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Surviving rape takes more than good medical care. It takes the coordinated work and compassion of a circle of professionals. Although the SANE (Sexual Assault Nurse Examiners) program has its roots in hospital care, it depends on the cooperation of local police, district attorneys, rape-crisis counselors and courts of law to provide comprehensive care to rape victims and collect the forensic evidence necessary to convict the perpetrators. A decade after Trustee published an article about the SANE program at Hillcrest Medical Center in Tulsa, Okla., the innovative program is still going strong.
"With SANE, not only rape but now domestic violence survivors are evaluated in a much more comfortable and appropriate environment," says Fred Garfinkel, MD., chair of Hillcrest's advisory board, which is responsible for approving and monitoring the hospital's community benefit efforts. "Traditionally, these patients would require evaluation in a busy emergency room-that's not the best environment and generates unnecessary ER time and cost. SANE patients are evaluated by people who are committed to the program and thus are treated with the dignity and respect they need and deserve."
When Hillcrest first implemented SANE in the early 1990s, only seven such programs existed in the nation. By 2004, the International Association of Forensic Nurses counted 276 programs, 75 percent of which were hospital-based. Nearly all serve adolescents and adults, and approximately half serve pediatric patients as well.
Another early adopter of SANE was St. Vincent Hospital in Green Bay, Wis.
"Never underestimate the potential of a research paper," advises Paula Hafeman, R.N., M.S.N., chief nursing officer at St. Vincent's. Hafeman was the director of St. Vincent's emergency department in 1992 when one of her nurses shared a research project she had done for her school on SANE. Her findings were compelling.
"At the time, rape survivors were essentially being re-assaulted when they came to the hospital for care," says Hafeman. seen as secondary to the "real" trauma cases, rape survivors were typically made to wait long hours in busy hospital emergency rooms, told not to eat or use the bathroom for fear of destroying evidence, and asked to give their "account" of the incident repeatedly-first to police, then to examining health professionals. According to Hafeman, physicians, especially, tried to stave off treating rape...