SOUTHERN INDIANA — A recent partnership between the Center for Women and Families and three local hospital systems in Louisville and Southern Indiana — including Clark Memorial Health — is helping to lower barriers for people who have been sexually assaulted to record the incidents and get resources for recovery.

Through an initiative based out of U of L Health, SANE (Sexual Assault Nurse Examiners) are now available 24 hours a day, seven days a week at 16 local emergency rooms — increasing the level of care for survivors of sexual trauma.

The examination, which can include documentation of injuries and collection of DNA and bodily fluids, can lead to prosecution of sexual assailants in court if the victim chooses to pursue that route.

Before the additional coverage, someone who went to the ER at Clark Memorial Health after an assault could be treated and be given the exam, but not necessarily by a nurse specially trained in talking the victim through the entire process and options. So in many cases, someone arriving there would be redirected to the Center for Women and Families or another area hospital that had a sexual assault nurse available, including Baptist Health Floyd.

But advocates for the program say just making the decision to seek treatment and the exam after an assault is a difficult enough decision without the added step of having to go to another location. They say that sometimes going somewhere else would just keep the person from going through with the exam.

Relieving stress

“There’s nothing more stressful than coming to a facility and saying ‘Hey I’m here, this bad thing just happened to me,’ and then being sent somewhere else for that exam,” Vicki Yazel, a U of L Health-based nurse with SANE certification working through that hospital’s SAFE (Sexual Assault Forensic Examiner) Services program, said. “I think now you can almost see the relief on their face. You say ‘I’m going to get a SANE nurse, they’ll be here as soon as they can.’”

“We need to make sure as a community that all of our hospitals are there to walk with those victims, 24/7, 365 days,” said Elizabeth Wessels-Martin, president and chief empowerment officer of The Center for Women and Families. “To turn a victim away and have them go and find another hospital just adds to all of those challenges and everything that they’re going through at that moment.

“Providing this service at all of our hospitals gives them that sense of ‘we’re here, we’re going to serve you, we’re going to support, you, we’re going to do what it takes to get you what you need.’”

And the program has already been showing it’s needed. In the first few weeks after starting in October, Clark Memorial treated on site five people — three who had exams and two with consultations. There have been nine more since then.

“I think it’s a resource that was under-utilized that’s now getting the best care to the patient where they show up, and not causing them to have to go somewhere else,” said Bryan Boone, director of Emergency Services at Clark Memorial Health. An average of 375 people are treated a year at local sites, according to a news release.

Help from advocates

The exam itself can compound trauma to the person who has been a victim of assault, that’s why the SANE nurses — who have 100 hours of training and clinical experience before certification — are so needed in those situations. The Center also sends an advocate to be with them for the process.

“Going through the exam after you’ve been sexually assaulted is a really difficult experience,” Wessels-Martin said. “And that’s one of the reasons it is conducted by a SANE nurse, because they are trained to be compassionate, to be able to have those conversations, to be able to let the victim know every step that’s taken so that they’re prepared for that...every touch, any time a picture is taken.”

Yazel said she makes sure to communicate with the patient what the exam will be like, the pros and cons, to help them make a decision on moving forward.

“We just kind of educate them on their rights as a victim,” Yazel said. “They’re the ones that tell us basically what they want to have done and we just try to move forward and help them through that in whatever way best suits them — whether that’s getting law enforcement involved or just doing the exam and not reporting.”

Not sure what to do

She said she knows that a person who comes in for the exam may not be ready to push forward with charges or they may at first want to seek charges and then change their mind. The kits are kept at the hospital for a year and may be sent to police during that time if the assault victim elects to go that route.

“That evidence is collected and it is held so once things are in a different place for them — maybe they’ve had some sleep, maybe they’ve taken care of what they need to at that moment — they come back and say ‘OK I do want to move forward with this,’” she said.

And, Yazel said, if the case ends up being prosecuted, that can mean reopening the mental stress of it a year or more after the assault.

“I don’t want to push anyone into doing an exam by any means but I encourage them to make that decision then [and] I also encourage them to follow up with therapy services and make sure they continue with the Center for Women and Families so they can decide what is the best option for them moving forward,” she said.

“Even if they decide that day ‘I want to talk to law enforcement,’ they can still go back to that detective later and say ‘you know what, I just don’t think I can continue this process’ and they can stop the process at any time.”

Gathering evidence

But as difficult as it can be, the exam can provide some of the best evidence for prosecuting or in some cases identifying an assailant. That’s why Wessels-Martin said it’s important to fight that instinct to immediately shower and remove traces of the assailant.

“When an assault happens, the first thing that victims want to do is they want to take a shower,” she said. “They want to remove any smell, anything that makes them relive that because they’re already reliving it in their mind.

“One of the things we always tell victims: do not take a shower, do not change your clothes, come get an exam with everything that you’ve had on. We even encourage them not to brush their teeth, don’t eat or drink anything. Gathering evidence as soon as possible right after the incident happens gives a better chance of being able to move forward with reporting and potentially prosecuting the perpetrator.”

Amanda Corzine, nurse manager of SAFE Services at U of L Health, said she is grateful for the partnership that can provide improved care for those women and men who may be vulnerable after an assault.

“Every survivor of sexual assault deserves to be treated specifically by a provider that has been trained to address their unique needs, and who will assist them in seeking justice if they choose to do so,” she said, according to a news release. “This partnership is a reflection of the health care providers’ commitment to doing everything we can to provide unparalleled care to these vulnerable patients, regardless of where they choose to seek treatment.”

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