BRATTLEBORO — While all nurses are heroes for the caring work they do, we must give some well-deserved public recognition to a specially trained few: those who step up to care for victims, and gather forensic evidence, after a sexual assault.
Sexual assault is a profound violation of a person's body, sense of safety, and autonomy, and each survivor's needs are unique.
We're fortunate in Windham and southern Windsor counties to have emergency rooms that provide critical services to victims.
These sexual assault nurse examiners, or SANEs, offer trauma-informed medical care, which means they are “informed about and sensitive to trauma-related issues present in survivors,” as a publication from the National Sexual Assault Coalition Resource Sharing Project defines the term.
The SANEs are “recognized experts in preserving forensic evidence,” according to Sarah Robinson, Vermont's SANE Program Coordinator. They share on-call responsibility all hours of the day and night, and they are called to the emergency room along with an advocate from the Women's Freedom Center whenever a rape victim comes in.
For a victim, choosing to go to the hospital after a sexual assault can be a scary decision, yet it's usually the best way to have any injuries treated and to prevent pregnancy and sexually transmitted diseases. Even a survivor who doesn't want to report the assault to police is entitled to free and confidential medical care.
This is where SANEs step in.
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SANEs are all registered nurses in Vermont, and they usually already have full-time jobs - not necessarily in the emergency room. They choose to undergo 40 hours of additional training on evidence collection, then acquire many supervised hours in the field before they're able to perform this vital exam on their own. (Please note: some graphic details follow.)
Theirs is a delicate task of balancing the various needs of their patient: treating the survivor with compassion and respect, yet also having to ask them painful questions and having them remove clothing to be examined for injuries, to permit gathering of DNA evidence, and perhaps to get injuries photographed.
It's a highly personal, invasive process that might include getting cheek swabs, pelvic swabs, pubic-hair samples, and fingernail scrapings. The victim might need to give up relevant clothing so it can be sent to a lab.
The process is also time consuming, and even with expert care, it takes an average of three to four hours to complete.
Every detail of the exam is covered by strict protocol, with each sample needing to be separately labeled and sealed for possible use in prosecution.
All material must stay in the custody of the SANE until she hands it over to law enforcement the same day. And, because their expertise in preserving forensic evidence is recognized, SANEs are often called on to testify as expert witnesses.
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It's hard to overstate the impact these special nurses have on rape victims. As advocates, we are often in the exam room with them at any hour of the day or, most often, night, providing support if a survivor wants us present, so we see first-hand the gentleness and expertise that SANEs bring to their sensitive work.
They explain each step in advance, allowing the victim to say “yes” or “no” to any part of the exam or treatment, a process that helps to restore a sense of autonomy and dignity to someone whose body has just been violated.
Moreover, SANEs recognize that only survivors themselves can decide what, if anything, they want to do in terms of law enforcement.
No decision is needed right away, either. Evidence can be stored for up to six months, allowing the survivor time to get support and choose what ultimately feels safest and best.
To all our great SANE nurses in this community: thank you for your dedicated work!