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US experiencing national shortage of nurses who treat sexual assault survivors

Posted at 10:56 AM, Mar 04, 2020

DENVER, Colo. – Amanda Dufresne Lee is a sexual assault survivor.

“I was on my daily run training for my first half marathon when I was attacked, beaten and attacked by a stranger,” Dufresne Lee said.

It happened in August of 2003. She was a college student in Waco, Texas. While she was running, something hit her head from behind and she fell to the ground.

“Then I turned to put my hand up thinking someone would help me up,” said Dufresne Lee. “And instead he picked me up by my throat.”

Nearly two decades later, her memory of the traumatic experience unfortunately hasn’t faded.

“I narrowly escaped with my life by rolling myself over a small cliff and running half-clothed to safety,” Dufresne Lee said. “I like to say that was the easy part, and everything following that was an absolute nightmare.”

Dufresne Lee had PTSD so severe she became an insomniac, and it took her years to feel safe again.

“I struggled to go to parking lots, because I felt like strangers were going to attack me,” Dufresne Lee said.

However, she says there is part of her story she looks back on in a positive way.

“I had two incredible nurses who were empathetic and warm and kind and patient who were there for me in absence of family or friends,” she said.

Following her assault, Dufresne Lee was treated by a specific type of forensic nurse, known as a Sexual Assault Nurse Examiner – SANE for short.

“A lot of people don’t know what they’re allowed to receive, what they can receive, what they can ask for. That’s the best part about being a SANE nurse is giving my patients that choice and that right back. And letting them know what is available to them,” UCHealth SANE nurse Tammy Scarlett said.

Tammy Scarlett has been a Sexual Assault Nurse Examiner for nearly five years. She currently works at UCHealth Memorial Hospital in Colorado Springs, Colorado. She says she treats both men and women of all ages, but a majority of her patients are adult women.

The exam varies depending on each situation. First, they address any medical concerns, and then they go through a history of what happened. Following that, the lengthy and intimate exam starts.

“That’s where we check out any genitalia making sure there’s no injury. We can collect evidence, and we can do photo documentation as well,” Scarlett said.

Dufresne Lee says the exam took even longer for her because her body kept going into shock, and she’d start violently shaking all over.

"It’s incredibly invasive. Many women – myself included – describe it as being re-traumatized because they are combing through everything looking for evidence,” Dufresne Lee said.

However, that evidence is necessary to find the offender and get justice. SANE nurses are able to provide one-on-one care. And that’s why Jennifer Pierce-Weeks – the Chief Executive Officer of the International Association of Forensic Nurses – says they’re trying to fill the gap of a SANE nurse shortage. There is no mandated data as far as statistics on the national shortage, but Pierce-Weeks says they have received feedback from hospitals and their patients.

“Widespread across the country, patients who present with sexual assault as their chief complaint have been turned away from hospital systems, have been misinformed about when evidence collection can actually occur,” Pierce-Weeks said.

According to Pierce-Weeks, there’s been a shortage of SANE nurses since they were first implemented at hospitals in the early 1990s. There has been considerable growth the past five years thanks to funding from health organizations, and the availability of an online course for nurses to get trained. However, Pierce-Weeks says there’s still a need – especially in rural areas of the country.

“No patient who has been sexually assaulted should ever walk into an emergency department in the United States and be turned away for care,” Pierce-Weeks said.

Although the work is rewarding, Pierce-Weeks says part of the reason for the shortage is because there is so much turnover of SANE nurses.

“To listen to patients trauma histories, can be equally traumatic to the clinicians who are caring for the patients,” Pierce-Weeks said.

Scarlett says it is incredibly tough, but she also says it’s the best job she’s ever had.

“I decided to become a SANE nurse, because I honestly think I was given a great gift of compassion.”

As the number of SANE nurses like Scarlett slowly grows, the International Association of Forensic Nurses is striving to establish education across the country for hospitals that don’t have the resources to hire a SANE nurse.

Dufresne Lee says her SANE nurses are a big reason she’s been able to heal. What happened to her does not define her. Instead, it’s a part of her story that can be used to help others who’ve faced similar challenges.

“I had incredible SANE nurses, I had incredible psychologists and therapists. I’m so lucky for that. And I feel like it’s my gift to other survivors to speak for them when they’re not able to speak for themselves for whatever reason that might be,” Dufresne Lee said.