Doctors should be better prepared to help sexual assault victims

Rewon Shimray | Cartoonist

Nearly a third of women are sexually assaulted at some point in their lives, but less than half will seek medical care for their injuries, according to a Boston University study. For those who do, emergency care often fails to have adequate knowledge to share with the victim regarding the procedure and options available to them.

Procedures for how to handle sexual assault victims and sexual assault nurse examiner (SANE) exams should be a required part of education in medical schools, followed by quarterly training for professionals.

Emergency room doctors are not currently required to have training regarding the sexual assault nurse examiner (SANE) exam, according to a study done by The Western Journal of Emergency Medicine.

When sexual assault victims arrive at the ER, they’ve already taken a brave step that many women don’t feel comfortable taking. They should be treated with care and doctors should be informed on exactly how to handle their case. If the doctors seem judgmental or unsure of what to do, this could lead to more women being unwilling to come in and seek medical assistance. It’s important for doctors to be knowledgable about options for survivors because they are the first line of defense that survivors will encounter. If the doctor seems confused or doesn’t know what’s going on, it may discourage women from continuing on with the process before getting to meet with a SANE.

Each program makes their own guidelines for how to handle sexual assault cases. More than half of residency program directors did not know how their sexual assault guidelines were established, according to the study. This study highlights both a need for increased awareness of emergency medicine resident sexual assault education nationally.

Additionally, the victim ends up paying the ER instead of the SANE nurse, who is outsourced. SANEs are quick-responding, specially trained, certified professionals who perform forensic medical-legal exams. When cases go to trial, the SANEs are available to testify, according to a Boston University study. Outsourcing SANEs lengthens the examination process, which could be fixed if hospitals would have hired SANE nurses on staff.

Although every sexual assault case is different, maintaining protocol is crucial, Judith Linden told Boston University Today, noting that cases in which SANE-trained nurses gather forensic evidence end in a 92 to 95 percent prosecution rate.

“One reason these cases are so scary to clinicians is they’re not familiar with them, and they’re scared of the justice system. They worry that they’ll have to testify,” Linden told Boston University Today.

According to findings from The Western Journal of Emergency Medicine study, nearly one-third of program directors reported that their residency did not require procedural competency for the sexual assault exam. Another 41 percent reported that their residents were required only to observe the completion of sexual assault exams in order to demonstrate competency.

Observation is not enough. Surgeons don’t simply learn by observing. They start off by observing, but they are required to have much supervised hands-on education before they are able to perform procedures on their own. ER doctors should be educated on how the experience should be handled in order to ensure that protocol is being followed.

Resident training with a SANE nurse can be an excellent opportunity to learn how to proficiently perform exams, Dr. Margaret K. Sande told Physician’s Weekly.

“A combination of case observation, completion of patient exams, and collection of evidence will be necessary to optimize the care of sexual assault cases. If SANE programs continue to thrive, broader support for more formal training of Emergency Medicine physicians in partnership with affiliate SANE programs may prove to be worthwhile,” Sande said.

Sexual assault is an epidemic. As the conversation about awareness continues, we need our doctors to be prepped and ready to help victims. If the doctors aren’t informed on the options available for sexual assault victims, the reporting process gets drawn out and it becomes more stressful at a time where survivors have certainly experienced enough stress already.