SANE nurses: Certified but unable to practice

The Truman State Health Center currently has two nurses certified to perform sexual assault examinations based on SANE, a developing program not yet implemented for use at the University.

The use of Sexual Assault Nurse Examiners (SANE) are becoming more prevalent nationwide, required by law in states such as Colorado since May 2015. Based on the rising concern of sexual assault, universities have considered the option of using university health centers as crisis centers in the event of a sexual assault. These specialized procedures are proposed by sexual assault nurses to be better for victims on university campuses by being more convenient and focusing on personalized counseling.

Brenda Higgins, Truman’s Student Health Center Director and trained SANE nurse, says two Truman nurses, Dr. Teri Tucker and herself, attended SANE training almost a year ago in Kansas City. Higgens says the training was not required by the University, but it was a certification for specialization in forensic examination and evidence collection of sexual assault.  The training included about 50 hours of instruction and a clinical component. The certification focuses on how to collect appropriate evidence from the body and clothing after an assault and how to process evidence to preserve it for court proceedings months or years later.

Higgens says SANE nurses on campus would be beneficial because the Health Center is close and convenient, while providing a safe and secure place for victims to seek medical assistance. Higgins says she expects the examinations would be inexpensive and available at all times, even outside of the typical Health Center hours.

“If it was available on-campus on-call — like how our counselors are on-call — it would feel much safer for a student to come to the Student Health Center,” Higgins says. “It would just kind of make that experience a little less traumatic for the student, and, perhaps, because of that, we would have more students be willing to report and actually collect evidence.”

Higgins says the closest hospital, the Northeast Regional Medical Center, currently collects evidence for victims of sexual assault on campus. The hospital does not have any certified SANE nurses, so rape kits and examinations are conducted by the emergency department. Higgins says SANE nurses are a better option on-campus because students would not have to wait in a general waiting room. She says the SANE nurses specifically are trained in how to treat evidence collection physically and mentally, as they are counselors of sexual assault and familiar with the age group of college students.

Dr. Mandy Doumit, the Emergency Department Director at Northeast Regional Medical Center, says the current process for sexual assault examination is invasive. It includes hair samples and pelvic samples. Doumit says they might ask the victim not to shower, or the doctors might ask the victim to provide clothes as evidence. This evidence is not maintained by the hospital, but given to law enforcement. However, she says if the victim is not seeking to report the claim immediately following the assault, there is not a reason to conduct an examination with evidence.

“When an alleged sexual assault victim presents, they are offered the choice for law enforcement to be called and for evidence to be collected. It is the patient’s choice. [The emergency department] does not mandatorily report such a complaint.”

– Dr. Mandy Doumit, Emergency Department Director at Northeast Regional Medical Center

Doumit says after the rape kit is completed, the evidence is sealed completely and immediately given to the police, but she is not sure how long evidence is held. She says there is not a reason to do the rape kit if the victim does not plan to report the sexual assault. After the evidence is given to the police, the police are liable for the evidence. Thus, if the victim wants to report the assault in the future, the individual must decide when the evidence is collected immediately following the assault. This is different than the proposed SANE nurse program on-campus, where evidence potentially could be preserved long-term if the victim decides later to report the assault because the evidence would be stored without having to be reported to authorities. Currently, victims of sexual assault would have to decide immediately following the assault if he/she wishes report it – otherwise evidence wouldn’t be collected. With the proposed SANE nurse program,  victims would have the option to have evidence collected without the binding intention of reporting the assault at the time of collection.

Lou Ann Gilchrist, Dean of Student Affairs, says evidence collection is a major liability concern for the University because if evidence is not stored properly, it cannot be used in court for months or years in the future. If, for example, the evidence was tampered with or damaged while in storage with the University, the victim could lose the ability to use the evidence in court, and the University would be liable for damages.

While the evidence is in the University’s possession, evidence must be stored as secure possible. However, Gilchrist says this requires specialized equipment and adequate funding. The Health Center already has applied for a grant to meet these needs, but a response has not yet been awarded. Gilchrist says, even with significant support, the University must consider how funding will be obtained, how evidence will be stored, and how claims of sexual assault will be reported prior to opening the service.

“It isn’t that there aren’t a lot of champions that would really like to see students have this option. It’s just whether or not it’s feasible for us to provide it.”

– Lou Ann Gilchrist, Dean of Student Affairs

Gilchrist says a small committee made up of representatives from the Health Center, the Department of Public Safety, the Title IX office and the Office of Student Affairs currently is discussing how to put this program into place. One option would be to fund the program through a grant. The committee must also consider how the program ties into current legislation, some of which is highlighted in the timeline below, such as reporting sexual assault cases as individual or aggregate data.

Gilchrist says the final say probably will be made by administration — either the University President or the Board of Governors. She says she hopes the program functions on campus as an option for victims to get help as needed.

“My priority is — let’s just give students a safe place to go, so that they can get medical attention because about ninety-percent of rapes don’t go reported to the police, but those people could still get some information,” Gilchrist says. “They could still get counseling, and they could get medical treatment.”