You have responded to a "Rape"

[Michael]

I am not suggesting that we start hugging every rape patient, but we are usually the first people they see after it has happened, can we be more compassionate without causing harm ?

You're asking for a great deal of maturity on the part of the provider, which of course is a excellent thing to want.

Any good training in meeting psychological crisis or distress requires that the provider be willing and able to confront his or her own personal feelings about topics that the distressed individual's presentation may provoke on the spot. Such preparation means not denying that the provider arrives at the encounter with judgments, possibly including irrational judgments, but being able to shelve them at least for the duration of the contact. The prospect of rape triggers primitive and extreme responses, for obvious reasons: the illegitimate conflation of violence and intimacy, the imposition of involuntary physiological reflexes ripped from the voluntarily entered context that would redeem and make personal surrender productive and (literally) fertile. Rape decocts a poison of individuality-effacement from the natural medicine of mutual self-giving.

Encountering violations of that caliber can easily prompt witnesses to "shut down" their emotional expressions, and their coldness, or even hostility or aggression that is really directed against the perpetrator of the offense will easily seem to be targeting the victim, because the perpetrator is inaccessible.

Without a doubt, a tough situation to meet without conveying unintended messages. When a wound is raw, any contact with it will provoke ambivalent reactions at best, which is why an apparent excess of caution seems prudent to those who would "First, do no harm."

[crotchitymedic1986]

Damn Mike, that was impressive (going to get a dictionary so I can understand all of what you said).

[Michael]

Sorry, I'm getting punchy. Time for a break.

[DwayneEMTP]

Ive only had one, but in that instance my goals were very clear...

To make sure she didn't have any life threats.

To get the history and vitals I needed to care for her properly.

To convince her to give a rape kit at the hospital.

Sounds cold, but understand that was what I NEEDED to feel that I had done the paramedic's job...

What happened is that she became "one of those pts" that I'll never forget.

Before I had fulfilled my duties she had cried, touched my face, asked my forgiveness, explained why she was a victim, told me clearly why she deserved it....but before the night was over I was at the jail, inside a cell, doing a paramedic medical clearance on the prick that had given her pain.

I don't know how to do the right thing, though I've read the psychology. I just know how to love a damaged patient, give them my full attention and try to make sure that they are safe medically. I started with my agenda, but soon changed to a knowledge that if I could just convince her that she deserved my respect and attention that she would be convinced that she didn't deserve the rest of the shit that happened to her. Yet, I DID fulfill my agenda.

Yeah, pretty pathetic. Take your best shot..I can take it.

Dwayne

[CBEMT]

I tend not to hug any of my patients, least of all those who are wearing evidence.

I think a great many male providers (and cops, and firefighters, etc) are also highly concerned about being accused of inappropriate conduct, especially when dealing with someone who is now (at least in their minds) extremely sensitive about men in general and touching in particular.

.but before the night was over I was at the jail, inside a cell, doing a paramedic medical clearance on the prick that had given her pain.

A what? :?:

[Michael]

medical clearance on the prick

Not sure that conveys the exact image you intended...

[island emt]

CB brings up a very important point about close contact contaminating any physical evidence left behind by the perp. Sometimes something as small as a hair can mean the difference between finding the perp or not. We try to wrap the pt. up with a sheet to preserve this trace evidence and unless there are injuries needing immediate medical intervention don't try to touch any more than required. What we can do is provide supportive care and an open ear & mind to give the pt our full attention. Some will want to talk , most will still be in the denial or shock stage of what has happened to them. Always explain everything you do prior to doing it and tell the pt that medical and counseling help will be available at the hospital for them. Many victims will feel they are "responsible" for allowing the rape to happen. Do not try amateur psychology on the pt unless you are properly trained , you can do more harm than good.

Just ask them what you can do to help them and provide necessary supportive care.

Another thought to remember is not ALL rape victims are female. I've dealt with both genders as pt's.

[WilfulFire]

On our department all rape patients with "minimal injuries" are taken to a hospital that has a specialized counselor on duty. That trip can take half an hour or more in bad traffic and weather. Since we are often on scene while the police are interviewing the victim we often have a large portion of our history completed before transport is even initiated. Sure, taking that half hour trip to sit quietly and finish our report means less work at the end of the shift, but I have found that most of my patients are grateful for a break in the silence. I ask them how they are holding up. I ask them if they want to talk about what they are feeling. I let them know that what just happened was not their fault (even a prostitute can be raped) and that feeling angry is okay. I let them know that it is okay to cry in front of me if that is what they need to do. It's not an easy conversation, and if I never have another one as long as I live it will be too soon, but most women, I've found are grateful for the human interaction after such a traumatic event. Yes, I realize that as a woman I appear less threatening in such situations, but if you remember to treat your patient the way you would want to be treated (even if medical care is not required) you are doing the right thing.

[Just Plain Ruff]

every medic and emt should have education on how to deal with Rape victims and other people who have been sexually assaulted.

This should be a mandatory requirement.

A qualified person from a rape crisis center should be doing the education rather than just a social worker.

[brentoli]

Question,

When you have a psych, rape, or intoxicated person of the opposing gender, what precations do you take in the back of the truck? Do you get a 3rd rider if possible? Do you sit in a certian spot, or do anything particular?