Jefferson Healthcare hires nursing experts to serve sex assault victims

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Jefferson Healthcare launched the first Sexual Assault Nurse Examiner program in the county on June 25.

Sexual Assault Nurse Examiners receive specialized training in forensic, psychosocial and medical care for victims of sexual assault.

Before Jefferson Healthcare launched the program, the nearest SANE examination program was in Bremerton, said program coordinator Katie Rose Fischer-Price.

As of September 2016, only 74 hospitals throughout Washington offered a sexual assault examination or employed SANE trained nurses, according to a study done by the Washington State Department of Commerce that showed the service is not uniformly distributed statewide. For example, the study showed that eight counties do not have a hospital that employs SANEs, while hospitals in four counties offered SANE services but could not confirm a trained SANE was currently on staff.

“Even in King County, finding SANE nurses can be a challenge,” said Amy Yaley, Director of Marketing & Communications at Jefferson Healthcare. “Not all hospitals have it, so when you start reading about how SANE is offered throughout the state and throughout the country it becomes even more pointed how unique this program is in a rural area.”

The SANE program will be providing services to patients who are 13 and older. Current data suggests that up to 10 sexual assault exams are requested within this age group per year, according to Jefferson Healthcare. However, it is likely that this number will increase once people are aware of the program, Fischer-Price said.

“The role of the SANE nurse is to take care of the patient’s immediate needs right away,” Fischer-Price said. “We talk to them about what their needs are because in a sexual assault there is a complete loss of control. We really let the patients guide us in terms of how we care for them.”

After a sexual assault, it is not necessary for a victim to make a police report before getting a SANE examination, she said. The patient can go directly to the Emergency Department, where they would get medically cleared by the emergency department physician, who would make sure there are no injuries that need medical attention right away.

The SANE nurse would then come in and ask the patient for a narrative of the events. The nurse would take a medical history as well as a forensic history, like what the patient has done since the event (showered, changed clothes, etc.) Then the nurse would do a thorough head-to-toe assessment in which they document injuries they see as well as swabbing areas that may have come into contact with body fluids.

Patients are provided with medication that can prevent sexually transmitted diseases.

If the patient has made a police report, the SANE nurses coordinate getting that evidence to law enforcement. If they have not made a police report and don’t wish to, the evidence is stored at the state’s crime lab, Fischer-Price said.

From the beginnings of creating the program, the hospital has been working closely with Dove House Advocacy Services. During any SANE examination, a Dove House advocate will sit with the patient as a support person if they desire it.

“We are one of the first calls they make,” said Beulah Kingsolver, director at Dove House. “We meet with the victim and walk them through the process based on what they want.”

After the examination, Dove House advocates will help victims with whatever they want to do next, whether that is transportation home, getting a hotel room or contacting family and explaining what happened. They also provide clothes to the victim, as oftentimes their clothes are taken as evidence.

Having a local SANE program is vital for sexual assault victims, Kingsolver said.

“It’s so much smoother and compassionate for the victim,” she said. “And it means that there is one less decision for them to make. They don’t have to decide whether they think it is worth it to make the hour-long drive to Bremerton when the exam can happen locally.”

It also makes the transfer of evidence to police an easier process.

Part of the role of a SANE nurse is as a witness in legal proceedings, if the victim chooses to press charges. SANE nurses take photos of injuries as well as swabbing for DNA evidence.

“We do a detailed evidence collection,” Fischer-Price said. “Having a SANE nurse do that exam is a lot more effective evidence collection process. You need special training to really do that right.”

The first year of the SANE program will be focused on training staff and gathering data to better understand how to best serve the needs of the community, according to a press release from Jefferson Healthcare. The hospital hired three experienced SANE nurses and four additional nurses are currently being trained.

Working with Dr. Molly Parker, who is the medical director of the SANE program, Fischer-Price is coordinating the training of SANE nurses. She was hired in November after working at Harborview where she received SANE training.

“We have spent the last year figuring out our workflows, our policies, our procedures and doing a lot of research to make sure that we create a quality program,” she said. “It’s really hard to create a quality program in a rural area.”

While it is good that there are not many cases per year, it also makes it difficult to have a SANE nurse on duty 24/7. Right now, Jefferson Healthcare will have SANE nurses available to be called in as needed. But the goal is to have a SANE nurse on duty 24/7 in the future, Fischer-Price said.

The current program is also only for patients age 13 and up. Pediatric sexual assault examination takes additional specialized training, but if there is a need for it, Jefferson Healthcare is willing to work to add that to the program, Fischer-Price said.

She hopes to continue to improve the program as it starts.

“There’s a need and it’s an unmet need in a lot of places,” she said. “There’s also a lot of misconceptions about sexual assault in general. Programs like this not only help the survivors themselves, but also with creating education and awareness community-wide.”