NOVA Develops County-wide Sexual Assault Nurse Examiner (SANE) Program
Article can be found in the June/July 2016 Bucks County Women’s Journal – buckscountywomensjournal.com
For More Information on the SANE Program Contact: Debbie Nugent at 215-343-6543 or Debbie@novabucks.org
Lucia Giron, BSN, RN, SANE, and Cynthia Vingara Wallace, RN, SANE, both trauma nurses at St. Mary Medical Center
Emergency Department, look over a sexual assault victim’s injuries in the SANE exam room.
For teens and adults who have suffered the trauma of sexual assault and choose to receive care in an emergency room (ER) setting, a new program in Bucks County has assembled the resources necessary to meet their emotional and medical needs.
Network of Victim Assistance (NOVA), in collaboration with healthcare providers, law enforcement, and the district attorney’s office, has developed a centralized Sexual Assault Nurse Examiner (SANE) program to deliver specialized health care and forensic services at Bucks County emergency rooms to adults and teens who are victims of sexual assault.
A Sexual Assault Nurse Examiner, or SANE, is a registered nurse (RN) who has been specially trained to provide compassionate, comprehensive, and gendersensitive care for the sexual assault patient. He or she objectively collects evidence during a forensic exam and is prepared to serve as a fact or expert witness in court, if needed.
The SANE program is staffed by experienced RNs with varied clinical backgrounds including emergency, trauma, critical care, and maternalchild nursing. In addition, all nurses on the SANE team have completed idactic and clinical trainings that allow them to approach a patient exam with advanced knowledge and understanding of sex crimes.
“Currently, three of the six hospitals in Bucks County— Doylestown Hospital, Aria Bucks, and St. Mary Medical Center—are participating in our program,” says Debbie Nugent, MS, RN, Project Coordinator for the SANE program. She notes that St. Luke’s Hospital in Quakertown operates a SANE program independent of NOVA.
How SANE works
The SANE team works in close collaboration with the Bucks County Sexual Assault Response Team (SART). The SART is comprised of medical professionals, law enforcement, and victim advocates. When a victim of sexual asault presents to a Bucks County emergency room or calls 9-1-1 for help, NOVA personnel are notified via the organization’s Hotline (1.800.675.6900), and the SART team is activated. The full team is available in every case, but the patient determines the level of involvement.
The Violence Against Women Act (VAWA) overseen by the United States Department of Justice requires states to provide sexual assault forensic exams free of charge and leaves the decision to work with law enforcement entirely up to the victim. Having a forensic exam within 120 hours following an assault ensures timely preservation of evidence and provides time for victims to decide if and when they want to speak with law enforcement. Even if a victim decides not to involve police, the SANE team is required by law to notify authorities that a crime was committed in a particular jurisdiction and to transfer the evidence collected. However, this can be done anonymously, since victims 18 and older can opt to have their identity withheld.
“We try to empower victims to have a choice in their care.”
Written consent is obtained prior to initiating the exam, and the SANE then explains each step and the rationale behind it, asking for additional verbal consent before moving forward. The patient’s right to decline any individual step or discontinue the process at any time is always fully respected.
How SANE came to be
Over the past five years, the SART noted that hospital- based SANE programs were no longer able to offer the level of services needed in Bucks County. In some cases, victims did not receive the care they needed or had to travel outside the county for treatment. With too few trained SANEs to meet the demand for services, lack of available training to expand the pool of SANEs, inability to ensure integrity of evidence collected, and insufficient coordination with external agencies, the SART determined that a centralized SANE model as a viable solution. NOVA, as administrator of the SANE program, provides personnel support, manages education and training, oversees procedures for gathering evidence, and coordinates with other agencies.
SANE services offered in the ER
Victims of sexual assault are seen as priority trauma patients and are immediately escorted from the general ER waiting area to a more private location. A brief evaluation by a triage nurse identifies any serious physical injuries that need immediate
treatment by a physician. The triage nurse is trained not to ask any questions about the assault other than date, location, and whether or not the victim wants law enforcement notified.
Additional options offered:
• Emotional support and victim advocacy by a trained NOVA volunteer
• Discussion of the risk of sexually transmitted infections and administration of prophylactic antibiotics
• Pregnancy testing and emergency contraception
• Forensic evidence collection including photographs of injuries
• Collection of blood and urine samples if a drug-facilitated assault is suspected
• A change of clothing and place to shower
• Translation services
Upon the patient’s discharge, he or she is given information regarding community support services to address medical, emotional, and legal concerns.
It is the intent of the SANE team to conduct medical-forensic exams in a way that minimizes any additional trauma while contributing to the early stages of the healing process.
For more information about the Sexual Assault Nurse Examiner program, contact Debbie Nugent at the NOVA office at 215.343.6543.