A sexual assault is committed in the U.S. every 98 seconds, according to the national anti-sexual violence organization Rape, Abuse & Incest National Network, and a new effort, Spokane SANE Foundation, is underway to train nurses to help and treat survivors.

Beth Sheeran, a registered nurse and founder of the Spokane SANE (Sexual Assault Nurse Examiner) Foundation, received SANE training through a course in Spokane hosted by the Seattle-based Harborview Medical Center, and she aims to make that training more readily available in Spokane at all times, so that every ER can have a SANE nurse available 24 hours a day.

Sheeran says she hopes through state House Bill 2101, a bill passed last year to increase the availability of sexual assault nurse examiners statewide, and other opportunities for funding, Spokane SANE will be an effective program accessible to all interested nurses, especially those working in rural hospitals.

The SANE program works to train emergency room nurses to help victims of sexual assault in an efficient, thorough, and humane manner while gathering crucial samples for evidence. Finding and holding a perpetrator accountable often is contingent on gathering accurate DNA evidence.

 “On a federal level, there’s recommended standards for training forensic nurses, and unfortunately, just because of a lack of money statewide, the education has been unevenly distributed throughout the state,” says Sheeran. “We need to start to develop these local training mechanisms so nurses can stay up to speed, so they can have access to training.”

Together, Sheeran and other nurses (involved in SANE) congregate for training conducted by professionals in the Spokane area in aspects of the forensic exam others might not consider, such as the trial and testimony portion. Nurses might have to accompany victims in court, but they can be unfamiliar with the process. A Spokane prosecuting attorney recently helped put on the first trial training for nurses in the Spokane area.

Just under a year ago, Lutheran Community Services Northwest received a $157,000 grant from the Washington state Department of Commerce Office of Crime Victims Advocacy to hire a SANE nurse in Spokane.  

The social services organization has hired SANE nurse Megan Lorincz, with the expectation that she’ll step into a leadership role and extend training to other nurses in the area, says Erin Williams, Spokane-based director of Victim Advocacy and Educational Lutheran Services.

Williams says the process of hiring and figuring out the details has been surprisingly difficult and extensive.

“It turns out that nurses are really expensive to hire and in super high demand in this area. Health care is a field where we just don’t have enough professionals here. Even in our counseling program, we have a difficult time finding candidates to work who are qualified and good enough to serve our clients. That’s why it’s been so important for us to be a training institution here as well,” says Williams.

Getting hospitals in the area on board with hiring SANE nurses isn’t as simple as it could seem.

“It’s been taking a really long time to navigate contracts with the hospitals to have an outside provider come in and do care. There are a lot of liability issues and issues to work out who is going to be responsible for what,” says Williams. “What we’ve really come down to is that we’d like to work on funding that is specific to what this community needs, and what this community needs is a nursing leader. And we think we have that in Megan Lorincz. She’s an incredible nurse, and she’s someone who can work closely with nurse educators at Providence and MultiCare.”

At Lutheran Community, victim advocates will work with the SANE nurses collaboratively to help guide a survivor through what potentially could be a daunting process. The goal is to take care of victims, help them to understand their choices, and provide access to follow-up resources and care.

 “The medical process can feel very dehumanizing, but it can be a place to restore respect and autonomy. And so, we try to use that experience, and we shape that around empowering that person to take charge of their body again,” says Sheeran. 

Seattle’s Harborview Medical Center is the only provider in Washington state that offers SANE training, and it only does so once a year in Spokane. The next five-day core training in Spokane is scheduled Oct. 7-11, 2019, at Deaconess Hospital. The training is free for all nurses residing in Washington state.

The training consists of informative lectures and hands-on training in certain tasks, such as taking proper photographs of any marks on a survivor’s body. SANE also acts to remove implicit bias from nurses helping survivors by preparing them to deal with individuals from different backgrounds, according to Terri Stewart, medical training coordinator for Harborview Center for Sexual Assault.

“We look at certain groups you might be encountering as a sexual assault nurse, such as teenagers, men, people from the LGBTQ community, elderly patients, military, trafficked people, prisoners,” says Stewart. “We drill down into some of those more specific populations.”

Stewart adds that without SANE training, a nurse might be more likely to misunderstand and respond unhelpfully to behaviors of assault victims.

“One of the benefits of the SANE program is you have nurses who really want to do the work, they thought about how it will impact their life, and they’re well-trained,” says Stewart.

Wendy Williams-Gilbert, professional development director and RN-Bachelor of Science in Nursing program director at the Washington State University College of Nursing, confirms that the nursing school is looking at developing a local training center for SANE nurses. Williams-Gilbert says online education will be developed for nurses in rural communities that can be independent of time and space. 

Often, defense attorneys can invalidate and throw out a rape kit in a legal case when the nurse is inexperienced in sexual assault examination, she asserts, adding that the SANE training helps victims build a stronger case that can hold up in court.

“It takes so much courage to report, so much courage to show up, that we really owe it to the patients to be able to provide care wherever they’re at in the community,” says Williams-Gilbert.