Journal of Advanced Practice Nursing

Specially Trained Nurses Help Put Rapists In Jail


By PJ Randhawa

Joanie Scheske remembers "the smiling man."

It was 1991 and she had gone to a bar with a coworker. But when Scheske turned around, her coworker had left with Scheske's coat and purse, stranding her at the establishment.

Enter a friendly stranger offering a ride home.

"How he finally got me to take a ride with him…he said to me, 'I can't in good conscience leave you here, look at you,'" explains Scheske. "I weighed 100 pounds if I was lucky back then."

But it wasn't long after she got into his Mazda that things began to take a horrifying turn.

First, he drove her to the St. Louis riverfront. When she asked why they were there, he drove on.

But: "Instead of getting onto the highway, he went north deeper in the city" says Scheske, eventually parking behind a fence in a rundown neighborhood.

And it was there that he savagely beat her and raped her, beginning an ordeal that went on for hours and injuries that she still endures.

Dazed, injured, part of her ear torn off, and suffering the beginnings of brain damage from his punches, her rapist led her to a quiet lot.

"This is where he brought me to kill me." His reason? She had seen his face.

"He put his hands around my neck and started squeezing and squeezing and squeezing..." when suddenly she says, something startled him, and he ran off.

Insult to Injury

But Scheske says, what happened next only made her feel worse. She managed to get help from nearby residents, which in turn led to the arrival of the police.

Soon she was at a hospital emergency room so that they could do what's called 'a rape kit.'

'Rape kits' are extremely intrusive and difficult exams of a rape victim that can take hours. Their purpose: To collect information and physical evidence from the rapist that might have been left on the victim's body, including any DNA.

But Scheske questions the quality of her own exam.

"There was no photos taken of me at the hospital" she says. "They didn't note on my chart all my injuries. I left the hospital and i don't even think they gave me aspirin."

Her conclusion? "I don't think the doctor was unkind, he just wasn't experienced enough to know what he was doing."

The Answer

So what's the solution?

They're called Sexual Assault Nurse Examiners, or SANEs and across the nation they're turning up in more and more emergency rooms. They're forensic nurses that are specially trained to treat rape victims while they also expertly collect any evidence of the crime.

"I 'gotta' tell you, nurses who aren't SANE trained are very afraid to do it," says Kathy Howard, a nursing coordinator and forensic nurse trainer at St. Louis University.

She's referring to the rape kit examination.

"Nurses aren't trained in their schooling and in the emergency room in forensics," she explains. "You don't have any forensic basic training in the emergency room."

Not having that knowledge can mean the difference between a rapist being convicted or going free.

"You only get one shot at recovering this DNA evidence," says St. Louis Metropolitan Police Detective Richard Noble. "We can't go back."

For example, a recent study by the University of New Mexico found that when properly trained forensic nurses did the rape kit examination of a victim, it resulted in 69% of those cases ending in a conviction and the criminal getting a longer prison sentence.

Which is why Noble and Howard are trying to insure that the St. Louis area has plenty of SANEs.

"When we get those specialized nurses that can keep up on their forensics and also pay attention to what the victim is saying," Noble explains, "that's when you're going to get the best evidence recovery."

But in Missouri there may be a few problems.

You see, many states like Colorado have a central state program that oversees the recruitment, training, and staffing of Sexual Assault Nurses. They also standardize exactly how a rape examination should be performed and what kind of evidence should be collected.

But Missouri doesn't do that and Howard says it can lead to confusion, with different hospitals deciding what evidence should be collected and how the victim should be treated.

"Missouri has no guidelines or protocols that cover this," says Howard. "It really is just each hospital has its own rules and regulations that they follow."

Howard says there is also another consequence of the current 'Missouri way.'

While there are a fair amount of forensic nurses in St. Louis and Kansas City, finding one in the rural areas can be difficult for victims. "Victims may have to wait a long time for them to come in or the hospital may even have to transfer the patient because they don't have these nurses," said Howard.

The only problem? As the clock ticks, the evidence on the victim's body degrades, especially the DNA, and may eventually become useless if the rape exam isn't done quickly enough.

Which brings us back to Joanie Scheskie.

"To be in the position I was in, to sit there for hours" she says of her treatment before there were forensic nurses. "I just sat there throbbing and hurting. No pain control. No nothing. That was not a great way to handle it."

In fact, the whole experience made such an impact on her, she is now a rape counselor and sensitivity trainer. Scheske thinks more forensic nurses are the way to go.

"I really have to think the good that you can do with a program like this. How you can help the victims as first responders, you can help law enforcement with their case."

As for Joanie's attacker, it took until 2009 for Mark Frisella to be identified and tried for his crimes.

In the meantime he allegedly raped two other women.

He's now serving a 19-year prison sentence.


Articles in this issue:

  • From what I hear about the increase in reoprted rape allegations, the best method of reducing rape would be for more women to stay more sober more often. Alcohol seems to be a significant factor. Of course a women cannot be held responsible for being raped because she is drunk, but the fact remains that many fewer women would be raped if they weren't drunk. They should take better care of themselves. This attitude doesn't just apply to rape. If I wandered round a rough area late at night, every night, eventually I would be mugged or worse. I would not be to blame for this, but most people would regard me as being idiotic to have been there at all. As for the low conviction rate, in many cases it is merely the woman's word against the man's. In a strictly legal sense, it does not matter whether the woman was raped or not. What matters is the prosecution's ability to prove that a rape has occurred. Evidence of an offence is required, and if there is no evidence there should be no conviction. A womans claim that a rape has taken place is not independent evidence, any more than the man's claim that sex was consensual is independent evidence.

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Editor-in Chief:
Kirsten Nicole

Editorial Staff:
Kirsten Nicole
Stan Kenyon
Robyn Bowman
Kimberly McNabb
Lisa Gordon
Stephanie Robinson

Kirsten Nicole
Stan Kenyon
Liz Di Bernardo
Cris Lobato
Elisa Howard
Susan Cramer