Collaborating with statewide experts, building a lifeline for rural nurses
One in five girls and one in 20 boys is a victim of child sexual abuse. Many of the faces behind those numbers from the Crimes Against Children Research Center at the University of New Hampshire in Durham are etched in Sheridan Miyamoto’s mind. Their experiences motivated her to pursue a doctoral degree and now lie at the heart of new research aimed at improving outcomes for victims.
“I was frustrated seeing the same children again and again for the same problems. I saw that society’s support systems were flawed and often failed to change the trajectory for these families,” says Miyamoto, a nurse practitioner and emergency response, pediatric sexual assault examiner. “There were no answers in the literature to the questions I had in my clinical practice. I knew I needed the skills to implement interventions and conduct research to determine what is most effective to support children and families.
Her pursuit of those answers led her to the inaugural Doctor of Philosophy class at the Betty Irene Moore School of Nursing at UC Davis. Now, as an assistant professor at Penn State University College of Nursing, she advances the work she started 20 years ago. Now with more than $6 million in federal funding, she has launched the Sexual Assault Forensic Examination and Training (SAFE-T) Center, a telehealth program to train rural nurses in assault exams. Telehealth enhances health care and education using telecommunications technologies, such as videoconferencing, the internet, streaming media and wireless communications.
During the 15-month planning phase, Miyamoto and her technology team will identify four pilot sites in rural or underserved settings in Pennsylvania to deliver live support to nurses in the field. By creating a 24/7 expert Sexual Assault Nurse Examiner team consisting of nurses with the most experience across the state, they, in turn, can support less-experienced nurses in the underserved communities through telehealth. Connection to SAFE-T Center at Penn State aims to improve the quality of forensic exams, thus improving the prosecution of the perpetrators.
“One of the nurses I recruited told me she was ready to quit. She told me the hope of this program is her lifeline. That’s powerful,” Miyamoto says. “No one tells these nurses that the work they’re doing is important. They need to know this emotionally burdensome work, done by many in isolation, is championed and really matters.”
Miyamoto empathizes with that isolation. She moved from California – her knowledge base and source of valuable academic and clinical connections – to State College, Pennsylvania, to start over. The tools of collaboration she developed during her doctoral program at UC Davis set her up for success. She reached outside the nursing school, across disciplines and into the community to develop partnerships with agencies, policymakers and professionals with knowledge and expertise of child sexual assault in Pennsylvania.
“Remarkably, Sheridan was able to assemble a team of scientists and providers who could execute the vision for this grant in her first few months at Penn State as a faculty member. She was able to build a successful research team with the collaboration skills she had when she arrived here,” says Paula F. Milone-Nuzzo, dean of the Penn State College of Nursing. “Sheridan has distinguished herself among the faculty for her ability to effectively design and execute a very sophisticated program of scholarship. She serves as a role model for her students, displaying a real commitment to her science and the passion for impacting care.”
“A Ph.D. program breaks down a lot of what you thought you knew. You have to rebuild your knowledge because you start thinking and seeing things in a different way,” Miyamoto explains. “After I relocated, it took me a while to come back to the central questions: ‘What am I really good at?’ and ‘What is the impact I want to ultimately have?’ Once I asked myself that, it became clear.”
Evaluating the program to demonstrate its effectiveness in improving the quality of forensic exams and overall cost benefits remains the first goal. Building a low-cost, high-quality solution that lowers the barrier of entry for rural hospitals to benefit from telehealth services is also desired. Ultimately, Miyamoto wants a sustainable program that becomes a model for other states.
“With strong institutional support at Penn State and excitement throughout the community, there’s a lot of pride in finally having solutions aimed at tackling these problems,” Miyamoto says. “I want to sustain these exceptional nurses who do the work. We can’t lose them to burnout, isolation or fatigue. When trained, compassionate and confident nurses are available, they can provide a clinical experience that is not traumatic and, in fact, is the first step toward healing from abuse.”