December 31, 2008

Former ER Nurse Gives Victims of Sexual Violence the Power of Hope

By Barb Berggoetz

Caroline Fisher sometimes gets the call she dreads in the middle of the night. A woman in the Indianapolis, Indiana area has been assaulted or raped.

So she dresses quickly and drives the seven minutes from her home to St. Francis Hospital's Center of Hope in Indianapolis, where she will guide the shaken and sometimes beaten victim through a physical exam and that crucial period right after the attack. In a small, homey room, with pink and purple terry cloth robes hung on a wall and two white, cushioned wicker rocking chairs, separated by a curtain from the medical exam chair, registered nurse Fisher gathers the evidence she hopes may lead to convictions.

Just as important, she hopes getting victims quickly into a special exam room -- away from the bustling emergency room -- and using trained sexual assault nurse examiners like herself will help ease victims' anxiety and start them on the road to recovery.

"If I can take (the victim) and give her the tools to start emotionally healing, then that's life-changing. Maybe she doesn't quit school or she's just able to cope with life better. If we're lucky, maybe she'll get counseling. "She shouldn't lose her future because somebody stole sex from her," said Fisher, center coordinator.

It's easy to see Fisher's strong dedication to the Center of Hope, which she advocated for and founded in 1997. You can hear it in her voice when she talks about victims' rights. You can see it in her eyes when she tells how their trauma impacts her life. Since the center opened at the Far-Southside Indianapolis hospital, more than 700 female victims, including 105 this year, have been treated there and provided with advice and resources for counseling and legal help. It's one of six such centers at hospitals in Marion County developed by then-Prosecutor Scott Newman. Together, they now treat about 800 assault and rape victims per year.

Her advocacy for a center at St. Francis was born out of frustration over how assault victims had been handled when she worked as an emergency room nurse. After going to the emergency room, they sometimes had to wait three or four hours in an exam room for doctors. She recalls waiting with victims, not knowing what to say. Doctors sometimes didn't collect evidence properly.

"It made sense (that) nurses could do this," said Fisher, who had been an ER nurse from 1982 until the center opened. Now, 10 trained nurses are on call 24/7, so someone is available any time a victim comes to St. Francis.

Dr. Arthur Stern, a St. Francis emergency room doctor, believes the center's work has had a tremendously positive impact on victims and on improving the collection of evidence for prosecuting cases. When emergency room doctors did exams, he said, a lot more variability existed in the approach and thoroughness.

"You want to make the person feel comfortable and treat any injuries they sustained and make them feel like they're in a safe place," Stern added. "It's a lot less traumatic for victims to have a woman (who is usually a nurse) be the primary person examining them."

Fisher hopes her work and that of the other nurses is having an impact, too. "Ninety-nine percent of the time, I feel like I've made a difference in how they're treated, even if they don't realize it, because I know how it used to be," said Fisher, who was born in Shelby County and got her nursing degree at Indiana Central University, now the University of Indianapolis.

Yet she sees much that still is amiss. Too many sexual assault victims don't report the crimes to police or other authorities, she said, adding that, typically, just 20 percent of women assaulted report the attack. A new study by Indiana University-Purdue University Indianapolis, released in November, reports an even lower percentage. Of 913 women randomly surveyed statewide, 13.6 percent reported being raped at some point in their lives, but only 12 percent said they reported it to police.

"They're afraid nobody will believe them. They're embarrassed or they've had a bad experience with law enforcement in the past," said Fisher. She doesn't push victims to call police. "That's their decision," she said. "But if they ask me what I think, I will encourage them to do so. They've had control totally taken away. One of our goals is to give them their power back." Fisher also is disturbed about misconceptions among the general public that lessen the chance for convictions. Too many people believe that DNA evidence has to exist or that the victim has to be injured to prove a rape occurred, she said. Victims realize this. "They think, 'Why bother?' "

"The common reaction is to try to forget it happened and go on," she said. "It's rare for someone to have counseling." Besides dealing with victims and handling administrative chores, Fisher speaks to students and any group who'll listen about sexual violence, domestic violence and bullying. She trains firefighters, police officers and others who may deal with victims. And she teaches volunteer advocates to assist victims and nurses to become sexual assault nurse examiners.

This isn't the type of work she leaves at the hospital door. In fact, she moved close to the hospital so she could respond quickly when on call. She often takes the victims' worries home with her. "I pray for them. It's a hard road these women face."

Some cases are more gut-wrenching for her than others. One victim was bitten all over her body. "That horrified me," she recalled. "I'd never seen a person bitten by another person like that. It just blew me away."

Women who are her mother's age get to her more, as do very young victims, near her 13-year-old niece's age. While her job gives her immense rewards, she recognizes the need to get away and take time for her own well- being. She travels, gardens and reads, and is trying her hand at writing a novel. Even so, she says her life and work are intertwined, partly because she's on call and also due to dedication to what she does.

"This may sound highfalutin. But I really think this is the work God has given me to do right now."


  1. Thank you for profiling a selfless human being.
    Beth Fehlbaum, author
    Courage in Patience, a story of hope for those who have endured abuse
    Ch. 1 is online!

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