Sexual assault victims in Jefferson County have been going to Harrison Medical Center in Kitsap County to have a specially trained nurse examine them, because there are no nurses at Jefferson Healthcare currently qualified to do the exams.

That is expected to change this month when several Jefferson Healthcare nurses attend a Sexual Assault Nurse Examiner (SANE) core training program being offered April 20-22 in Port Townsend by the Harborview Center for Sexual Assault and Traumatic Stress.

Beulah Kingsolver, executive director of Dove House Advocacy Services in Port Townsend, raised the issue of the lack of such nurses locally during a meeting of newly elected officials in January.

Both prosecuting attorney Michael Haas and county administrator Philip Morley contacted Jefferson Healthcare CEO Mike Glenn shortly thereafter and suggested the hospital get involved. Glenn agreed.

“I’ve also reached out to the Washington Coalition of Sexual Assault Programs to learn more about how rural hospitals provide this specialized service for their communities,” Glenn said.

“While one or two SANE-trained nurses does not a program make, it seems like a reasonable place to start,” Glenn wrote in an email.

The SANE training issue rose before the American Civil Liberties Union (ACLU) pressed the public health care system to offer abortion services, something the health care system also is looking into.

CONVENIENCE

From Kingsolver’s perspective, the issue is convenience in a time of crisis.

“We send two staff when we transport,” to Bremerton, Kingsolver said, “one to drive and the other to help the victim in trauma.”

In a case within the past year, Kingsolver said two people from Dove House were gone for 12 hours helping one victim.

“And how long is that for the victim? They won’t call in their SANErs until we get there,” she said of the nurses at Harrison. “We get there and we wait. They do a great job,” she added.

Although Kingsolver has money to help advocate for victims, she said rapes and assaults are typically not reported during business days or business hours.

Kingsolver is pleased that Jefferson Healthcare is willing to send nurses to the class later this month.

SANE, RAPE KIT

So is Jefferson County Sheriff's Detective Barb Garrett, who has been the lead investigator of sexual assault cases in Jefferson County for the last eight years.

“It would be great. The SANE exam requires some specialized equipment, and it would be great if we had that equipment in Jefferson County,” Garrett said.

Garrett said SANE exams are typically done on children, while rape kits are more often done on adults, mainly because of the kind of evidence that is collected.

A SANE exam is typically not invasive, while a rape kit typically is, Garrett said of the difference between the two. The rape kit collects DNA evidence as well as hair and blood samples. The rape kit is an official kit that is used to maintain a chain of custody and ensure that evidence can be used during a trial, for example.

In 2014, Garrett said, there was a second-degree rape case and a third-degree rape case in Jefferson County, both involving adults. In both cases, the victims were taken to Harrison Medical Center in Bremerton so that a rape kit could be used.

There were more child rape cases (nine) in Jefferson County in 2014 than adult rape cases (two) reported to authorities, and that has been fairly consistent since she began working here, Garrett said.

Garrett said that in 2014, there were six cases of first-degree rape of a child involving a victim younger than 12 years old and a perpetrator at least 24 months older than the victim. There were three cases of second-degree rape of a child, in which the victim was 12-14 years old and the perpetrator was at least 36 months older than the victim.

And there were three third degree cases involving victims 14 or 15 years old and perpetrators who were at least 48 months older.

“I think the misnomer is that when people hear ‘rape,’ they connect it with violence [in the case of children]. And oftentimes, the perpetrators are family members,” the detective said of such cases not involving violence.

It often takes time for a child to speak up and tell what’s happened, which makes the timing of a SANE exam all the more critical, so that important evidence is not lost, Garrett said.

“But we would send them to the SANE exam. That’s when we send them to Harrison,” she said, echoing Kingsolver’s hope that Jefferson Healthcare nurses can be SANE-trained.

Terri Stewart of Harborview, who is conducting the special training for nurses, could not be reached for comment by this story’s deadline.

ADVOCATES AVAILABLE

Garrett reiterates Kingsolver’s message that rape victims should know that they have a right to an advocate from Dove House. It is a free service Dove House offers.

“I think more and more people are realizing that [advocates are available], and even the hospitals do tell patients of any physical trauma [that] they can get an advocate to come with them,” Garrett said.

While there may be lag time between a deputy taking a call about a case and Garrett getting involved, Garrett says she always encourages victims to contact Dove House, whether to obtain an advocate or get other services the agency might provide.

Garrett also said that in a recent rape involving a 15-year-old girl in Quilcene, the girl first went to Jefferson Healthcare and then, because there were no SANE-trained nurses at Jefferson Healthcare, was sent to Olympic Medical Center in Port Angeles so that a rape kit could be used to collect evidence.

Garrett said the last time a rape kit was used at Jefferson Healthcare that she’s aware of was perhaps five years ago.

Glenn said the hospital medically stabilizes a person who presents as a rape victim and then transfers the person to Harrison Medical Center, because Harrison has nurses available 24/7 who are specially trained not just to do a forensic examination, but also to give emotional support to the victim.

Those nurses also serve as expert witnesses at trials, he noted.

“So the issue isn’t having rape kits available, per se, but having trained resources at the ready to manage (medically and emotionally) this traumatic event and specialized procedure,” Glenn said.

And that’s something the hospital expects to be able to offer after the training this month.