Shortage of sexual assault nurses in NC could impact survivors

Thursday, March 23, 2023
RALEIGH, N.C. (WTVD) -- A mom and her teen daughter said they waited hours at Duke Regional Emergency Department for a medical forensics exam, also known as a rape kit. It happened in March of 2022. The 15-year-old girl had just survived a sexual assault.

"The police escorted us to Durham Regional. And from there they literally were calling Chapel Hill UNC. They were calling WakeMed. They were calling everywhere trying to find a singular nurse who could come in and take the sample," the mom recalled.


The nurse they were waiting to arrive is known as Sexual Assault Nurse Examiners or SANEs.

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There's a shortage of them in North Carolina and across the country.

According to the International Association of Forensic Nurses, only 17-20% of American hospitals have SANEs on staff.

This family found out how dire the problem is and the impact the shortage can have on sexual assault survivors.

"Hearing my 15-year-old daughter say Mom, I smell him on my body and crying about it. I couldn't do anything except encourage her to continue sitting there and that filth because we knew we needed DNA evidence," described the mom.

ABC11 discovered Duke Health has approximately 12 nurses who function in a SANE capacity. WakeMed has 17. UNC has 15, two are full-time.

Nurse Jenny Anand leads the SANE Program at UNC. 50% of their patients are children.

"I've definitely heard of these, like, horror stories of patients having to wait a really long time or, you know, the alternative is they are told to go to another hospital or transferred to another hospital that's even further away," shared Anand.


She said UNC also had challenges with its program back in 2019.

"When I took over our rape crisis center, our local rape crisis center had kind of told the hospital that they were not going to send patients because wait times were so long at that point and they really were looking for the hospital to invest in the SANE program."

Anand said things have improved and their program is growing. In 2022 her team cared for survivors in 30 counties. They try to have a SANE respond within an hour of being paged. Anand said it's re-traumatization when a survivor is forced to wait hours for care.

"When you're forced to wait, it makes you feel that you're less important. It makes you second guess being there. And then obviously, like most people after experiencing something like this, are wanting to get home. They want to get back to normalcy. And this just kind of prolongs that," she continued.

There's nothing forcing hospitals to invest in sexual assault nurses. Neither hospitals nor law enforcement agencies are required to have SANEs on staff, which forces long wait times or patients driving from one county to the next for care.

"Hospitals are not able to just do this work on their own. And it seems like there have been some efforts in the legislature to kind of help connect the dots. But I know there are also some pretty strong lobbyist organizations that don't want these kind of requirements placed on hospital systems."

Lauren Schwartz is the director of sexual assault services at InterAct Solace Center.

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She is also a SANE but with a community-based medical forensic exam center.


"We're in a community-based setting, which means that we're not connected or associated with the emergency department. It's a much more quiet environment. We're able to respond 24/7 when we have nurse coverage. They don't have to worry about confidentiality issues that might be present in the ED or long waits at the ER," explained Schwartz.

She said there are gaps in coverage in Wake County, but more prevalent in rural communities.

"If there's not access to a lot of public transportation or support, maybe child care issues, there are definitely barriers if they can't access the care they need in their community. We receive referrals from all over. We get referrals from all of the surrounding counties around Wake County, and we'll even have detectives or other advocates," continued Schwartz.

She encourages all hospitals to have a treatment plan for sexual assault survivors.

"One of the biggest barriers is just a health care facility that does not have a plan for how they're going to care for sexual assault victims or survivors and how they're going to get them the specialized care that they need and that they deserve," said Schwartz.

And that's what the 15-year-old survivor needed last March. Her mom described how critical SANEs are for survivors. "The nurses who are doing it are people who understand that there's a need and they are doing it out of the kindness of their hearts honestly," she said.

Duke Health officials responded to the claims made by the family.

"Our hearts go out to all survivors of sexual assault and their families. We recognize that people who have undergone this trauma require compassionate physical and emotional care. To protect patient privacy, however, we cannot comment on individual cases."
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