SANE Program
Sexual Assault Nurse Examiner (SANE) Program

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Rape, attempted rape, sexual assault, and the sexual abuse of children are violent crimes that devastate the lives of men, women, and children of all nationalities and socio-economic groups. Despite the physical and psychological effects of these crimes, they remain among the most under-reported violent crimes in our community and in the nation.

In an effort to maximize care for the victims of these crimes as well as increase the number of perpetrators brought to justice, Harrison Medical Center instituted the Sexual Assault Nurse Examiner (SANE) program in October of 1997. This program is designed to assure compassionate care for victims, assist law enforcement in the prosecution of the crimes, and provide education about sexual assault for the community.

Today, the SANE program at Harrison is implemented by a dedicated staff of nurses with expert clinical skills and extensive training in forensic exams and evidence collection. The team is led by Jolene Culbertson, SANE Clinical Coordinator, and Kate Espy, SANE Clinical Nurse. These women were the first pediatric-certified SANE nurses in the state of Washington.

Before the SANE program, sexual assault patients were treated in the Emergency Room, often waiting more than five hours to be seen because their physical injuries were not life-threatening. The wait time combined with the lack of privacy in the waiting room resulted in patients leaving before being seen or being further traumatized by their hospital experience. SANE nurses, however, are on call around the clock, so it takes no more than an hour for a patient to be examined in a private room upstairs from the ER. "We are there just for them," emphasizes Kate.

With a patient’s permission, the SANE nurse performs a medical forensic exam, collects physical evidence, documents the patient’s story, and administers any medical treatments necessary. Before discharge, the SANE nurse offers referrals to local agencies that may be of assistance to patients following their assault. If a patient plans to press charges, the SANE nurse helps prepare him or her for the legal process. "Putting patients on the right road to having good interactions with the rest of the professional community results in the best outcomes for everyone involved," explains Kate.

When patients choose to pursue legal action, SANE nurses work directly with police and prosecutors and can serve as expert witnesses in legal proceedings, greatly increasing the chances of the conviction of sexual assault perpetrators. "Harrison’s SANE program represents the single-most important advance in prosecution of sexual assaults in Kitsap County, period," says Russell D. Hauge, Prosecuting Attorney for Kitsap County. "Kitsap County’s citizens—particularly our children—are safer because Harrison Medical Center has demonstrated the vision to establish and support this program."

In addition to acute care, SANE nurses also conduct non-acute sexual assault exams as well as train law enforcement, schools, military advocates, and other community personnel who deal with sexual assault crimes. These critical services extend care and support to victims who may not access the SANE program through the Emergency Room.

Positive feedback from patients and their families confirms the success of the SANE program at Harrison. "We hear how much different—how much better—it is now than before," shares Kate. "People come in and ask to talk to a SANE nurse. We don’t lose as many patients as we did before."

In 2012, Harrison’s SANE program saw 128 patients, 69 of whom were under the age of 18. But to the SANE staff, it’s not about the numbers; it’s about each individual and the difference the program may make in his or her life. "To us it’s about knowing that today there’s one less patient out there dealing with the trauma of sexual assault alone," says Kate.

Because insurance doesn’t cover sexual assault exams and fees from the Crime Victims’ Compensation Program don’t offset all expenses, Harrison Medical Center Foundation was instrumental in the initial funding of the SANE program. Today, the Foundation continues to raise money to pay for the continuing education of SANE nurses and up-to-date equipment such as forensic cameras.

As the only hospital with a SANE program in Kitsap, Mason, Jefferson, and Clallam counties, Harrison is committed to meeting the needs of all its sexual assault patients. "Our youngest patient was just months old and the oldest was over 90," says Kate. "Sexual assault can affect anyone of any age at any time. We have a system that is dedicated just to these patients and their families, whoever they are and whenever they need us."

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