ELLSWORTH — Just one hospital in Hancock County, Mount Desert Island Hospital, has sexual assault nurse examiners on staff. The other two hospitals, Northern Light Maine Coast and Blue Hill, do not.
Sexual assault nurse examiners (SANE) have undergone 40 hours of classroom training as well as additional clinical time learning how to obtain evidence from victims of sexual assault.
A sexual assault nurse examiner searches a victim’s body for evidence and records injuries.
“The specialized training for certification results in a greater understanding of proper evidence collection/preservation for prosecution,” said Hancock County Sheriff’s Detective Stephen McFarland.
McFarland has been investigating sexual assault cases and other serious crimes in Maine for many years.
“It also gives the nurse a far greater familiarity with the components of the sexual assault kit and the order in which they should be collected,” McFarland said. “This makes the collection process more efficient and less stressful on the victims.”
According to RAINN (Rape, Abuse & Incest National Network), the nation’s largest anti-sexual violence organization, a sexual assault exam includes internal exams. It also may include taking samples of blood and other bodily fluids, swabs of body surface areas, and sometimes hair samples.
Photographs of a victim’s body may be taken as well, with the victim’s consent, to document injuries. Clothing also may be collected as well as any other evidence identified.
“The trained nurses can complete the kit collection in much less time,” McFarland said. “They are trained on proper questions to ask and how to maintain a proper evidence chain of custody that is essential for successful prosecution.”
For example, examiners are trained not to ask accusatory questions such as “How much did you have to drink last night?”
McFarland said the examiners also are trained on courtroom testimony and how to assist law enforcement in getting the information and evidence they need to investigate the case more efficiently.
“Victims have told me they were much more comfortable being examined/treated by a trained nurse examiner than someone who was not familiar with the process,” McFarland said.
District Attorney Matt Foster agreed with McFarland that victims are not getting the same quality of care from nurses “untrained in sexual assault protocols.”
“I am actually pretty shocked that MCMH hasn’t taken the initiative to make sure they have a SANE nurse on staff,” Foster said.
Maine Coast has previously had certified sexual assault nurse examiners on staff.
“We do have two of our staff members that were previously certified but for various reasons let the certification lapse,” said Kristin Cyr, vice president of nursing at Maine Coast.
Cyr said she wants people to know that “they should feel OK to come to the emergency department” in a sexual assault situation.
“Our doors are open to any patient that needs emergency care, especially these victims that need our help,” Cyr said.
From a law enforcement perspective, the training helps.
“In my experience, being able to work with a trained nurse examiner is smoother and more productive than dealing with a medical professional who has not received the training,” McFarland said.
“I think one of the obstacles to the training has been the added costs to the hospitals,” the detective said. “They have to pay the nurses while they are trained. The trained nurses often have to be called in from their time off and this requires overtime pay and being paid to be on call.”
Some hospitals require nurses to pick up the cost of certification and to use vacation time to do the training, but that’s not the case locally.
Oka Hutchins, spokeswoman for MDI Hospital, said the hospital pays for the training of its SANE nurses.
Maine Coast and Blue Hill also pay for the training and provide nurses paid time off to take it, said spokeswoman Kelley Columber.
She said the hospitals hope to hold a class in the spring.
The lack of sexual assault nurse examiners is a problem elsewhere too.
At one point in recent history, only 32 registered nurses of the 196,000 total nurses in the state of Illinois had been certified as sexual assault nurse examiners.
But that’s changing in the Midwestern state.
Governor Bruce Rauner signed a bill in 2018 requiring hospitals to train enough nurses in how to treat sexual assault victims so that a patient was able to be seen by a trained examiner within 90 minutes of arriving at an emergency room, according to the Chicago Tribune.
The Office of the Illinois Attorney General is providing free SANE training for nurses.