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Beyond the Distance: When Technology Meets Compassion (Episode 5)
18 Plays17 days ago
Content warning: This episode discusses sexual violence, evidence collection, and the systemic barriers survivors face in accessing forensic care.
Access to forensic care after sexual violence should not depend on your postal code. Yet for survivors in rural and remote communities across Canada, geography remains one of the most significant barriers to justice and healing. When the nearest forensic nurse is hours away, critical evidence is lost and Survivors are left without the support they deserve.
In this episode of Beyond the Rape Kit: Canada's Forensic Frontline, we sit down with Kathleen Nicholson, Registered Nurse, Forensic Nurse Examiner, and Regional Educator for Interior Health's Sexual Assault Forensic Examination Program. Kathleen brings frontline and systems-level experience to a conversation about TeleSAFE -- a virtual forensic nursing model designed to bring expert support directly to local health teams, wherever they are.
Together, we examine how remote guidance from a trained forensic nurse examiner can help frontline staff preserve evidence and deliver trauma-informed care in communities that have long been underserved. We also sit with the harder questions: How does remote support integrate into existing workflows? What are the evidentiary implications of evidence collected without a forensic nurse physically present? And what do Survivors lose -- or gain -- when care is delivered through a screen?
A must-listen for forensic nurses, rural and remote health workers, policy makers, legal practitioners, survivor advocates, and anyone working to close the gap between where Survivors are and where care exists.
Recommended
Transcript
Introduction to 'Beyond the Rape Kit'
00:00:07
Speaker
This is not just another medical podcast or true crime series. This is the voice of forensic nursing in Canada. This is Beyond the Rape Kit, Canada's Forensic Frontline.
00:00:20
Speaker
We're the Canadian Forensic Nurses Association. We're pulling back the curtain on what really happens when trauma meets healthcare, when survivors seek justice, and when nurses stand at the front lines of both.
00:00:32
Speaker
Follow us today Spotify, Facebook, LinkedIn, and Blue Sky. Or
Case Study: Remote Forensic Support in Rural BC
00:00:37
Speaker
check us out on the Canadian Forensic Nurses Association website.
00:00:50
Speaker
It's midnight in a small rural BC town. The local community health centre is open for emergencies. A woman walks in and asks for a rape kit. There's no forensic nurse on call and there's only a handful of staff and nobody is specifically trained in forensic exam.
00:01:05
Speaker
But instead of waiting hours or being transferred miles away, the local team connects instantly with Telesafe.
Evaluating Telesafe's Integration and Challenges
00:01:12
Speaker
An expert forensic nurse examiner suddenly appears on screen, evidence is preserved and care begins right away.
00:01:18
Speaker
This sounds like a game changer, right? But like any new tool, Telesafe does raise questions. How does it fit into existing workflows? What are the limits of remote support?
00:01:29
Speaker
Will this stand up to legal scrutiny? Let's explore further today. From rural ER to virtual expert, Telesafe might just be bringing forensic nursing anywhere.
00:01:40
Speaker
It's a headline that makes you lean in. But behind the promises, there might be real trade-offs worth considering. Telesafe reminds us that innovation in healthcare care is never just about technology. It is about people, access, and trust.
00:01:55
Speaker
For some survivors, it can mean immediate support where none existed before. But for others, it raises important questions about privacy, connection, and the limits of remote care. So as we move forward today, the challenge is to balance these realities with compassion and practicality.
Kathleen Nicholson on Telesafe's Impact
00:02:10
Speaker
I want to welcome you to Canadian Forensic Nurses Association podcast, Beyond the Rape Kit, Canada's Forensic Frontline, where we explore innovations shaping healthcare and survivor support.
00:02:22
Speaker
Today we're talking about TELESAFE, Distance Supported Sexual Assault Forensic Exams. This model is supposed to be transforming access to care across Canada, especially in rural and underserved communities.
00:02:35
Speaker
Joining us is Kathleen Nicholson, Registered Nurse, Forensic Nurse Examiner, and Regional Educator for Interior Health Authority's Sexual Assault Forensic Examination, also known as SAFE, program. Kathleen was on the team that developed and implemented the Telesafe program in British Columbia's Interior Health, where she also works as a Telesafe consultant and forensic examiner.
00:02:57
Speaker
Welcome, Kathleen. Thank you so much for having me. So probably the best place to start is to explain what exactly is Telesafe and how does it differ from what we think of as traditional in-person sexual assault forensic exams?
00:03:14
Speaker
It's a good start. TeleSafe is that way to get access to a forensic expert and basically anywhere that has an internet connection. So we have expert examiners on call 24-7 and they can provide support using traditional telehealth tools like the phone, like video conferencing.
00:03:36
Speaker
It of course still requires processes, procedures. We have to ensure exams have forensic relevance.
Developing Telesafe: Inspirations and Partnerships
00:03:44
Speaker
but it will allow non-forensically trained provider to support or minimally forensically trained provider to support a patient through that forensic sample documentation, ah through the sample collection, through documentation and all the treatments for the effects of sexual assault.
00:04:05
Speaker
So Interior Health, currently we're working within our emergency departments to provide Telesafe services. What inspired this?
00:04:18
Speaker
I think there there were a number of of inspirations and and we are really working on the backs of a lot of other programs. um We look at the Canada Health Act and we looked at ah patients being able to access care and we would have to be traveling that patients can access experts in our rural and remote communities.
00:04:41
Speaker
um So We wanted them to be able to access those experts regardless of geography. The BC Ministry of Health also recently put forward a policy that required every emergency department to have some sort of pathway to forensic care. And and for us and for our geography and interior health, telehealth is kind of what made sense. So it's not a new process. There are many organizations throughout the US who are using this. We were also able to meet with Dr. Siobhan Bell and Lorraine Boyleau, and Dr. Bell's PhD thesis was providing telehealth services for patients who had experienced sexual assaults in Northern Ontario. So kind of looking at all of those things together and looking at what we had, we thought, oh, this is probably going to work well for interior health.
00:05:35
Speaker
There was another tiny piece of the puzzle, I think, and ah We didn't have forensic nurse examiners. We had some very dedicated physicians who provided this care at four or five, I think, five of our sites. So we didn't have forensic nurses. We didn't have access to experts. And when we needed to train more of them, we needed access to those
Implementing Telesafe in Emergency Departments
00:06:01
Speaker
experts.
00:06:01
Speaker
And how can you do that? If you don't have anyone in the town who's ever done this before, how can we provide access to So tell us if it it was really a way for us to access expert care in areas that just didn't have access to it before.
00:06:18
Speaker
So when I think about forensic examinations, I'm in an urban community, patient walks into the emergency department, says to the triage nurse, I was sexually assaulted, i need some help, et cetera. And then they page or call the forensic nurse who's on call, or you know if you're lucky, you may have somebody onsite already.
00:06:37
Speaker
what does the process look like then for when the patient walks through the door? Is this an emergency department? Is it a community health center? Is it a doctor's office? What does it look like when they walk through whatever door they're walking through? What happens that's so different than what's currently happening?
00:06:55
Speaker
Well, and again, every site is going to be a little bit different. We have had to limit ourselves to the emergency department. So We are still referring within Interior Health. We're still referring any patient who is asking or requesting for a forensic exam. We're referring them to the emergency departments.
00:07:15
Speaker
So they're walking into the emergency department and they start off as a patient. And it is something that I find we miss and our emergency department staff miss that we first have this medical response that we have to provide. So we come into the emergency department, we say,
00:07:33
Speaker
I want a rape kit. But we know that our what our patients are asking for is health care. So they are going to be triaged. They're going to be, we have two pathways for care. Some of our sites have on-site examiners and some of our site sites work through Telesafe. And it really just starts with a phone call. The team is going to bring them in and say, you know what, this is not something we're super familiar with. Let's check on you, make sure you're okay.
00:08:02
Speaker
Are you bleeding? Do you have pain? Was there pressure applied to your neck? And, and we're going to look at that medical piece. And then once that medical piece is met, I can phone a friend or even before the medical piece is done, we're going to phone a friend and we're going to say, Hey, the patient here has been sexually assaulted. What do I do?
00:08:22
Speaker
And that first conversation over the phone gets things started. Let's make sure our patient meets our guidelines. and And let's make sure they're getting the health care. A lot of sites don't think about that. They don't think about the medical care. So let's think, is the patient okay? Well, I don't know. We haven't asked them. So great. Let's go back to the patient and come back and let me know.
00:08:45
Speaker
um Maybe the patient needs to see a physician. Maybe we need to do a strangulation assessment, a head injury assessment. Maybe there's safety concerns. So the first thing is making sure that that patient is medically well.
00:08:57
Speaker
And then we're going to look at our options. What does the patient want? And a all forensic care really goes back to that. What does the patient want? We're not required to do these things medically. So what we're going to do is say, okay, patient, here's our options for care. We can absolutely medically treat you, provide you with medical care.
00:09:20
Speaker
um Some of our sites, we have an expert that can come in.
Overcoming Barriers to Telesafe Adoption
00:09:24
Speaker
Sometimes we have to transport the patient out to another site. But our forensic, our Telesafe examiners, if the patient is willing, interested, if we have staff available at our site, we're going to bring in an expert over the iPad.
00:09:40
Speaker
um And so that kind of process, it's actually, it's quite a long process for the site. The patient, it's a very similar process to any forensic exam. They're going to wait, the provider is going to come in. In our case, it's the provider,
00:09:57
Speaker
plus an iPad with ah another provider. And then the process is going to happen from there, just like a regular forensic exam. And I think it's worth noting that it's the onsite providers that have kind of a bigger task. They're going to meet with our Telesafe consultants in a different room away from the patient and say, okay, what do I do? I'm not a forensic examiner.
00:10:22
Speaker
How do I do this? And our TeleSafe consultants are going to say, great, let's pull out all of the information that you were given. Let's get your onsite binder. Let's figure out what next step, what's best for you, what works. um And then we're going to do that.
00:10:41
Speaker
Then we're going to go into the room and do the exam. And after the exam, we're going to sit with that onsite consultant. So for the patient, the only difference is there's that iPad in the room with another provider.
00:10:54
Speaker
It's the onsite process that is maybe a little bit more, requires a little bit more detail and training and attention than the exam
Training and Costs for Effective Telesafe Use
00:11:04
Speaker
process itself.
00:11:07
Speaker
How is this being accepted by those providers? Like it's going to take more time from one of the providers, maybe in the emergency department who's busy already. Are they begrudging this process?
00:11:19
Speaker
That was a very big barrier. We visited every site. We have 28 sites. We visited every site. And a lot of them said, well, we don't do that here. We don't have time. We don't have staff.
00:11:33
Speaker
And it's not required. Again, it is not a required thing. So we we say it's added value. You can call us. We're experts. We'll make sure the patient is medically taken care of. The next steps just depend on your site. So for example, a small site with one nurse, they're not going to be able to do this. But a small site with monday night one nurse may be able to call in someone else to help support this.
00:12:03
Speaker
um And once we kind of get around, you have those people who are buying in and we have a lot of our management is buying in. This is a government policy. So a lot of our management has said,
00:12:17
Speaker
Okay, we'll call someone in. We'll bring them in. We we agree. This is important to us. um and And really, the way we need the buy-in is we need you to make that phone call because then we can work it all out once you've phoned us. Once you've phoned us, we can talk about how this would work. And no, it's not going to work every time.
00:12:36
Speaker
um But we have found that once we get that phone call and once you have the expert on the phone, there's more of an understanding. I think it's really about the why. Why are you making me do this? Well, because we know that if a patient is getting the care in the moment, that they're going to have better outcomes for their health.
00:12:56
Speaker
And that's going to ultimately decrease pressure on the healthcare system. So we have research that shows if you're going to send them to another site, they're only going to show up at that other site 33% of the time. So why would you not try and provide this healthcare? Forensic care is healthcare. care Why aren't you going to try and provide it in whatever way you can provide it. So we went back to the why.
00:13:20
Speaker
This is why we're doing this. No, it's not required, but it's the best thing for your patient. So that's kind of how we framed it. And
Remote Forensic Exams and Survivor Feedback
00:13:29
Speaker
we're still working on it. We still, we still will face barriers from, from our sites and from, from our providers.
00:13:41
Speaker
But we're, we're growing and learning. It's, we've only been doing this for two years now. So. Has there been any pushback about like the financial implications? I know that in person, if we call in a forensic nurse on call, they are typically played double time when they get called in. If they're on site, they're being paid straight time to be there. um Wouldn't this be sort of like double calling somebody in? So if we need to call in an on-call expert, tell us a forensic nurse, plus we're paying the nurse or provider at the site where the patient's in person, are we not looking at like triple the money now? um And maybe we are, but is it being supported by leadership? Are they like, yeah, we're okay at this cost or who's paying this?
00:14:33
Speaker
When we were doing our finances, we were looking at, again, we went back to the BC policy and the policy stated, if you can't provide the care on site, then you are responsible for transporting the patient. So within interior health, some of our sites are six hours apart. So we would be sending our patients in a in a taxi, in healthcare care provided transportation for six hours to the secondary site. where we would then have a response at the secondary site. So that was one of the the considerations when we were looking at budgets for sure.
00:15:12
Speaker
so beyond budgets, what we what we were looking at is the healthcare of the patient themselves. And again, we know that providing it in the moment is what gives us the best outcome for the patient. So future healthcare dollars is what we looked at. We said, provide this care now We're going to prevent seven more visits from the same patient patient for the outcomes of of not being treated in the moment. And that's kind of where we had our our leadership buy-in. Yes, transporting the patients, especially we have some winter roads, winter passes, avalanche, that kind of thing. Transporting the patient is not the the safest. So let's go with the safest and best possible option, I think is one of the ways that we got a lot of buy-in from our
00:16:01
Speaker
a senior leadership. And then what kind of training do the on-site people need? We all know about forensic nurse examiner training and whatnot, but if I'm a nurse by myself in a community health center, do I need to go through a whole course to become a forensic examiner? What what kind of training do they need?
00:16:23
Speaker
i think that's another, actually, it's a really good point. i This work can't happen without standardized processes, policies, procedures. And that was what the team worked on before we went anywhere near implementation. We developed online learning modules, and it is a requirement of everyone who works in an emergency department. That said, we know that our emergency department staff does not have time to do online learning. So they're not always done. Our online learning, we have two 20-minute modules, and then we have a once a year refresher That's about five minutes just to keep them reminded of the fact that forensic care is health care, that patients who've been sexually assaulted require health care and that they have access to our resources. So that's the first level of training. But in every encounter, there is a training session. There's a the pre-encounter with someone in a room with that expert to say, I didn't do the ILEARNS. I don't know what I'm doing. I've never opened a kit.
00:17:26
Speaker
And we have those materials so I can sit down and I can say, oh, open the binder, go to this tab, you'll see photos of the inside of the kit. Let's talk about how you're going to do this.
00:17:37
Speaker
And we can do that before we go into the exam. So it's real in the moment training. Because even if they did do those ILEARNS, they might have done them two years ago and not remember them. So we, we following that standardized process and procedure, we can make sure that we're having the best kind of forensic outcomes for these encounters.
Legal Implications of Telesafe-led Exams
00:17:58
Speaker
Now I'm thinking about the forensic exams that I've been a part of specifically for sexual assault and the genital exam. um i I see there's probably no big deal if the the patient is like, sure, you can have somebody on an iPad looking at my face and my arm, but I don't know how I feel about someone on iPad looking at my private genitals or my anus. um how How does that part work?
00:18:24
Speaker
um And that's actually one of the things that we highlight in our pre-encounter. And it's a separate, whole separate, let's talk about the genital exam. Our onsite providers are either registered nurses, physicians, or nurse practitioners. So we have people who have familiarity with the physical exams. And we often say this to the nurses who are doing this, you put in a Foley catheter.
00:18:51
Speaker
So you know what normal looks like. you you provide peri care, you know what normal looks like. So when you're looking, we want you to look for things that don't look normal.
00:19:03
Speaker
Often our Telesafe consultants, the turn the camera gets turned away during this part. So we're not doing full injury evaluation.
00:19:14
Speaker
Telesafe is a little bit more about the the evidence collection, because it's very challenging to teach someone how to document ah to document injuries when they haven't had that kind of training and especially genital injuries.
00:19:30
Speaker
We have three options when patients for the genital exams. And the first option is that we will actually bring in an experienced provider. Registered nurses are not ah routinely trained in genital pelvic exams and speculum training. So if our, if our onsite provider does not have that training, we will access the onsite provider that does have that training. So our first option is we can bring in that doctor who has already seen the patient and medically cleared them, and they can do the exam while we do the swabs that we talk about in our pre-encounter.
00:20:07
Speaker
um Or we do offer a blind swab and the technique for a blind swab where we're actually doing the the onsite clinician is the one who's collecting the swab. And if a patient is uncomfortable with that, we do allow them to do a self-swab because for all of those things, we think it's better than not getting the care.
00:20:28
Speaker
And traditionally what we have is is that our onsite examiners are doing blind swabs. Occasionally the physician is coming in to do a speculum exam. And if there's any sort of injury, bleeding, ah abnormal tissue,
00:20:47
Speaker
we call that healthcare. care So then we refer back to our provider and bring our provider in and make sure that that's documented somewhere that it was the provider who then stepped in to do the exam.
00:20:59
Speaker
Have you had any feedback from survivors who've experienced having a ah telesafe forensic exam?
00:21:07
Speaker
I've been the examiner and we've we have various, they generally speaking, they are grateful that they have an expert. you know, a lot of them who live in these smaller towns know that, no, I got to travel if I want to get, you know, ah an oncologist, or if I want to see the sports medicine doctor, I got to travel. or if i So the fact that they don't have to travel, they're usually quite grateful that they're not being required to travel to another community. They're also, they're having two nurses instead of just one nurses and one nurse. So a lot of the time that that's another piece that they're,
00:21:44
Speaker
grateful for the fact that they have two care providers. Everyone walks into an emergency department and sees how busy and crazy it is. And and so they really feel that focus on them. We have um we provide a a questionnaire to get feedback from our questionnaire.
00:22:02
Speaker
And some of our feedback was that they had concerns before the exam. But as soon as the exam started, all of their concerns went away because it was so easy to talk to the on to the on iPad provider.
00:22:17
Speaker
um So the you know the patients, any anxiety that they have is usually resolved through the exam itself. That's kind of the feedback that we've gotten. Have any of these Telesafe-led exams been tested in court yet?
00:22:33
Speaker
um And if so, what did that look like? Is it both the on-site provider and the Telesafe provider being called in? I don't know, what's it look like in the legal system? And is it being supported?
00:22:46
Speaker
Yeah, again, really with a great, great thought, great question, because it they really hasn't. And when we were in development and we went through a lot of the U.S. programs and asking them, have any of your Telesafe cases gone to court? When we were in development, there were two cases that were booked in New York that were going to go to court and neither of them did go to court.
00:23:09
Speaker
ah So I haven't checked back in with any of the U.S. programs. ah One of the things during program development, of course, we went to our partners. We went to law enforcement. We went to Crown. We said, what will this look like? If I have to pay my expert who would have to be flown in because they live so far away to come to local court, that's a really big added expense. And if we're putting that expense on healthcare, how can we do this?
00:23:37
Speaker
So our process really looked at what does the TeleSafe consultant do? and the TeleSafe consultant ensures the policies and processes are followed. So they are an observational role. um Yes, they do ask questions, but it's the onsite person who's documenting all of that.
00:23:59
Speaker
And so the Telesafe consultant really has nothing that the onsite practitioner does not have. So our Telesafes are just the person who makes sure processes are followed. And we developed, that we have a handout that we give to our law enforcement when we hand over our forensic kits.
00:24:20
Speaker
And the handout says this was done with a TeleSafe consultant. The role of the TeleSafe consultant is to ensure the policies and processes are followed. And our crown indicated that if they were to call, they would probably just call on the process. So they would use that document to say, yes, there was a TeleSafe consultant there, and this is what they did.
00:24:41
Speaker
Our TeleSafe consultants being offsite, they don't do any documentation. So they can't really say, but the majority of their testimony would be I can't independently recall because they haven't documented
Addressing Misconceptions and Outreach Efforts
00:24:55
Speaker
anything.
00:24:55
Speaker
They have a standard process and procedure, they follow the standard process and procedure, and the rest of it would be in the documentation from the site. We have yet to see how this plays out, which I think we had that challenge when we introduced to nurses doing this work in 1992. and as we've gone through the world to recognize different ways to support survivors of violence. So I'm very keen and eager to hear how Telesafe supported exams will play out within the legal systems.
00:25:29
Speaker
um In talking about those legal systems, what feedback have you had, maybe even informally, from law enforcement?
00:25:40
Speaker
I suspect that they were pretty happy that this model came in because they maybe are being able to access more forensic exams in these more rural and remote areas. Or were they frustrated that now they have to do all these investigations and take these reports because there's also an evidence collection process that's able to be accessed by survivors?
00:26:04
Speaker
It's a little of both, I think. our ah um We have a lot of great community partners and bringing this in for the frontline investigators to be able to stay within their communities and not have to arrange for evidence transfers from other sites, they have found that to be very useful.
00:26:27
Speaker
They also, in a lot of our smaller communities, they understand that we have this and they can be frustrated when it's not available because the site is not able to support this and the patient is still being transferred. I think one of the things right now for us in and our Telesafe program is in sites, most of our sites don't have freezers. So we're not doing a stored exam.
00:26:52
Speaker
we These have to be reported to to law enforcement. And I think that's one of the places where we could improve. If our law and law enforcement had the ability to store these anonymous kits, then we would be transporting less because we're still finding, you know, people coming in immediately after their exams and not wanting to report, we can give them that medical care, but without being able to do that evidence collection kind of right away, we could be missing that little piece.
00:27:24
Speaker
So ah we've still been in communications with some of our smaller detachments. ah Because we just think it would be great if they would store anonymously, then we could capture a whole other kind of group of patients with forensic care.
Advice for Healthcare Leaders on Telesafe
00:27:42
Speaker
What are the most common misconceptions that you're having to address when you're introducing Telesafe, whether it's to providers or clinics or hospitals, law enforcement survivors? Walk me through like what people think and what the reality is.
00:27:58
Speaker
but they They think that they have to do this. so So you're making us do this. And we have to go back to our patients. It is our patient's choice. Forensic care is never required or forced upon a patient. So if our patients don't want this, then we are not going to do it. If we don't have the capacity within our departments to do this, then we're not going to do this.
00:28:27
Speaker
But I think the other piece is making sure that they're still getting access to the healthcare. So um they're not phoning us right now for those little healthcare things because they're worried that we're going to make them do the exam and they don't have capacity for that. When in reality, we can just be that consult and we can offer options for that patient to really make sure that the patient is getting the healthcare that they need.
00:28:57
Speaker
post-sexual assault. We also recognize that forensic care can be provided for a lot of different types of patients. Our current Telesafe is for patients who've been sexually assaulted.
00:29:12
Speaker
They've been, and they're greater than 13 years of age. So we again have to look at that aspect. And I think one more thing is that we also have follow-up. Our region is, it's a large region and we have seven coordinators who will follow up. We have a coordinator assigned to every site. So people who say, well, we don't know how to do this or, you know, nobody teaches us how to do this. We'll actually have a coordinator who will go to the site, will teach the site. And, and that piece has been ah very successful. We've had people at smaller sites who said, I don't want to be a forensic examiner, but they can call me and I would do this. And so some of our smaller sites have champions who are really aware of the process and they have that one step more. Maybe they're not ah an independent forensic examiner, but they've done a couple of kits and they're more familiar with the process and that just increases everybody's comfort level.
00:30:11
Speaker
So if I'm a healthcare care leader or a policymaker, for example, in a rural community, maybe in another province, you've led the way definitely in British Columbia, but I'm thinking, tell us, this sounds great. I want to do this. I want to implement this.
00:30:25
Speaker
What advice would you have for them in terms of sort of where to start and like, watch out, here's the pitfalls you're going to need to think about? ah So the first thing is access to experts.
00:30:38
Speaker
We are very lucky in BC. um and And I personally am very lucky to know a lot of very experienced forensic nurses who joined our team early on. We started with nine nurses in Interior Health. We have now have 80.
00:30:55
Speaker
So um we had to access the experts first to help us grow our program. And now we're having experts develop within our own program that can take over and help support the Telesafe. So we have to consider where are we accessing the experts from? And that has to be kind of the first piece. If there are no experts, then then Telesafe it can be very challenging to do because you you really do need that expertise.
00:31:24
Speaker
um And it has to be standardized. So um I know within Interior Health, we welcomed in examiners from other health authorities and we had to say, okay, turn off your other health authority. You now work for Interior Health and you now have Interior Health policies. So making sure that all of the the policies for wherever are being followed and that they're standardized and that everyone has access to them.
00:31:51
Speaker
I think it really goes back to that, having those standardized processes and procedures, which is, you know, forensics. We follow a very standardized process, procedure to make sure that everything remains forensically relevant and that our patients are getting that really high quality trauma and evidence informed care. So i say,
00:32:12
Speaker
Find your experts and build really strong policy.
00:32:17
Speaker
Finally, where's the future of Telesafe? Do you see it expanding? If so, how, where, how does it integrate with other innovations? Like I'm thinking AI, for example.
00:32:32
Speaker
What's next?
00:32:37
Speaker
What's next? we had We had worries when we did this. that, oh, well, if you can do it over Telesafe, then we don't need examiners in communities.
00:32:49
Speaker
And that, I think, is actually a worry that we have, that we want people to have the best possible access to care, and that's that forensic examiner in the room.
Future of Telesafe and Healthcare Innovations
00:33:00
Speaker
So I think we have to um consider that as oh oh worry, that something we want to continue to provide the best care and be able to do that. So i think that we have to make sure that we're still aiming for a gold standard of having that forensic examiner available for every patient who needs one. And so I think that's a first important thing that we want to, let's look at what our gold standard is, that's having a forensic expert everywhere. But if we can't have a forensic expert physically there, then let's get access to one in every
00:33:40
Speaker
tiny little community right now, like I say, we're in emergency departments, but why can't we, why can't a doctor's office call us? Why can't a local clinic call us? Why can't we be called by community-based victim services where a patient presents so that we can give them, here's the next step to the best care that you can have. And, and I think again, funding will get in the way, but that would be ideal if it was,
00:34:08
Speaker
an access how do I find access to what I need? And what are my steps to take? Because this is what the patient wants. So then in the end, it all goes back to get the patient access to what the patient needs for their best health outcomes.
Conclusion: Teamwork and Forensic Care Innovations
00:34:24
Speaker
Thank you so much, Kathleen, for talking with us today. Is there anything I've left out that you wanted to say before we wrap up?
00:34:34
Speaker
I think it's, I have a great team working with me. And if any of them are listening, this is the way that you get your projects going. You have great teams that you work with. And I am so grateful for the team that I work with, for the amazing nurses and physicians and pharmacists who have collaborated with us. The team has really made this a joy to do. And we've been able to provide care for people who really wouldn't have accessed it otherwise. And I...
00:35:06
Speaker
I am just so grateful to be a part of a team that has really put patients first. I agree so much. A strong, passionate, expert team, supportive team is so important, especially in this work where things can be hard and challenging. And I have found in general that forensic nursing teams seem to be just awesome.
00:35:30
Speaker
And they're so highly skilled. And they just want to do this work to the best of their ability. So I agree, Kathleen. A team is so important. And to build it around these new innovations.
00:35:45
Speaker
So today we were joined by registered nurse Kathleen Nicholson, who is a forensic nurse examiner and regional educator for Interior Health Authority in British Columbia as the Sexual Assault Forensic Examination Program, or the SAFE program.
00:35:58
Speaker
After today's conversation, i am imagining a Canada where every survivor of violence, no matter where they live, has immediate access to expert forensic care.
00:36:09
Speaker
Maybe that's the promise of Telesafe. I'm hoping it's the reality. But are systems ready for this? Is technology turning distance shortage and delay into connection expertise and timely care?
00:36:22
Speaker
think Telisafe might be writing its own story here. From rural ERs to urban hospitals, it is a story rooted in access and access to care and perhaps access to justice.
00:36:34
Speaker
Thank you, Kathleen, for joining to explore the promises and the questions around Telesafe in Canada. Whether you see Telesafe as a breakthrough or a work in progress, one thing is clear. I don't think the conversation's over.
00:36:45
Speaker
The future of forensic care, the good, the tricky, and the potential ahead, it all continues to unfold. But like any innovation, it comes with both opportunities and challenges, as we've learned today.
00:36:56
Speaker
So until next time, keep asking, what's possible when technology meets compassion? If you've recently been hurt or assaulted or you're being stalked or harassed, please seek medical care at your closest emergency department.
00:37:08
Speaker
Connect with support services or your local police. This is forensic nurse practitioner Hannah Varto, and this is Beyond the Rape Kit, Canada's Forensic Frontline, a podcast by the Canadian Forensic Nurses Association.
00:37:22
Speaker
Thank you for listening. Stay safe.