Saturday, June 25, 2022

Government funding to double the number of sexual assault examiners in tri-county region

New legislation could funnel additional money into Coastal Carolinas training program

Hospitals in the tri-county region will gain 12 more sexual assault nurse examiners by summer, following training from Coastal Carolinas Health Alliance. (Port City Daily photo/file)

SOUTHEASTERN N.C. — New Hanover Regional Medical Center sees on average one sexual assault victim per day come through its doors. With sexual assault awareness month in April, it’s fitting a new class of sexual assault nurse examiners is beginning training with Coastal Carolinas Health Alliance.

Funded with $115,000 annually from the Governor’s Crime Commission, the 15-person class — with 12 students coming from New Hanover, Pender and Brunswick counties — will learn best practices to collect sexual assault evidence and support victims, earning certifications by July. The timing is right, according to Emily Turner, sexual assault nurse examiner (SANE) regional coordinator for Coastal Carolinas Health Alliance. A spike in sexual assault cases is seen during the summer months.

“All incidences of crime increase with the sale of ice cream,” Turner said. “It’s a vacation town, a military town, a college town. We’re 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 sexual assault cases — including rape, child sex offense, incest and sex trafficking — in New Hanover, Brunswick and Pender counties in 2021. That’s down from 571 cases in 2020.

As with many positions in the healthcare field, SANEs are in short supply. Right now, roughly a dozen trained SANEs are stationed throughout the tri-county area. Turner said the newly graduated class will double local coverage.

“We’re in a rebuilding phase,” she explained. “We’ve seen a lot of turnover and burnout on ER nurses doing trauma work amidst the pandemic.”

SANEs are registered nurses, typically working in the emergency room department, who complete additional education to provide medical, emotional and legal support to sexual assault survivors. They perform sexual assault kit exams and collect evidence, while connecting patients with the necessary resources.

Turner said she feels victims are more encouraged to come forward knowing there’s a trained presence. For example, NHRMC used to handle an average of 60 sexual assault cases per year, but now it’s seeing closer to 365. Some of that is attributed to the introduction of a dedicated SANE coordinator on staff, Turner explained. NHRMC has eight trained SANEs on staff currently.

But not all medical facilities have the funding and resources for a dedicated coordinator. Her goal is for more SANEs to be available at other regional facilities to support victims in other areas.

“I’m definitely behind the mentality, if you build it, they will come,” Turner said. “So, the more SANEs you get at a facility and the more it’s advertised in the community, people will go to those facilities.”

She also explained sexual assault kits collected by a certified SANE, are more commonly admissible in court.

“They know how to collect evidence and think outside the box,” Turner said. “Overall, kits are more reliable.”

A press release from Congresswoman Deborah Ross’ office reiterated this: “SANEs are specifically trained to not only properly collect DNA samples, but to also take notes on testimony that can later be invaluable in use during a criminal case.”

Without a SANE present, an ER nurse can gather evidence and a physician would perform the pelvic exam. Once trained, SANEs can perform the entire exam from start to finish, making it more approachable for victims and easing added labor in hospitals.

The program teaches skills for SANEs 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 Child Advocacy Centers of N.C. medical services coordinator Deb Flowers. Turner explained the program has moved away from a virtual component because only half of participants were following through. 

“During our classroom training, we have guest speakers focused on trauma-informed, vulnerable population presentations,” she said. “They learn everything we consider best practice.”

The didactic portion is then followed by three days of hands-on clinical study taught by gynecological teaching associates.

“They’re doing pelvic exams and proctored sexual assault kits,” Turner said. “So instead of having their first proctored exam on a survivor in the emergency department, it’s someone guiding them through the exam, providing feedback … Getting those hands-on, practical skills for when they’re on their own.”

Following completion, SANEs shadow a content expert mentor to ensure they are ready for their own cases. The mentor also provides added support for the employee. 

Coastal Carolinas has trained 59 SANEs since 2017 when its program was re-funded by the Governor’s Crime Commission after a six-year gap. The nonprofit utilizes $30,000 of its funding to cover training and other expenses for each class.

Turner said she recruits nurses from seven of its nine member hospitals, including New Hanover, Pender, Brunswick, Onslow, Robeson, Columbus and Bladen counties. This includes in the tri-county region three from Novant New Hanover, Pender Memorial, Novant Brunswick and Dosher Memorial.

Coastal Carolinas Health Alliance must reapply every two years for the 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 SANEs by the end of summer. 

Also, Congresswoman Deborah Ross also introduced the “Supporting Access to Nurse Exams Act” to improve care for sexual assault survivors. This was signed into law last month under President Joe Biden’s reauthorization of the Violence Against Women Act (VAWA). The legislation comes with $30 million annually dedicated to the training and retention of sexual assault nurses.


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