From Victims to Survivors – A SANE Approach

Each year, startling statistics reveal hundreds of cases of sexual assault in Newfoundland and Labrador. In 2018 alone, Eastern Health treated 67 victims of sexual assault.

When those who’ve experienced sexual assault seek medical care, it can be very stressful and traumatic. According to Cindy Mackey, program coordinator of Eastern Health’s Sexual Assault Nurse Examiner (SANE) Program, the manner in which these individuals are treated following such trauma can really make a difference in their immediate and long-term recovery.SANE Program Stats

“Our team is dedicated to providing the best care possible to victims of sexual assault,” she says. “It is important they receive both physical – and psychological care – to aid in their journey to recovery.”

The Need

Like other health-care organizations across Canada, Eastern Health recognized the need for a holistic approach when caring for sexual assault victims.

This means treating the whole person, mind and body. The SANE program was developed and introduced in November of 2005 and operates out of the emergency department at St. Clare’s Mercy Hospital.

The goal of the program is to provide specialized care, as well as support and guidance to anyone of any gender, 16 years and older, who reports a sexual assault through the emergency department.

“It’s a good feeling knowing you can help someone through one of the most difficult days of their life,” says Cindy, who’s worked with Eastern Health for over 30 years. She’s been the SANE program coordinator since 2010.

Ann Marie Provencher is a certified sexual assault nurse examiner and assists with coordination of the SANE program. She has worked in the emergency department for many years and knows what it’s like to care for a patient who’s been sexually assaulted when there was no program or support in place. “There was very little education for medical professionals in this area,” she says. “When I heard about the SANE program, I knew I wanted to be part of something that made a positive impact and difference.”

Care and Compassion

The SANE program is staffed with a team of registered nurses who’ve been trained to address the unique needs of people who have experienced sexual assault. Their work is multi-faceted, specialized and reaches beyond typical medical examinations or emergency care.

The nurses in this program approach their work with sensitivity and knowledge, understanding the medical, emotional and legal aspects of each case. They are passionate about the care they provide.

“You have to be a certain kind of person to do this job and those who do it, do it well,” says Bonnie Delaney, SANE nurse. “The most important part of this job is never to judge a person, be supportive and always reassure them they did nothing wrong.”

Having training as a SANE allows the nurse to devote time and focus solely on the victim, giving them the undivided attention, they need and deserve.

“As unfortunate as it is that there is a need for this service, it is beyond rewarding and a true privilege to be of service, to be the one to provide any sense of comfort to anyone who has been the victim of a sexual assault,” says SANE nurse, Stacey Griffiths. “We are trained to provide medical care, emotional support and collect forensic evidence, but the SANE program is more than that.”

Stacey feels that Cindy and Ann Marie have worked hard to grow the program into something bigger. “We are now part of a community that educates the public, other health professionals and first responders on what sexual assault is, how to identify it and how to help,” she says.

In fact, in May 2018, the SANE program invited health-care providers from across the province to take part in training sessions. Ultimately, the hope is to expand provincially.

About the Program

It’s important to note that the program uses a non-judgmental, victim-centered approach. This method empowers individuals and allows them to make their own choices about the treatment they receive – including whether or not they want to report the assault to police.

The SANE program becomes involved when a patient goes to the emergency department and says that they’ve been sexually assaulted. A sexual assault nurse examiner is called immediately. The patient is then placed in a comfortable and safe location called the quiet room, away from the emergency waiting room.

There, they meet with the nurse examiner who consults with them regarding treatment options so they can make informed decisions about their care and how to move forward.

The patient can choose to have a support person present, before and during the exam and, can also avail of a volunteer from the Sexual Assault Crisis and Prevention Centre.

A forensic examination may be conducted following the assault. Evidence is collected based on the patient’s account of the assault and the observations and findings of a SANE. This evidence is stored for up to 365 days and will be turned over to police should the victim choose to report the crime.

The SANE emergency response service is available 24 hours a day, seven days a week. It’s available to victims up to five days post assault, for evidence collection and longer for medical needs, which include medications for the prevention of pregnancy and sexually transmitted infections (STIs), a major concern following a sexual assault.

Emotional and Counselling Support

There is no “normal” reaction to an assault. While many experience shame, self-blame, and self-doubt, each person may react differently. In addition, not all victims have physical injuries, which does not mean the sexual assault is any less serious.

The SANE will work with the patient to provide information about support services for immediate and ongoing care. “Sexual assault is an injury that needs help, just like any injury,” says SANE nurse Ann Kinsella. “The patient has suffered a traumatic event and you need to just be there, listen and let them know help is available.”

Kim Pike, regional director Emergency Services and Ambulatory Care, said: “A person in need of this service is in a very vulnerable position. It is important that they receive the appropriate treatment as well as emotional support. I am very proud of the dedicated nurses who staff the program and care they provide.”

Patients who have accessed the SANE program say they:

  • were satisfied with the immediacy of care.
  • felt positive about being able to make informed decisions about their medical care/follow up options.
  • felt their choices were supported and accepted.
  • were treated in a nonjudgmental manner.
  • were cared for medically and emotionally.

What to Do If You Have Been Sexually Assaulted

If you or someone you know has been sexually assaulted, it’s not something you have to live with on your own. Here are some things you can do:

Ensure that you’re safe

If you’re in immediate danger, or you’re worried about your safety, call 911 or your local police immediately and try to get to somewhere safe.

Talk to someone

Tell someone you trust. Find someone you can talk to, such as a friend, family member, or health-care professional.

Get medical help

If you’ve been sexually assaulted, medical support is essential. If you can, try to get to a hospital or medical clinic as soon as possible where they can give you appropriate medical care.

If possible, do not change your clothing, shower or bath, brush your teeth, smoke, and/or chew gum.

Trust yourself

If someone has assaulted you, you may not feel confident about what to do next. Trust your instincts. Remember that it’s never okay for someone to assault you for any reason.■


Eastern Health SANE Program

NL Sexual Assault Crisis and Prevention Centre Line (24-hours)

Mental Health Crisis Line

Sexual Health Centre/Planned Parenthood

Royal Newfoundland Constabulary (RNC) Non-Emergency

This story was written by Angela Lawrence, manager of graphic design services, Corporate Communications.

One response to “From Victims to Survivors – A SANE Approach

  1. Comparing a baseline group of 130 sexual assault victims with 39 patients who were evaluated after the SANE approach was implemented indicated increased clinical interaction and significant improvements in quality indicators, such as completeness of evaluation and information gathered relevant to medical-legal issues.

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