Giving the power of control back

By Rick Cohler

Contributing Writer

NORTHEAST WISCONSIN – Sexual Assault Nurse Examiners in northeast Wisconsin are working to give survivors of sexual assault their power of control back.

According to the Wisconsin Department of Justice, a Sexual Assault Nurse Examiner (SANE) is a registered nurse with at least one year experience who completed additional education and training to provide comprehensive health care to survivors of sexual assault.

Additional training includes the International Association of Forensic Nurses or the Wisconsin Department of Justice’s program that has adult, adolescent and pediatric services in one program.

There are currently 14 nurses in the HSHS St. Vincent SANE unit which is a 24-7-365 program.

Dana Stueber is the team leader and works closely with the Sexual Assault Center of Family Services.

In order to offer comprehensive care, the role of the SANE includes evaluating and treating the patient in a holistic way, being mindful of both the acute and long-term consequences of sexual violence victimization.

The SANE can gather a culturally and developmentally appropriate medical history and a history of the assault, with an essential understanding of the medical and legal implications of both.

Gathering this history lays a foundation to offer the patient suitable options in care, which may include forensic evidence collection, testing and treatment or prevention of sexually transmitted diseases and the human immunodeficiency virus (HIV), pregnancy prevention, and immediate and follow-up services with community-based sexual assault advocacy and medical and law enforcement partners.

The SANE ultimately provides culturally sensitive, developmentally appropriate, trauma-informed and patient-specific evaluation and treatment.

SANEs are also prepared to testify in a criminal or civil trial as a fact or expert witness when necessary and understands the ethical obligations of their testimony and the limitations.

Stueber said the majority of their patients are walk-ins.

“The charge nurse will call the SANE nurses and the Sexual Assault Center,” Stueber explained.

She added that the patient is seen immediately instead of having to wait for other cases in the emergency room.

“We take vital signs and make sure medically they are okay,” Stueber added. “The Sexual Assault Center and SANE have a 30-minute response time and once we are there I’ll gather my paperwork and the advocate will go in and introduce themself.”

The SANE nurses currently staffing the program have experience in many areas of the hospital.

“When we have meetings; they are able to bring their own experiences to it,” she said. “Having an advocate present is a very important part of the encounter and about 90% accept it.

“The way I explain it to them is that they are their new best friend in this area. If they need to talk to somebody about it and they don’t want to talk to family or friends, this is someone that’s available 24-7.

“When I get my consent, I tell them exactly what I’m going to be doing.

“The physical exam includes looking for other injuries such as bruises; looking at the genital areas if necessary; and allows me to take photos of any injuries. I do want to point out that during last year, 69% of patients had no other injuries.”

Patients have the right to refuse any part of the exam.

“We’re giving them back the power of control that was taken away from them in their assault,” she said.

If the patient just can’t go through with the exam they are reminded that they have five days to have it completed.

Stueber proceeds from head to foot conducting a thorough examination knowing consistency is important.

When a case goes to court, the SANE nurse will testify in the same county where an offense has occurred.

“That way when I go to court I say I do my job the same way every time and you’re not going to forget anything,” she said.

Taking its toll

Working with traumatized patients day after day can take a toll on providers.

“Years ago I asked a nurse in the program how she stays sane,” Stueber said. “She told me ‘I give myself a day-and-a-half to worry about it then I have to let it go. I can’t keep carrying that baggage with me or I can’t do my job.’ What I need to do in that moment and a half I have with that patient is to do the very best that I can, giving them back the power of control, collect the evidence and do it in the least traumatizing way possible.”

In 2023, the SANE unit at St. Vincent had 229 encounters with 13% being male and there were 118 patients under 18.

The SANE team at St. Vincent also provides services to Oconto, Marinette, Door, Kewaunee, Shawano and Menominee, Mich.

“That is why I want to stay 24-7,” Stueber added. “If someone drives an hour-and-a half or two hours to get here I want to make sure there is a nurse there to take care of them.”

Stueber said needs for the program include “clothing of all types for patients to wear home, gas cards for those needing transportation and prayers.”

For more information, call HSHS St. Vincent Hospital at (920) 433-8181 or visit www.hshs.org/st-vincent/services/emergency-care/sexual-assault-nurse-examiner-(sane).