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"SANE Nurses" An 40th anniversary APR encore presentation

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Alabama Public Radio is celebrating its fortieth anniversary this year. The news team has generated a lot of stories in all that time. And we’ll be spending the year listening back to the best of the best of these features. That includes this story from 2017 by APR student intern Katie Willem. A sexual assault case and the suicide of a University of Alabama student led to renewed interest in what’s called the SANE program. Katie explained how nurses are specially trained to counsel victims of sexual abuse. Here’s an encore presentation of that story from the APR archives.

“Have you ever seen a SANE facility before? Let’s do that. Yeah, let’s do that.”

That’s Meg McGlamery. She’s the Executive Director at the Crisis Center in Birmingham. This includes what’s called a SANE facility. SANE is short for Sexual Assault Nurse Examiner. The SANE facility is located in the crisis center, and is calmly quiet. One of the first things you notice is the art on the walls. It’s done by patients.

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“I just noticed those,” said McGalmery. “The hearts! Yeah, those are amazing. Yeah, and you’ll see them all throughout the SANE facility also. They’re done by survivors, and people who’ve worked with survivors, to help show people that they can get through it and that they’re not alone with what they’re feeling.”

McGlamery walks through three initial screening rooms connected to a door that victims of sexual assaults enter when they come to the SANE facility. There, they meet an advocate and a nurse tried to collect evidence from the attack. After that, the client can take a shower…

“This is my favorite room of all the rooms, and I know that sounds really, really strange, but it’s true,” she said. “This is where the client can just take their time. They can take a long shower. We bring in new clothing for them so they can leave with dignity and respect. They are not identified as a victim when they leave here. When a client comes in, once they get to this point, and they take the shower, they come out and it’s like a different person, and it is just amazing to see how people leave here.”

The SANE facility runs as a nonprofit, and had seen over four thousand people from 2002 to late 2016. McGlamery explains why the facility stays open despite the high expense.

“It’s too important,” she contends. “There was a time where we really had to consider: it’s a hard program to run, because it’s expensive, but at the end of the day when we had to look at what to do to keep it going, our board, our community, they’re behind us 100 percent, because we know how important it is. We’ve got to do it. We can’t go backwards.”

McGlamery says there are major differences between a SANE facility and a hospital room. She says she would spend up to eight hours in the hospital with a survivor.

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“It makes all the difference to have someone who understands the work, understands how to be compassionate and how to be unbiased in doing that work, but still be empathetic and kind,” she said. “We had one survivor come in who went to the hospital first and the doctor said something along the lines of ‘What did you learn from this.’ And that survivor almost did not come here because if that’s your experience with someone you’re supposed to trust how do you go somewhere else, and who knows what they’re going to say to you?”

Beyond the gentle treatment for victims of sexual assault, there are issues of evidence collection and dealing with the trauma.

“You can’t look at someone and know that they’ve been raped,” said Dr. Patricia Speck. “You can look at someone and know if they’ve had a trauma.

Among Speck’s many titles, she is the coordinator of advanced forensic nursing at UAB.

“In these situations, we have to look at it scientifically. It’s the way I look at it with my research,” she said.

And the number of assaults appears alarming. A report by the Centers for Disease Control and Prevention says almost thirty five percent of rape survivors were first attacked between the ages of 18 and 24. The National Research Council did a study and found that eighty percent of these attacks go unreported. These groups deal with the numbers. People Like Speck deal with the victims, and what that does to caregivers.

“However, it takes its toll on your health, and particularly your mental health. So I think there’s a common experience in human beings about being sad about an outcome,” Speck observed. Speck says this presents a problem…

“So when we medicalize it, we basically tell them you’re no longer normal, when in fact they are very normal. They’re very normal,” Speck said. “What they feel is very normal, and how they manage it, they need help, because nobody is prepared for sexual assault trauma.”

People who have experienced sexual assault need specific care in the hours after the event. This includes medical exams, evidence collection, and a strong support system. This is what SANE was created to be. Speck says the role is one comparable to a CPR technician in the Emergency room.

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“Think about it like this: in the emergency room, everyone knows CPR, but there’s going to be two or three in the emergency room that are going to actually be able to teach it and have advanced skills,” Speck contended. “They had to go and get the education in order to do that and be confirmed to be competent in that role.”

Speck says she’s seen a lot of change happen in her time studying sexual assault, especially when it comes to societal standards.

“What women my age would put up with, our daughters and granddaughters will not, and so for that I’m very grateful, but I also realize it’s not a nice world out there,” Speck said. “Where supervision around children, adolescents, and young adults is the only insurance against rape. That’s what kept me interested. I also felt that I was—I didn’t feel it. I saw it. Victims that came to me, left better off because I was a nurse.”

DCH Regional Medical Center partnered with community agencies to create a SANE program at the end of June this year. This follows the suicide of Former University of Alabama student Megan Rondini. She accused a local man of assaulting her. Megan left the University of Alabama in 2015, and killed herself a year later. Terri Snider is the director of the emergency department at DCH as well as a registered nurse. She says the agencies working on the SANE program are currently deciding which SANE model would work best for the Tuscaloosa community.

“There’s hospital based models. There’s community based models, and the community based model seems more compassionate to the sexual assault victims because when you’ve been sexually assaulted, you certainly don’t want to have to be in the ED because you’re already traumatized,” said Snider. “It’s loud down there. People are coming and going. So if we can get them in a place where it’s more serene, quiet, and offers them a sense of privacy, that’s kinda what we would want to do.”

Snider says the hospital currently sees around 70 to 75 cases every year. Already twenty-six nurses at DCH have volunteered to take classes to become SANE certified.

“The nurses that have expressed interest want to provide that care to those people. They want to support the victims of sexual assault,” Snider said. “Cause a lot of times when you hear sexual assault victims talk, they’re trying to come up with reasons why, you know, I shouldn’t of done this or I shouldn’t have done that. You’ve got to reassure them ‘it’s not your fault.’ This is not your fault.”

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Overall, Snider is positive that whatever program is placed in Tuscaloosa will be the right one, much like the SANE facility in Birmingham, and whoever becomes the director will be empathetic and help all that come through the facility’s doors. Whoever becomes the director of the Tuscaloosa SANE facility will have to talk to survivors, and Meg McGlamery has a message they can learn from…

“The first thing that I’d want any survivor to know is that it’s not their fault. No one deserves to be hurt in this way,” said McGlamery. “It doesn’t matter what you were doing or not doing, what you’re wearing or not wearing. Every person has the right to be respected, periodThe second thing is, whatever they did to survive is the right thing to do. If that means that you have to comply to survive, then that is the right thing to do. And so it seems to be that a lot of survivors beat themselves up for not fighting back or for not getting away. Most of the time people freeze. They can’t fight back, they can’t get away. So it’s really important that survivors get that message. Whatever they did to survive, right thing to do. And that we believe them. We believe them

The goal is to avoid future cases like Megan Rondini’s.

That story came from the Alabama Public Radio archives as APR celebrates forty years on the air. You can hear all of these stories by going to our website, apr.org.

Former APR intern Katie Willem covered stories for the newsroom ranging from the sexual assault SANE Nursing program, a voting registration drive by U.S. Senator Doug Jones, and University of Alabama researchers studying a 2017 solar eclipse.
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