Colorado shortage of specialist rape-examination nurses spurs recruitment

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AURORA | In the immediate aftermath of a sexual assault, victims are often faced with a second trauma: A medical exam that can be so intrusive, it brings the horror of the attack rushing back.

Leni Sutton, a sexual assault nurse examiner at Littleton Adventist Hospital, said the exam can be difficult for victims and the nurses who conduct it, but it is a crucial first step toward healing.

“Our job is to start the healing process and help the victim, help the survivor move on with their lives, give them back a lot of what was taken away from them,” she said.

But forensic nurses like Sutton — who do everything from conduct rape kit tests on sex assault victims to testifying court — are in short supply along the Front Range and across the country.

In Aurora, just one hospital, Medical Center of Aurora’s South Campus, has Sexual Assault Nurse Examiners on staff. At University of Colorado Hospital, doctors will perform a rape kit if a patient is too injured to be discharged from the hospital, but if they can be discharged, they are sent a few miles south to Medical Center of Aurora. The same system is used at many hospitals around the region where SANE nurses are not on staff.

Around the country, experts estimate fewer than 10,000 of more than 3 million nurses specialize in forensic nursing.

Sutton, who oversees 10 forensic nurses at Littleton Adventist and Porter hospitals, said that if there were trained sex assault nurses at every hospital, victims wouldn’t have to wait as long to be seen, and they wouldn’t have to travel from one hospital to another in the immediate aftermath of an attack.

“I would love to see a SANE program at every hospital,” she said.

Even at Littleton Adventist and Porter, the 10 SANE nurses make up a small chunk of the almost 900 nurses at the two hospitals. In a typical month, the SANE program sees about a half dozen patients.

Last week marked National Forensic Nurses Week, a week when the International Association of Forensic Nurses tries to get the word out about the profession and the need for more nurses to choose forensic nursing as a specialty.

Sheila Early, president of the group, said many nurses aren’t drawn to the specialty because many hospitals don’t offer it as a full-time position, or because it is a part-time role that sometimes doesn’t come with benefits. If more hospitals offered the programs on a full-time basis, Early said nurses would be more likely to choose it as a specialty.

Early, who has been a nurse since the 1960s and a forensic nurse for more than 20 years, said IAFN has about 3,400 members, all of them forensic nurses. She estimates there could be about three times than number practicing forensic nursing across the United States and Canada.

In Colorado, where there are more than 70 hospitals, just 17 have SANE programs registered with IAFN.

Local prosecutors say the nurses are vital to sex assault and domestic violence prosecutions, but they see a need for more nurses who can conduct the necessary exams.

Leora Joseph, Chief Deputy District Attorney for special victims in the 18th Judicial District, said that for sex crime prosecutions, the evidence a SANE gathers and testifies to in court can be vital.

“Much like we need crime scene investigators to go to the scene of a crime and process a crime scene, we need a nurse to process a human body, which in sex assault and domestic violence cases is a crime scene itself,” she said.

But the judicial district, which includes Arapahoe, Douglas, Elbert and Lincoln counties, doesn’t have SANE nurses at every hospital.

“And the ones that do, many times there is a wait,” she said. “All of that has an effect on our ability to maintain and record evidence.”

It isn’t just a challenge in terms of evidence gathering, Joseph said. One of the first things a sexual assault victim wants to do after an attack is shower, Joseph said, but they can’t always do that until after a nurse conducts the necessary exam.

“We need to be able to assure victims that we are able to get their evidence processed quickly,” she said.

At Littleton Adventist and Porter, Sutton said hospital officials hope to grow the number of nurses in the SANE program from 10 to 12. There are also plans to expand the SANE program’s exam room to include a shower and bathroom for victims.

Today, the room is a small room with a hospital bed and some specialized equipment in a quiet hallway a short distance away from the hustle and noise of the emergency department.

Sutton said the quiet room off a hallway with light traffic gives victims a calm place to stay during their exam.

“We try to make sure it’s a non-stimulative environment,” she said. “It’s a peaceful environment to allow them to start that healing process.”