Deborah Taylor has a common profession but an uncommon certification: this Methodist Medical Center nurse is a Sexual Assault Nurse Examiner (SANE), which places her front and center in the aftermath of rape. “SANE is a national certification attained after attending a 50-hour classroom training, meeting clinical requirements, and taking a national certification exam. This is relatively new to Illinois, but other states have been using SANEs since their inception in the mid-1990s. Before SANE, if a sexually assaulted person—male, female, child, or elderly person—was brought to the Emergency Department (ED), any nurse would attempt to care for them,” she said.
Though she had been a registered nurse for 22 years, Taylor said there was a lot to learn when she was certified. “After the classroom training, I had to come back to the ED and learn the mechanics of the pelvic exam. SANEs do the whole exam; this allows the assaulted individual to have one examiner throughout the experience. Our goal is to guide them through the evidence collection with as much of their dignity intact as possible. Rape is a life-changing traumatic event. It’s theft of human dignity. The goal of a SANE is to collect forensic evidence while providing victim-centered, compassionate care. One statement made in training stopped me in my tracks and has really guided my practice: ‘people won’t remember what you say, they won’t remember what you do, but they will remember how you make them feel.’ People feel at their lowest when we see them after an assault, and we’re changing the way we care for them.”
This new approach to care has been a community effort, she said, with both OSF and Methodist choosing to have certified SANEs on staff (Methodist currently has two) and other area organizations joining forces. “Training is put on in cooperation with the Center for Prevention of Abuse. Nancee Brown is the medical legal advocate from the Center and is a key player in pushing our area to improve victim care. It’s important to have SANEs, as opposed to regular ED nurses, because we’re specially trained. I was amazed when I went to training and realized the injustice I was doing to people I treated after an assault. After training, I was able to ask more and better questions of assault victims. I look deeper for possible clues. I listen closer, document more, and communicate better. I’ve learned this person is a crime scene, and I have to treat them as such in order for the assailants to be brought to justice.”
Taylor said the medical community and law enforcement agencies work cooperatively after an assault. “We’ve made an effort to teach the police about what we have to offer. Recognizing and handling victims as crime scenes and presenting evidence is a real benefit to them. Nurses are also more available to testify in trials than physicians are, so this, too, helps strengthen their cases. Part of changing the culture has been to change the way we—police and the medical community—work together. I’m married to a Tazewell County detective, so we have some interesting and sometimes heated discussions about cases. I’ve found he’s an excellent resource for me, and he’s found I am to him as well. We’re working together with the police better every year; our roles and perspectives are different, but they’re all important.”
The Center for Prevention of Abuse—specifically, the Inner Strength Program—is an integral part of navigating the experience of the sexual assault patient, Taylor said. “We call them immediately when we become aware of a possible assault, and they send a patient advocate. The role of the advocate is to help the patient emotionally through the exams. Advocates help the nurses by comforting the patient during a particularly trying time. They also advise the patient about services provided by the Center, discuss follow-up counseling along with medical needs, and are knowledgeable about rights of the victims. Advocates know how to help keep survivors safe by offering shelter, fixing a window the attacker may have broken, changing locks if necessary, and obtaining orders of protection or a civil no-contact order. The Center also provides clothes for victims since clothing is usually held for evidence.”
Ideally, Taylor would like to see a standard of care for sexual assault where every victim got a SANE nurse, though she’s aware of potential obstacles. “If the police would call ahead to the Emergency Department when they knew they might need a SANE nurse, it would give the ED time to mobilize prior to the victim’s arrival. The Peoria area needs more SANE nurses, but it’s trying work emotionally, so not everyone is cut out for it. I feel too much of what my patients feel, and it costs me a piece of my emotional health. Doing this work costs the caregiver some precious sense of safety. You realize safety is an illusion. Statistically, one in four women and one in seven men have been victimized.”
Though her work can be very difficult, Taylor said the best part about her career is using her God-given gifts to embrace patients and their families during their time in her care. “I see them, comfort them, and attempt to ease their suffering. When I give lectures to people about the Sexual Assault Response Team, there’s a picture of a little dog perched on a tightrope, and the caption reads, ‘I am bigger than anything that can happen to me.’ I want my patients to feel that way. There’s another quote that keeps me going: ‘Never doubt a small group of committed citizens can change the world. In fact, it’s the only thing that ever has.’ I want to be a part of that small group of committed citizens. I want to help change the world—at least my part of it. It’s hard to put into words, but my work captures me, and when I’m engaged in caring for a sexual assault patient, trauma patient, or sick child, time goes so quickly because I thoroughly believe I was born to do this.”
She offered advice for helping prevent assaults. “When you go out with friends, stay together. Don’t accept drinks from other people, and never leave your drink unattended. Alcohol is the most common drug used in drug-facilitated sexual assault, but it’s not the only one. Be aware. If you begin to feel more drunk than what you’d normally feel after a specific amount of alcohol, you may have been drugged. Seek help, but stay with your friends. Date rape drugs often make you feel sick, so you go to the bathroom alone, and guess who’s waiting there to ‘help’ you and take you home?”
Fighting the injustice she sees as a result of these attacks keeps Taylor going strong on her chosen path. “We all have the right to live free of family violence and sexual assault, yet our society has the highest rate of sexual assault among developed countries. Eventually, you’ll be acquainted with a survivor or you may be a survivor yourself. Speak out, and make people aware of this issue. Rape is theft of human dignity, and no one should have to experience it. But if an assault occurs, know we’re here, and let us help you.” TPW