SOUTHEAST NC — The New Hanover Regional Medical Center sees an average of one sexual assault victim walk through its doors a day. With Sexual Assault Awareness Month in April, it’s fitting that a new class of Sexual Assault Nurse Examiners begin training with Coastal Carolinas Health Alliance.
Funded with $115,000 a year from the Governor’s Crime Commission, the 15-person class — with 12 students hailing from New Hanover, Pender and Brunswick counties — will learn best practices for collecting sexual assault evidence and supporting victims. victims, obtaining certifications by July. The time has come, according to Emily Turner, regional Sexual Assault Nurse Examiner (SANE) coordinator for the Coastal Carolinas Health Alliance. A peak in sexual assault cases is observed during the summer months.
“All crime cases increase with the sale of ice cream,” Turner said. “It’s a vacation town, a military town, a university town. We are surrounded by all these different populations and we see an increase in sexual violence.
The Rape Crisis Center of Coastal Horizons reported a total of 490 cases of sexual assault — including rape, child sex offenses, incest and sex trafficking — in New Hanover, Brunswick and Pender counties in 2021. This is down from 571 cases in 2020.
As with many healthcare positions, SANEs are rare. Currently, about a dozen trained SANEs are stationed in the tri-county area. Turner said the newly graduating class will double local coverage.
“We are in a reconstruction phase,” she explained. “We’ve seen a lot of turnover and burnout among ER nurses doing trauma work amid the pandemic.”
SANEs are registered nurses, usually working in the emergency department, who undergo additional training to provide medical, emotional, and legal support to victims of sexual assault. They perform sexual assault kit examinations and collect evidence, while connecting patients with needed resources.
Turner said she thought victims were more encouraged to come forward knowing there was a trained presence. For example, the NHRMC used to handle an average of 60 sexual assault cases a year, but it is now seeing closer to 365. Part of that is attributed to the introduction of a dedicated SANE coordinator on staff, explained Turner. The NHRMC currently has eight trained SANE staff.
But not all medical institutions have the funding and resources for a dedicated coordinator. Its goal is for more SANEs to be available in other regional facilities to help victims in other regions.
“I’m definitely behind the mentality, if you build it they will come,” Turner said. “So the more SANE you get at a facility, the more it’s advertised in the community, people will go to those facilities.”
She also explained that sexual assault kits collected by a certified SANE are more generally admissible in court.
“They know how to collect evidence and think outside the box,” Turner said. “Overall, the kits are more reliable.”
A press release from MP Deborah Ross’ office reiterated: “SANEs are specifically trained not only to properly collect DNA samples, but also to take notes on testimonies which can then be of value. invaluable in a criminal case.”
Without a SANE present, an ER nurse can collect evidence and a doctor will perform the pelvic exam. Once trained, SANEs can perform the entire exam from start to finish, making it more accessible to victims and facilitating additional work in hospitals.
The program teaches SANEs the skills to be “trauma-informed,” Turner said. They are advised to connect victims with additional resources, such as a rape crisis center, local law enforcement, and child advocacy.
The upcoming 11-day training includes eight days of in-person classroom sessions led by North Carolina Child Advocacy Centers Medical Services Coordinator Deb Flowers. Turner explained that the program had moved away from a virtual component because only half of the participants attended.
“During our classroom training, we have guest speakers who focus on presentations on vulnerable and trauma-informed populations,” she said. “They learn everything that we consider best practices.”
The didactic part is then followed by three days of practical clinical studies taught by associate teachers in gynecology.
“They do monitored pelvic exams and sexual assault kits,” Turner said. “So instead of having their first exam proctored on a survivor in the emergency department, it’s someone guiding them through the exam, providing feedback…Getting those hands-on, hands-on skills when he is alone.”
Once completed, SANEs follow an expert content mentor to ensure they are ready for their own cases. The mentor also provides additional support to the employee.
Coastal Carolinas have trained 59 SANEs since 2017, when its program was refunded by the Governor’s Crime Commission after a six-year hiatus. The nonprofit uses $30,000 of its funding to cover training and other expenses for each class.
Turner said she is recruiting nurses from seven of her nine member hospitals, including New Hanover, Pender, Brunswick, Onslow, Robeson, Columbus and Bladen counties. This includes in the tri-county area three of Novant New Hanover, Pender Memorial, Novant Brunswick and Dosher Memorial.
Coastal Carolinas Health Alliance must reapply every two years for Governor’s Crime Commission funding.
Legislation in Congress could provide more federal money to fund these efforts. Attorney General Josh Stein recently announced a new program to train 50 North Carolina nurses to serve as SANE by the end of the summer.
In addition, Congresswoman Deborah Ross also introduced the “Nursing Exam Access Support Act” to improve care for victims of sexual assault. This was signed into law last month as part of President Joe Biden’s reauthorization of the Violence Against Women Act (VAWA). The legislation comes with $30 million a year dedicated to training and retaining sexual assault nurses.
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