Nurses are trained to help victims while preserving evidence at the same time
By Susy Kelly
(Uniontown) Herald-Standard
UNIONTOWN, Pa. (AP) — At the intersection of medical treatment and evidence collection in cases of sexual assault stands a committed group of nurses in Fayette County who provide compassionate care and special forensic expertise: the Sexual Assault Nurse Examiners.
What makes SANEs different from other nurses is how gentle they are, said Megan Simms, volunteer coordinator for the Fayette County Crime Victims Center.
“The way they respond to victims is very compassionate,” Simms said.
For those who have experienced the trauma and deep personal violation of sexual assault, making the decision to seek medical help is difficult, but important. The Pennsylvania Coalition Against Rape (PCAR) indicates that without immediate follow-up care, victims of these crimes may experience long-term health-related problems including sexually transmitted diseases or unwanted pregnancy.
Furthermore, PCAR estimates that only one-third of all rapes and sexual assaults are reported to law enforcement. Shame, fear and lack of confidence in the legal system may prevent victims from immediately pursuing criminal charges.
At Uniontown Hospital and Highlands Hospital in Connellsville, SANE nurses are available around the clock to help victims get the care they need, while also preserving crucial evidence, should the case proceed to court.
The SANEs at Uniontown Hospital recently described the procedures surrounding the “rape kit.”
“Injuries are always treated first,” nurse Denise Klink pointed out, but the first 72 hours after the assault are critical for evidence collection.
Inside the evidence collection box are several items — swabs and slides for gathering bodily fluids, plastic bags to hold the victim’s clothing which may contain evidence as well, envelopes for collecting hair or fingernail scrapings, paper that’s placed under the exam table to catch any hair or other debris during the procedure, forms and documents for the patient, and a chain of custody form to protect the integrity of the evidence as it’s handed over to law enforcement.
Following the kind of trauma that a sexual assault victim has already endured, the notion of having hairs plucked from sensitive areas, for example, may be unpleasant. Nurse Diane Swanson said part of the role of a SANE is to let the victim know she or he has the ability to refuse any step in the exam that’s too difficult.
“If they need a break, we stop,” said Swanson.
She said victims are given the option to scrape their own fingernails or pluck their own hairs. “You give them the freedom to do what they can and keep them informed every step of the way,” Swanson said.
“We make sure they have privacy,” nurse Jane Harkins added. If the victim doesn’t want anyone else in the room, she or he can ask for privacy. Many times, the victims only want the presence of a volunteer victim advocate.
Klink said counseling is important right away, because victims often express guilt and shame at the time of the exam.
“The whole time you’re doing this kit, they’re blaming themselves,” said Klink. “This was a rape. A violent, vicious rape. Maybe she did drink too much — so what?”
In addition to treating the injuries and collecting evidence, SANEs discuss options with victims like antibiotic treatment to ward off potential transmission of diseases, and emergency contraception.
Swanson said she hopes victims understand they have support when they choose to seek medical attention, and that the SANE’s job is to care for victims first, collect evidence second.
“Don’t have fear, we are your advocates,” she said.
According to state police Trooper Heather Clem-Johnston, who is part of a sexual assault response team, having the SANEs available when victims are in their most vulnerable state is invaluable.
“There’s so many people that don’t know what a SANE nurse is,” said Clem-Johnston. “They are so fundamental to our job, especially on a rape case.” She said they do a wonderful job for both the victims and the police.
“I think they’re absolutely fantastic,” said Clem-Johnston.
Mark Dillon, executive director of emergency and surgical services for Uniontown Hospital, said the hospital’s support of the SANE program demonstrates its commitment to its vision statement: “We will make a healthy difference in the lives we touch.”
“We believe that sexual assault victims have a right to immediate, compassionate and comprehensive evaluation and treatment by a specially trained nurse who has the experience to anticipate their needs during this time of crisis,” said Dillon.
Uniontown Hospital’s nursing director, Kris Shiley, also commended the SANEs for their dedication and care.
“I’m very proud to have nurses who have stepped up to take the training,” said Shiley. “To be a true patient advocate takes a special person.”
