Access

Clients can access sexual assault/domestic violence emergency services through the ER department of a hospital with an associated SA/DVCC. Hospitals without a SA/DV program can ensure transfer to one that does. The services are covered by O.H.I.P. Contact individual Centres to determine wheelchair accessibility. Clients can come alone, with a friend/family member or police.

Medical Treatment

Any injuries requiring medical attention such as lacerations, fractures, and head injuries will be treated by the emergency department physician. Some Centres have specially trained staff to assess child victims of sexual abuse/assault. If the centre is not equipped to see children a referral will be made to a tertiary centre.

Documentation

The sexual assault/domestic violence (SA/DV) nurse will document the assault history as required to treat and assess the client's physical, emotional and mental wellbeing. The Network has developed documentation forms to ensure that the hospital record is accurate and useful for legal purposes.

Photographs

Photographs of the client's injuries can be taken and kept with the hospital chart should she/he wish to report to the police at a later date. If the police are involved at the time of the assault, they may take the photographs or the nurse at the hospital will take them. Our Centres are using either a 35mm, digital or polaroid camera.

Forensic Evidence Collection

A Sexual Assault Evidence Kit is used to collect medical evidence from the client's body and clothing to assist in legal proceedings. This evidence must be collected within 72 hours after the assault. If the client is a child, forensic evidence is collected up to 24 hours after the assault.
If the client is unsure of having police involvement, this evidence can be collected and kept frozen at the Centre for up to 6 months, unless otherwise stated by the individual Centre.

Anonymous Third Party Report (Available in sexual assault cases only)

The purpose of a third party report is to help the police in identifying repeat sex offenders. The client's name is not used in the report. The form can be obtained from the Sexual Assault/Domestic Violence Care Centre. This report outlines what the survivor can recall about the details of their assailant and the assault. The third party reporting option is not available at all Centres.

Safety Planning

Domestic Violence: It is recognized that for many reasons, women return home to an abusive situation. Assisting the woman to stay safe if returning home is an important part of the nurse's role. Information and strategies are provided to the woman to assist her if a violent situation arises. Written information is given, only if it is safe to do so.
Sexual Assault: Assistance with lifestyle assessment; behaviours that may put client at risk for further sexual assaults. General safety guidelines reviewed.

Risk Assessment

The client answers a series of questions that may predict the likelihood and severity of a repeated assault by the batterer.

Reporting

Domestic violence or sexual assault do not need to be reported to the police unless requested by the client. SA/DV staff do not release any information to anyone until the client signs the appropriate release forms. It is important that clients be aware and knowledgeable about the legal system and the process involved once a report is made.
If a client tells the SA/DV nurse that there are children under the age of 16 in the home either witnessing domestic abuse or experiencing child abuse, the nurse is mandated by law to report to the Children's Aid Society. The client is encouraged to make the call to CAS.

Social Work / Counselling Services

Centres provide Counselling by specially trained staff or may refer clients to an appropriate community agency. These services are confidential within the limits of the law. Counselling services offered vary between Centres.

Referral to Community Agencies

The Centres have access to community resources such as legal services, shelters, and 24- hour hotline phone numbers.

Cultural Interpreter Services

The Centres make every attempt to provide sign language and cultural interpreters when necessary. The use of family members and non-trained staff is discouraged. The interpreters are accessed through community agencies.

Follow-up Services

Many Centres have a follow-up nurse who contacts the clients a few days after they have been seen at the SA/DVCC, providing it is safe to do so. This contact may be a phone call or a follow-up visit, in which the client returns to the Centre. This provides an opportunity for the nurse to

• Check on the client's emotional and physical wellbeing
• Answer questions
• Review of and continued safety planning
• Risk assessment
• Re-document or photograph any injuries that have become more apparent
• STI testing
• Provide STI test results
• Provide referrals
• or any of the above services, clients may call to book an appointment with the follow-up nurse without having accessed the emergency SA/DVCC service.