Journal of Nursing

The Nurse Who Is There After Sexual Assault


By Adrienne Green

The public discussion over how to think about and address sexual violence has heated up in recent years, prompted by high-profile allegations like those against Nate Parker, Woody Allen, and Bill Cosby, as well as increased attention to sexual assault on college campuses. The increased coverage has also brought attention to widespread problems in how sexual assault is investigated. Across the U.S., there is a backlog of tens of thousands untested rape kits—evidence collected during examinations following sexual assaults—that are currently in police custody. In 2015, the police department in Tucson, Arizona, received a grant of more than $1 million to test its more than 1,000 backlogged kits.

Arlette Stevens Castaño, a sexual-assault nurse examiner in Tucson who conducts these examinations, acknowledges the challenges that crime labs and police departments face in getting them tested promptly. I spoke with Stevens Castaño about what inspired her to work with sexual-assault survivors, a nurse’s relationship with law enforcement, and the problem of untested examination kits. This interview has been lightly edited for length and clarity.

Adrienne Green: What made you choose nursing as a career?

Arlette Stevens Castaño: Even back in high school, I knew that I wanted to take care of people. I was leaning toward health care, but I wasn’t really sure if I would become a nurse or a physician. After learning more about nursing, I decided that I liked it because I wanted to spend more time educating patients. I've always been a person who wanted to prevent bad things from happening, and that tied into the career that I chose. I still feel that preventing infection and disease is very important, not just treating things with medication.

I am a first-generation Mexican-American and I grew up in Tucson, Arizona. I’m bilingual—Spanish is my first language, and I still use it on a daily basis—and I wanted to be out more, working in the community. I attended the University of Arizona, and I have been a registered nurse now for 16 years. Working with the sexual-assault nurse examiner team was a life-changing event.

Green: How did you start doing the work you do now with sexual-assault survivors?

Stevens Castaño: I had worked at the Veterans Affairs hospital as a medical surgical floor nurse for about two and a half years before I applied to nurse-practitioner school at the University of Arizona. In my last semester, I asked a classmate of mine what her plans were, and she told me that she was also getting training to become a sexual-assault nurse examiner. I thought that seems like an area that I'd be interested in as well, because I was interested in domestic violence during my pre-nursing courses.

My classmate told me that there was a training coming up the following year in Tucson, so I called the Southern Arizona Center Against Sexual Assault, a non-profit organization that serves Southern Arizona sexual-assault survivors. I did the 40-hour, eight-day training the next February and I learned that it was an independent contractor job. So I could still work in a permanent job at the veterans’ hospital, and work as a sexual-assault examiner on the side on weekends and perhaps holidays.

Green: How did they train you to interact with sexual-assault survivors?

Stevens Castaño: It was just like being in a college course where they educate you about what sexual violence is and is not. They started out with the plain definition and then worked up to more in-depth and intense education about sexual-violence statistics. In order to take the course, you had to be a registered nurses already and have worked for a couple of years.

We learned what to look for and also the examination timeline: It's best if the examination happens within five hours of a sexual assault, for example. You're trying to get their history, assess their body, and also collect evidence from them, which will go to the crime lab. After five days—most often due to showering and wiping—all of that evidence is sometimes lost and you cannot do a full sexual-assault examination kit.

A patient can always seek help, though—that never stops.


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