As the designated Regional Pediatric Centre in the Fraser Health region, Surrey Memorial Hospital offers specialized and unique care to babies, children and youth from Burnaby to Hope. The Leader provides an inside look at how B.C.’s second-largest hospital has grown and adapted to treat its youngest and most vulnerable patients.
In a quiet area, removed from the bustle of the rest of Surrey Memorial Hospital, is a simple room with a few chairs and an adjoining exam room.
Hours earlier, a teenage girl was there. The 16-year-old was sexually assaulted the night before and after telling her mom and contacting police, she’s been referred to SMH.
Upon arrival, the teen is met by a registered nurse from the Forensic Nursing Service (FNS) who’s specially trained to deal with such sensitive scenarios.
In the safety of the secured hospital area, the girl shares her story, agreeing to a physical exam to ensure she doesn’t have injuries requiring immediate medical attention.
The possibility of involving police is discussed with her, as is the possible collection of medical evidence for any potential legal action.
After some thought, the young victim – to her mom’s dismay – chooses not to involve police further and the hospital visit ends.
Though frustrating for a parent seeking justice, Lynn Gifford isn’t unhappy with the outcome. Not only has the teen spoken up about her attack and sought help, but she has found the strength – in the shadow of an apparent rape – to take control of her situation.
“When power has been taken away from anybody, you want to return it – give them choice,” explains Gifford, Forensic Nursing Services (FNS) coordinator at SMH. “I think of it as putting them back together.”
Surrey and Abbotsford Regional are the only two hospitals in the Fraser Health region with forensic nursing services available 24 hours a day, seven days a week, 365 days a year. Patients referred to the program are either gender and have experienced some form of violence, including but not limited to, child abuse, dating violence, drug-facilitated sex assault and human trafficking and exploitation.
While Abbotsford treats patients 13 and over, Surrey is the only site between Burnaby and Hope where child victims of sexual assault are treated.
Surrey’s FNS treats a total of about 320 patients of all ages per year. It’s been just over a year since the program began seeing children. More than 30 kids have come through the doors so far and the number continues to climb.
Before the program was expanded in 2014, child victims had nowhere to go but B.C. Children’s Hospital in Vancouver, meaning they’d be brought to SMH only to be turned away.
Now, anyone aged two and older is seen. (Children under two still go to B.C. Children’s because of their specialized pediatric resources).
In addition to ensuring the safety and physical well-being of patients, a key focus of the FNS, says Gifford, is to return choice to the patient, who has usually had something done to them against their will.
“We reassure people that this is a safe place and we’re here to help,” she says.
Like the 16-year-old, a patient can choose to receive medical care only, or they may proceed with further examination, including evidence collection. They may refuse any treatment at all for the time being, but can always return for further examination another time – an option 30 per cent of patients choose.
The treatment proceeds only at the victim’s pace and direction. In its entirety, the meticulous process can take up to six hours. The nurse’s role is an objective, non-judgmental one, listening, carefully documenting injuries and making observations. Any advocacy is passed to community organizations such as Surrey Women’s Centre, which can provide ongoing support and resources for the victims and family.
During their time at SMH, forensic nursing staff will often let patients know that violence is common, that they’re far from alone in their struggle, Gifford says.
“We provide a lot of information about the fact that abuse is illegal. Many of them don’t know that.”
Nurses are specially trained to deal with child victims. The examination process is similar to the care adults and adolescents receive, with every sensitive procedure explained in a calm and supportive atmosphere.
Depending on the willingness of a younger patient, a child life specialist may be involved or a social worker may be present to provide support to family. (If there are concerns about a potentially unsafe home situation or if the alleged perpetrator is a family member, the Ministry of Children and Family Development is contacted).
At any age, it’s all about patient choice – something they were denied when they were assaulted.
“We follow the same process in terms of making sure we have consent from the child,” says Gifford. “We don’t ever do anything without permission. We may get consent from the parent, but we still make sure the child is willing to cooperate.
“When I watch young people empowered, their whole posture changes, their whole demeanour changes.”
The new forensic nursing exam area is far cry from what was once available, before the Critical Care tower was completed at SMH.
It used to be victims of sexual assault would simply be seen alongside others in the ER, allowing for little privacy or security.
Gifford sits back in one of the chairs in the re-vamped unit. It may not be big, but it’s secluded, quiet and has a locking door.
“Once we’re in here, people tend to settle down and relax,” she smiles.
The exam room is now being used daily, sometimes two or three times per day.
And while Gifford knows some might lament the fact there is a steady stream of patients seeking treatment following a sex assault, she takes a realistic view.
“When there’s no patient there, it’s not that it’s not happening. It’s that people aren’t accessing the resources.
“I’m happy they’re coming in.”
ON FRIDAY: BUILDING A MENTAL HEALTH CENTRE ESPECIALLY FOR YOUTH
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