My Working Day: Moira Dolanexplains her role as clinical nurse manager of the Sexual Assault Treatment Unit, Rotunda Hospital, Dublin
My job involves managing the Sexual Assault Treatment Unit in the Rotunda Hospital. The unit was established in 1985, the first of its kind not only in Ireland but also in Europe.
As a nurse, I am one member of a multidisciplinary team providing care to victims of sexual crime. The other team members are doctors, An Garda Síochána, counsellors, administration staff and forensic scientists.
It is difficult to describe a typical day in my job as there is an enormous variety of duties and challenges encompassed in a working day. A phone call from a garda requesting that a victim of sexual crime be seen, evaluated and forensically tested as soon as possible will determine how my working day evolves.
Those who work with assault victims recognise the horror of sexual assault and the devastation it can cause to its victims and their families. Staff in the Sexual Assault Treatment Unit try to ensure that patients are not re-traumatised by this visit and aim to provide a patient-centred approach to service delivery by adopting a non-judgmental, professional, kind and compassionate attitude.
Although extremes of age are seen in the unit, ie from 12-13 years upwards, the majority of patients are teenagers and young adults. The risk peaks in the high teens or early 20s with females aged 17-24 being four times more likely to be assaulted or raped than the rest of the population. About 70-80 per cent of incidents occur when large quantities of alcohol are taken.
Some 5-8 per cent of our patients are male victims of sexual crime. That is the tip of the iceberg as males are reluctant to come forward, but need care just as females do.
As sexual assault is extremely traumatic and can have long-term effects on a victim's physical and psychological health, we offer each patient two appointments to attend the follow-up clinics. On Tuesday and Wednesday, a doctor and I run early morning clinics, and I run a nurse-led clinic on Wednesday afternoons for those unable to avail of the earlier clinics.
This is an opportunity to assess how patients are coping and to offer advice and referrals if required. Patients are encouraged to attend the Rape Crisis Centre for psychological support or a counsellor of their choice.
Part of my work involves phone calls to and from victims, relatives or friends of victims and, in particular, mothers, who have discovered their daughter or son has been the victim of a sexual crime. Anxious patients will call for the results of their sexually transmitted infection tests.
My role as manager requires that I deliver presentations on sexual assault to post-graduate nurses doing A&E courses, trainee Rape Crisis Centre volunteers, students of social science and trainee psychiatric nurses.
The most difficult part of my job is being woken up by a request to attend the unit for an emergency case.
I would like to see faster response to requests from gardaí for examination of the victim of a sexual assault. This should be somewhat addressed with the advent of the Sexual Assault Treatment Unit Nurse Examiner course due to start in 2008.
The easiest and most rewarding part of my job is interacting with patients and relatives. Knowing that patients leave the unit with a feeling that they have taken a positive step towards recovery and have received a caring, professional and comprehensive service gives me great satisfaction.
The unpredictability of the work is challenging and provides variety and interest. People think that working in this area must leave one pretty unshockable. Not so - every case is unique and has the capacity to affect me very deeply as a human being.
In conversation with Michelle McDonagh