18:47.960 school like you did RN and BSN. You've gone through 0:18:48.000 --> 0:18:50.600 this whole thing. So you were an RN and were 0:18:50.640 --> 0:18:54.639 even a BSM prior to even taking the certification for sane. 0:18:55.440 --> 0:18:58.480 Yeah, it was a BSN right from the start. So 0:18:58.520 --> 0:19:01.000 when I first said nurse, I just got my four 0:19:01.080 --> 0:19:02.919 year out of the way and then went into the 0:19:03.200 --> 0:19:05.760 er and then my second year as nursing as when 0:19:05.800 --> 0:19:07.879 I became a sane. So I've done it for a 0:19:07.880 --> 0:19:08.320 long time. 0:19:08.400 --> 0:19:10.800 So you've based you've always been an R nurse that's 0:19:10.840 --> 0:19:14.000 all you ever like what I guess the question I'm 0:19:14.000 --> 0:19:17.879 getting at is how did you know that this was 0:19:17.960 --> 0:19:20.960 because you seem like this is a good fit for you. 0:19:20.960 --> 0:19:23.760 You're very you're you're very into it and you're gonna 0:19:24.280 --> 0:19:26.760 make changes in the field, and I love that. So 0:19:27.240 --> 0:19:30.119 how did you know that that's something that was going 0:19:30.200 --> 0:19:32.240 to be your, like your thing? 0:19:32.800 --> 0:19:38.160 Yeah, I I wouldn't say I was interested in forensics Initially. 0:19:38.200 --> 0:19:40.480 I always knew I wanted to do the er because 0:19:40.760 --> 0:19:43.800 I thought the adrenaline is great. It totally suits me. 0:19:43.920 --> 0:19:47.720 I'm cool, calm, and collected ninety nine percent of the time, 0:19:47.880 --> 0:19:51.280 and it just it was also an area where I 0:19:51.400 --> 0:19:53.159 like taking care of people, but I don't want to 0:19:53.200 --> 0:19:55.000 take care of them for days and days and days. 0:19:55.040 --> 0:19:57.280 I like when they come in and then they leave. 0:19:58.359 --> 0:20:00.280 Yeah, that's that's good, right. 0:20:00.920 --> 0:20:04.760 And the same thing came about just because we didn't 0:20:04.800 --> 0:20:07.240 have that coverage in our county and so our manager 0:20:07.320 --> 0:20:10.080 asked everybody, Hey, does anybody want to do this? And 0:20:10.119 --> 0:20:12.479 I volunteered. So I think three or four of us 0:20:12.520 --> 0:20:16.280 went and got trained at And at first I thought 0:20:16.760 --> 0:20:21.800 that was like just a lot, because I'd never had 0:20:22.800 --> 0:20:25.439 I don't think I'd had any sane patients at that point. 0:20:25.520 --> 0:20:30.600 And the training is just incredibly heavy. It is so sad, 0:20:30.760 --> 0:20:34.400 and and it just has to be that way. There's 0:20:34.440 --> 0:20:38.400 no other way to get somebody prepared to appropriately take 0:20:38.400 --> 0:20:42.120 care of a rape victim than case studies and pictures 0:20:42.160 --> 0:20:44.399 and examples of like the worst of the worst. So 0:20:44.800 --> 0:20:47.400 it was definitely eye opening. But then once you start 0:20:47.440 --> 0:20:50.600 taking care of your first couple of patients, I was 0:20:50.920 --> 0:20:54.159 just I loved it. I was I was like, I 0:20:54.200 --> 0:20:56.000 felt like I did a good job because I was 0:20:56.040 --> 0:21:00.440 able to empathize but also be objective and just take 0:21:00.480 --> 0:21:04.439 good care of them. And I know that also most 0:21:04.480 --> 0:21:07.639 people say I could never do that, and those are 0:21:07.640 --> 0:21:09.960 the people I don't want taking care of those patients. 0:21:10.000 --> 0:21:12.400 It's got to be the select few that are meant 0:21:12.520 --> 0:21:14.160 to do that kind of work. And there's a lot 0:21:14.160 --> 0:21:18.680 of times where we'll get nurses totally trained up and 0:21:19.320 --> 0:21:21.639 it's deer in headlights for them, and they do a 0:21:21.640 --> 0:21:24.760 couple of exams just shadowing, and they'll say, I can't 0:21:24.800 --> 0:21:28.080 do this, And to me, that's no big loss, because 0:21:28.200 --> 0:21:30.640 you don't. If you think you can't do it, then 0:21:30.680 --> 0:21:32.480 you can't do it. And I don't want you taking 0:21:32.480 --> 0:21:34.919 care of patients like that when they're going to be 0:21:35.000 --> 0:21:38.600 so vulnerable and emotional and maybe altered. I mean, you 0:21:38.680 --> 0:21:41.760 just have to be the best you can to take 0:21:41.760 --> 0:21:43.639 care of them in that moment, because you're also going 0:21:43.680 --> 0:21:47.880 to have other healthcare providers, doctors, law enforcement that are 0:21:47.880 --> 0:21:50.080 going to have an attitude towards people like this. And 0:21:50.119 --> 0:21:53.679 I see it still more than i'd like to, where 0:21:54.280 --> 0:21:57.439 somebody has an attitude like, well, if she wasn't so drunk, 0:21:57.560 --> 0:22:01.040 maybe that wouldn't have happened, you know, or whatever she 0:22:01.119 --> 0:22:07.080 was wearing like that wouldn't have happened, or it's suggestive 0:22:07.200 --> 0:22:09.920 or something, and that's just that's bullshit. So if anybody 0:22:09.920 --> 0:22:12.440 has that kind of attitude towards somebody like that, then 0:22:12.920 --> 0:22:15.000 screw that and they shouldn't be taking care of patients 0:22:15.040 --> 0:22:15.320 at all. 0:22:16.040 --> 0:22:19.800 Yeah, that's true, because there's actually a case, I don't know, 0:22:19.920 --> 0:22:22.239 I'm sure you've heard of it, that there was an 0:22:22.400 --> 0:22:26.560 LSU student that was raped by two I think it 0:22:26.600 --> 0:22:30.120 was two fellow college students and then she got out 0:22:30.119 --> 0:22:32.080 of they let her out of the car on the street, 0:22:32.119 --> 0:22:34.240 and then a car drove by and like killed her. 0:22:35.080 --> 0:22:40.240 I don't know if it just happened recently, but yeah, 0:22:40.240 --> 0:22:43.840 the defense team is obviously trying to say that she 0:22:44.040 --> 0:22:46.840 was drunk, and they have proof that she you know, 0:22:47.560 --> 0:22:50.320 it just it really pisses me off, and from a 0:22:50.359 --> 0:22:53.439 mother's perspective of sending your kid away to college. But 0:22:54.119 --> 0:22:57.080 in a case like that, for example, because you're talking 0:22:57.080 --> 0:22:59.639 about a lot like taking care of live people and stuff, 0:22:59.640 --> 0:23:04.480 but case like that, would you be involved with collecting 0:23:04.520 --> 0:23:08.600 specimens for the autopsy too, or you only deal with 0:23:08.640 --> 0:23:09.240 live people. 0:23:09.720 --> 0:23:12.800 No, I could totally do it on a decedent. But 0:23:13.880 --> 0:23:17.119 I had a case a while back where it was 0:23:17.160 --> 0:23:20.240 somebody that committed to a side a female, a young female. 0:23:20.800 --> 0:23:26.439 And you know, suicide's a hard concept for people to grasp, 0:23:26.600 --> 0:23:30.720