Washington nurse observes teen patients for signs of sex trafficking

“Sex trafficking happens in every community, though it may seem invisible,” said forensic nurse Paula Skomski, MSN, ARNP, SANE-A, FNE, who made the statement calmly while describing the nightmare-like, invasive nature of this criminal activity ensnaring teen girls all across North America.

“Even the medical community is usually unaware sex trafficking exists in their area,” Skomski said. As a sexual assault nurse examiner at the Providence Intervention Center for Assault and Abuse in Everett, Wash., Skomski said she regularly encounters teen girls, and occasionally teen boys, who present with STDs or injuries, such as blunt force trauma, bruises or abrasions. While these clients rarely admit they are being trafficked for sex, Skomski said she can see the signs, such as unexplained injuries and emotional withdrawal.

“Girls are being trafficked up and down the I-5 corridor [throughout the state],” she said, adding about 200 trafficked youth were identified locally in the past 18 months by Skomski and others involved in their care.

Skomski said Seattle is part of a sex-trafficking circuit, transporting girls between urban areas such as Portland, Ore., Las Vegas, Phoenix and Vancouver, B.C. Major sporting events, such as the recent winter Olympics, draw pimps with their trafficked victims.

“Big cities are the hot spot, but it happens everywhere,” she said. “You won’t necessarily see girls walking the streets. Most of these victims are sold through the Internet, such as Craigslist.”

Skomski’s expertise and compassion for abused patients started eight years ago when she received SANE training at Providence. She attended 40 hours of classes and shadowed an experienced SANE professional. In 2010, she was awarded the March of Dimes Nurse of the Year for Innovation and Creativity for helping develop the Sexual Exploitation Intervention Network that combats sex trafficking locally.

Skomski’s work encompasses all types of victims: domestic violence, sexual assault and elder abuse.

While she cares for all types of patients at the intervention center, she said she is particularly concerned for the girls entangled in sex trafficking.

How to intervene

Nurses — especially in clinics, EDs and schools — often care for these victims. “Be aware of unexplained bruises, girls acting emotionally beaten down, or conversely angry and defensive,” Skomski said. “If they’re living on the street, they might be disheveled. Look for tattoos or branding. Also watch for girls looking more sophisticated than expected, with cell phones, expensive jewelry, nice hair and nails.”

Skomski recommends asking possible victims how they were injured or what their tattoo means. “Investigate what you see,” she said. “Ask open-ended questions and follow the thread of what they say.”

She suggests referring girls to local advocates and offering them the national hotline number, 888-373-7888. Nurses also can call 911.

“Sex trafficking is a very complicated problem, and it’s very difficult to get girls out of this situation. Nurses can plant seeds by offering services and safe places,” she said. They also can talk about prevention when in contact with teen girls, introducing the topic of safe dating. “Just start the discussion,” Skomski said.

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