Thinking About Earthquakes

Of course, the entire world is focused on the impoverished country of Haiti which, even before the horrendous seismic disaster this past week, suffered from multiple socioeconomic problems.  Now, the poor Haitians are dealing with meeting their most basic needs, food and shelter, while mourning the loss of their families, suffering from major traumatic injuries and seeing what little they did have taken from them instantaneously in a moment's tremor of the the very earth at their feet.  Many of us have no idea what that even feels like, to have the ground shake beneath you, to wonder if the roof might topple on your head, but, those of us who live in
California know, and like the rest of the world, our hearts go out to the earthquake victims in this part of Hispanolia.  We have watched in dismay, glued to our television screens, as news has come out of Port au Prince, depicting grim scenes of trapped citizens, crying for help, children wandering the streets, looking for parents who are never going to be able to soothe them again.
Relief is still slow to come and it is hot and humid and miserable and their city is in ruins around them.

The greatest tragedy, of course, is the abject poverty of this nation.  Construction was so shabby, without any sort of building standards, that homes collapsed at the first tremor.  Even the hospital, schools, and presidential palace were no match for the fury of nature.  Hundreds of thousands of people, more than the population of many of our towns and cities, will never take a breath again!  Thousands more are suffering in agony from injuries caused during this earthquake.  The world is responding but what will happen in the months ahead to help the people recover from all this devastation?  There is no one in this nation who will not be suffering from post traumatic stress!

All morning long, I've been preoccupied with thoughts of earthquakes.  Living in the San Francisco area, of course, one must give this possibility some consideration.  When I first moved here, over thirty years ago, I remember when I felt my first tremor.  I was working in the operating room of a downtown hospital, "scrubbed" on a case when the surgical lights began
swaying.  I felt the floor move, as it sometimes did when someone was moving a heavy O.R. table down the hallway outside.  The anesthesiologist commented quietly, "Earthquake."  I looked at him in a panic as the surgeon continued on with the procedure.  Finally, in a squeaky
voice, I asked, "What are we going to do?"  My knees were weak and I was terrified.  The
surgeon looked calmly at me and said, "Well, we're going to finish this operation."

I fully expected to leave work that day to find buildings demolished and streets impassable.  However, the tremor had been a 3.6 and had caused no damage whatsoever.  I decided to take an earthquake course at a local community college to help overcome some of my anxieties about this whole issue.  It proved very interesting and helpful.  During the course, we learned how to prepare as much as possible for our own safety in the event of an earthquake, we did a tour of San Francisco and saw some of the areas damaged in the 1906 earthquake and we all had extra credit projects.  I got an A on mine.  I baked a cake in the shape of California and made different colored icings for all the different earthquake faults.  We ate it in our final class.

When we had our big Loma Prieta earthquake, October 17, 1989, I was on my way to the offices of Sunset Magazine in Palo Alto, CA for a big Caribbean Tourism Organization party.
I had almost reached my destination when my car suddenly became difficult to steer.  At first, I thought I had a flat tire.  Then, I noticed the car in front on me swaying and I realized we were
having an earthquake.  I looked about and didn't see any problem with the traffic lights or buildings along the way so I continued until I arrived at the Sunset offices.  Once inside, I saw several colleagues who told me a number of wine glasses had broken but the party started.  It wasn't until a staff member came out and said she had just seen t.v. news that there had been a major earthquake, and that a section of the Bay Bridge had collapsed, that we became aware of the true disaster.  I wanted to get home to my boys, fearing that the freeways might be down.  I had no problem making it to Pacifica and all were safe.  As I hugged my sons tightly, they squirmed and said, "Mom, it's okay, we just got under the table, like we practiced!

The Loma Prieta earthquake, with a magnitude of 7.1, had a loss of 62 lives, left 3757 people injured and the estimated damage toll was between $6 and $10 billion.  The earthquake itself lasted about 15 seconds.  The Haiti earthquake had a magnitude of 7 and the estimated death toll is more than 100,000 or higher.  The number of injured is in the hundreds of thousands.  Nearly all of Port au Prince is homeless.

Today, I looked on the US Geological Survey website at the section on California earthquakes because, in the past couple of weeks, I've felt a couple of tremors.  I usually sit at my computer ( my room is downstairs ), waiting to see if the movement subsides before I run outside!  I was amazed to see that, between 1-9-10 and 1-16-10, there have been  546  recorded California earthquakes.  Of course, most of them have been very small earthquakes.  Thirty-three of them,
the USGS listed in bolder print, indicating 3.0 or higher.  January 7, 2010, there was an earthquake of 4.1 in the San Francisco Bay area and, on January 10, 2010, there was an offshore earthquake of 6.5 in northern California near Ferndale in Humboldt County.  With all this shaking and the horrible situation in Haiti, I've rechecked my earthquake supplies, updated flashlights and batteries, replenished my first aid kit and medications and feel I am prepared as I can be for such a catastrophe.  I just pray that none happens.

No matter what our situations are,  none of us can be suffering as are the people of Haiti.  I hope everyone is doing whatever they can to contribute to support the great need there.  If dollars are scare, please offer prayers!  As one who lives in what we term "earthquake country" - there, but for the grace of God, go I -

The Forensic Nurse

Today is the last day of the first "Forensic Nurse Week" ever. It will take place annually the second week of November. This is very exciting for all of us in the profession. When I began working in the field in July of 1987, we were not even officially recognized as a specialty in nursing!

Many people are completely unaware of forensic nursing. Just what is it? I will share with you this definition directly from my organization, the International Association of Forensic Nurses, of which I was a founding member ( www.iafn.org ):

"Forensic Nursing is the application of nursing science to public or legal proceedings; the application of the forensic aspects of health care combined with the bio-psycho-social education of the registered nurse in the scientific investigation and treatment of trauma and/or death of victims and perpetrators of abuse, violence, criminal activity and traumatic accidents.

The forensic nurse provides direct services to individual clients, consultation services to nursing, medical and law related agencies, and expert court testimony in areas dealing with trauma and/or questioned death investigative processes, adequacy of services delivery, and specialized diagnoses of specific conditions as related to nursing."

Also, the International Association of Forensic Nurses has listed the various areas in which forensic nurses work:

Interpersonal Violence Domestic Violence/Sexual Assault Child & Elder Abuse/Neglect Physiological/Psychological Abuse Occult/Religious Human Trafficking Forensic Mental Health Correctional Nursing Legal Nurse Consulting Emergency/Trauma Services Automobile and Pedestrian Accidents Traumatic Injuries Suicide Attempts Work-Related Injuries Near-Fatal Trauma Disasters

Patient Care Facility Issues Accidents/Injuries/Neglect Inappropriate Treatments/Medication Administration Public Health and Safety Environmental Hazards Drug/Alcohol Abuse Food and Drug Tampering Illegal Abortion Practices Epidemiological Issues Anatomical Gifts (Tissue/Organ Donation) Death Investigation Homicides/Suicides Suspicious/Accidental Deaths Mass Disasters

I came into the field as the result of an accident. I had previously worked in psychiatry, both adult and child, or the operating room, alternating between the two. After a fall in the OR, which resulted from slipping on hydraulic fluid that had leaked from an orthopedic table, which ultimately resulted in my having extensive back surgery and being disabled for a year and a half, my surgeon felt it would be unsafe for me to resume OR duties or to work in psychiatry. The Child and Adolescent Sexual Abuse Resource Center was advertising for an on call RN to cover cases and I applied. The rest is history.

When the city decided to train nurses to do adult sexual abuse exams, which was a half time position with benefits, I applied and was hired there, also retaining my on call work for CASARC. I found the work very exciting and exacting and my colleagues in the profession were always willing to help, in any way possible.

While there were programs of sexual assault nurse examiners in the U. S. since 1976, it was not until 1992 that 72 nurses met in Minneapolis, MN, called together by Linda E. Ledray, RN, Ph.D., SANE-A, FAAN, Director, SANE-SART Resource Service, MMRF, Minneapolis, Minnesota. It is the only time in my life that I was in the right place at the right time.

We spent two days, and long into the night, deciding on our name, our goals, and talked about our dreams. I recall, fondly, staying up almost until dawn, in the University of Minnesota dorm, with the pioneers in forensic nursing, such as Ann Burgess, Virginia Lynch, and Pat Speck and many more - 72 of us. We agreed to hold an annual scientific assembly and set a date for our next meeting, to be held in my own home state of California.

Just a few years later, the American Nurses Association recognized forensic nursing as an official specialty and, not long after, our newly established forensic nursing certification board offered the first specialty exam for adult sexual assault nurse examiner certification. I very anxiously sat for that exam and proudly was able to write SANE-A, after the RN following my name.

At our scientific assembly in 1996, when our founding president, Virginia Lynch, handed over the gavel, I read a poem, "The Forensic Nurse" that I had written to honor her and all of my colleagues inf our International Association of Forensic Nurses. This specialty and that membership in IAFN has been the most wonderful aspect of my nursing career. It has defined me as a nurse professional and I feel I have done the most good in this specialty for an often overlooked population. I would encourage all nurses to consider forensic nursing as their area of specialization

On this last day of our first ever Forensic Nurse Week, I want to say thank you to so many. I won't and can't name you all personally but you know who you are - my wonderful colleagues and mentors, friends and fellow forensic nurses who have been there for me, every step of the way for my entire twenty-two years in the field. I am blessed to have had you in my life. I thank God daily for putting me in the right place at the right time! May you all continue in the work with great blessings.

The Forensic Nurse

At the dawn of a new millennium, there has evolved a need,
For a new group of nurse professionals, a pioneering breed,
On the cutting edge of nursing, to fight crime's vicious curse,

Health care responds to violence, in the role of forensic nurse.

The tasks are many and varied, each sharing a common thread,

A search for truth and justice as this specialty forges ahead.

Fighting interpersonal violence, making note of multiple clues,
Learning to hear the unspoken, recognizing the tiniest bruise.

A commingling of nursing science, forensic science and the law,
From this vast wealth of knowledge, the forensic nurse must draw,
From sociology, and psychology, criminology and fields diverse,
An arsenal of such education, arms the forensic nurse.

Easing the trauma of rape, responding to a criminal scene,
Compassionate notification of kin, judging nothing as routine,
Dealing with drug and alcohol abuse, calling for a hearse,
Providing care for inmates, these are roles of the forensic nurse.

Facilitating organ donation, expert witness testimony in court,
Investigating work place injuries, writing a medicolgeal report,
Assisting in forensic research, providing specialized quality care,
Educating and consulting with colleagues, making the public aware.

From birth to death, and far beyond, there is a difference made,
By nurses who have undertaken to embrace a new crusade,
In the fight against crime and violence, helping in its reverse,
Is the commitment and dedication of the forensic nurse.

Carmen Henesy

Dedicated to founding president, Virginia Lynch, 

and my colleagues 

of the 

International Association of Forensic Nurses

Copyright (c) 1996 by Carmen Henesy
All rights reserved.