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American News Service

August 12, 1999

Faster Medical Response to Rape Helps Victims and Prosecutors

Karen Pirozzi

(ANS) -- As the emergency room doors of the metropolitan hospital swing back and forth admitting a flow of heart attack patients, car accident casualties and gunshot survivors, a bruised and shaken victim of a sexual assault sits alone in a seemingly endless wait for medical attention.

According to the D.C. Rape Crisis Center, in the District of Columbia victims have had to wait eight hours or more, all the while instructed not to eat, drink, shower or use the bathroom because doing so could destroy physical evidence. When the women is examined and treated, the doctor may be poorly trained in evidence collection, impeding the case.

Successful adopted in other areas and soon to be introduced to hospitals by the D.C. Rape Crisis Center is a program that assures such victims of a sexual assault get prompt attention from nurses specially trained in caring for rape victims and collection of evidence.

Denise Snyder, executive director of the Washington crisis center, said the Sexual Assault Nurse Examiner (SANE) program is proving highly effective. "These nurses won't have other responsibilities, and their training is stronger than that of other emergency room personnel," Snyder said. "They'll be better trained to identify with the woman and they'll make stronger expert witnesses. It's really a win-win-win situation for the police, the victim and prosecutors."

SANE programs have received high praise from health care workers, law-enforcement officers and sexual assault victims themselves.

In 1991, when Sue Brown was instrumental in starting the SANE program at Inova Fairfax Hospital in northern Virginia, it was one of the first programs of its kind in the country. Now there are approximately 100 SANE programs across the United States and the Justice Department's Office for Victims of Crime recently developed a guide for organizations interested in developing such a program to help improve response to the more than 300,000 sexual assaults that take place in this country each year.

SANE programs may be run by rape crisis centers, hospitals, municipalities or other organizations and funded through private or public funds.

"In an emergency department, it's hard to get a medically stable patient in to be seen," said Brown, coordinator of the Fairfax program. "The waits have traditionally been three to six hours. That's inappropriate. I remember thinking that there had to be a better way."

The SANE system prevents long wait times, she said, but ensures that evidence will be collected by people who are well trained and conduct the exams often enough to remain proficient.

A SANE nurse completes about 80 hours of training and must maintain expertise with continued training and a minimum number of exams each year. In contrast, a typical emergency room doctor has little training in gathering forensic evidence and may complete only one or two such exams each year. The doctor is not only rushed and pressured but often ends up reading exam instructions as he or she goes along.

And while many doctors wanted to avoid sexual assault evidentiary exams because they can lead to time-consuming court appearances, SANE nurses' job includes that of expert witness, and their experience gives them a distinct edge in that role.

Mark Purcell, a detective in the Alexandria City Police Department, said most rape cases, especially those involving acquaintance rape, end up before a jury. SANE nurses' expert testimony carries a lot of weight, especially in acquaintance rape cases where subtle forensic evidence is often the only barrier between a her-word-against-his situation. "They make tremendous expert witnesses," he said. "They're very hard to impeach."

Purcell, who along with his partner handles sexual assault cases for the city, said the Inova Fairfax Hospital SANE program has led to more rape convictions. First, he said, the sensitive treatment of victims gives them greater confidence in the system and increases the likelihood they'll cooperate in the investigation. Second, the evidence and expert testimony provides juries with stronger evidence to convict.

"The doctors really didn't want to do the exams, and that attitude came across," he said. "With SANE the women are treated special. Right away they get a good feeling, and it helps give them confidence to go on."

Once, he said, before SANE was initiated, he waited in the emergency room with a victim for several hours. He asked a passing nurse when the woman might be treated. When the nurse replied that staff members had more serious things to do, the distraught woman left the hospital. It wasn't until the next day, when much evidence was likely destroyed, that Purcell was able to get the victim to come back to the hospital for an exam.

"The SANE program is like coming out of the Dark Ages," he said.

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Karen Pirozzi is a free-lance writer based in Albany, N.Y.


Sue Brown, SANE coordinator, Inova Fairfax Hospital, Falls Church, Va., 703-698-3505; fax: 703-280-3821; e-mail: <legalsane@aol.com>.

Mark Purcell, detective, Alexandria City Police Department, Alexandria, Va., 703-838-4349; fax: 703-838-4604.

Denise Snyder, executive director, D.C. Rape Crisis Center, Washington, D.C., 202-232-0789; fax: 202-387-3812; e-mail: <dcrcc@erols.org>; web site: <http://www.dcrcc.org>.


Linda Mansour, spokesperson, Office of Congressional and Public Affairs, Office of Justice Programs, U.S. Department of Justice, Washington, D.C., 202-616-3534; fax: 202-514-5958; e-mail: <mansour@ojp.usdoj.gov>; web site: <http://www.ojp.usdoj.gov>.