Barbra Chikowore has learned some things about rape patients after six years as a nurse. She knows they don’t always immediately come forward. Even when they do, they’re often scared. And they sometimes leave out details because they don’t remember or are ashamed to describe them.
Chikowore takes all that into account when she meets patients for the first time. Introducing herself as Barbra, she sits beside them, finding a spot on the floor if she thinks that will help them relax.
She explains that she’s there to do an exam, asks about their medical history, and takes swabs and photographs, which go into a secured evidence box. She also dispenses medication and information on sexually transmitted diseases and mental health resources.
Chikowore, a sexual assault nurse examiner, sees victims ages 18 and older in the District’s SANE program. Based at Washington Hospital Center, the program has 15 on-call nurses who work in shifts that provide round-the-clock coverage so patients are seen immediately, anytime, and by a single nurse from the start of their visit to the end.
The medical samples they collect are turned over to police. The job requires nursing skills coupled with the ability to gain a person’s trust soon after it has been shattered by violence.
People who know Chikowore say she is well suited for the job, describing her as matter-of-fact and more concerned with others than herself.
Last year, when work-related stress had her contemplating a break from SANE, she never said a word during her regular telephone conversations with her mother, a nurse in Tennessee. Instead, she kept quiet as some of her hair fell out and found therapeutic company in her dog Maita, a Shih Tzu-bichon frisé mix.
“I don’t like to tell people when I’m stressed or don’t show it, because I don’t like to burden others with my ‘stuff,’ ” said Chikowore, 27, who has a trace of an African lilt in her voice. “I have a pretty okay life, and there are a lot of people with much bigger problems.”
Her mother, Tsitsi Chikowore, was a local magistrate in their native Zimbabwe. Barbra, the second of three children, grew up hearing stories about her mother’s work in the courtroom.
She’s not surprised by her daughter’s choice to pursue a kind of nursing that intersects with the justice system. Of her daughter’s tendency to put others first, Tsitsi Chikowore said, “She has a heart for people.”
According to 2010 statistics that D.C. police reported to the FBI, rapes increased by nearly 25 percent last year in the city. That has meant putting a renewed focus on increasing effectiveness and communication among programs that serve assault victims, said SANE Medical Director Heather DeVore.
In the hospital, Chikowore is often the first person to see the physical impact of a violent sexual assault. She knows it is a delicate perch fraught with responsibility.
“I am seeing people in their worst possible time,” Chikowore said, “but I’m there to help. I’m there to make it better. I enjoy that.”
Nandi Chihombori-Quao, Chikowore’s best friend, calls her honest and composed while bearing a warmth that helps people relax.
“She has a mothering personality,” Chihombori-Quao said. “I would imagine that she’s good at putting people at ease — although, while putting them at ease, still getting the information that she needs.”
The SANE program’s $500,000 annual budget is funded by the D.C. Office of Victim Services and pays for the nurses and exams. Most of the patients are from the District, but some live in Maryland and Virginia. The nurses are trained in forensic medicine, a growing speciality that merges medical care with evidence collection and documentation of injuries that prosecutors might present in court.
Eileen Allen, president of the International Association of Forensic Nurses, said the discipline makes a special contribution.
“We understand the physiology of the human body and what it does to protect itself. But what we do is nursing care,” Allen said. “What we do happens to have a side benefit to law enforcement or to the research community.”
Mindful of the legal implications of her work, Chikowore aims to perform examinations meticulously.
Over several hours, each sample of fluid, skin or other matter she collects from a patient’s body is placed in a sealed, labeled envelope. Chikowore signs her name across the back of each envelope and places the samples in a numbered cardboard box with the label “Metropolitan Police Department, Victim Physical Evidence Recovery Kit.”
The kit is sealed with tape. On the front of the box, Chikowore writes the patient’s name, which for privacy reasons is recorded in only two other places. After the patient’s physical wounds are treated, Chikowore offers information about community resources that work with sexual assault victims.
Chikowore moved to Washington in 2005 to take an entry-level nursing job at the hospital, working in the burn unit and the emergency room before she saw an advertisement for the SANE program about 2008.
At first, she said, she signed up because of the extra pay. Now Chikowore soaks up research papers on best practices, seeks opportunities for more training and says she can’t imagine doing any other medical work.
“As I see it, I’m first and foremost a nurse. My job is to take care of the patient,” Chikowore said. “The evidence collection and testifying in court is secondary. It’s definitely important that it gets done right, but the most important thing is to take care of and treat the patient.”