Ten years ago, Humboldt General Hospital took part in a landmark effort
to send local victims of sexual violence a very important message: You
are not alone.
That message was recently challenged by social media posts claiming the
hospital is refusing to perform “rape kits,” which according
to HGH Director of Community Education and Development Nicole Maher, is
a “gross mischaracterization” of the hospital’s obligation
to both victims and the justice that will put their perpetrators behind bars.
In February 2008, the hospital joined with the Humboldt County District
Attorney’s Office, the Winnemucca Police Department and the Humboldt
County Sheriff’s Office to create a Sexual Assault Response Team, or SART.
Since that time, the addition of Winnemucca Domestic Violence Services
provides an expansive array of advocacy services for local victims.
The formal network is designed to offer sexual assault victims compassionate
and competent care regardless of the length of time since the assault or abuse.
The team coordinates immediate and follow-up medical, advocacy and criminal
justice services to victims of sexual assault. Maher said this approach
increases the potential for recovery on the part of the victim and increases
local authorities’ ability to prosecute such crimes.
In mid-September, however, a community Facebook post charged the hospital
with neglect toward victims of sexual violence for not providing evidence-retrieval
examinations at the local facility.
The post’s author also accused the hospital of refusing to treat
victims’ visible wounds in the Emergency Department, and delaying
victims’ transport to the facility in Reno where a Sexual Assault
Nurse Examiner (SANE) can perform an evidence retrieval exam.
“We cannot allow people to spread such dangerous misinformation,”
said Maher, “especially when it could be shared with potential victims
who might believe their hospital is not available and ready to help them.”
Humboldt General Hospital is among the lion’s share of Nevada hospitals
that use an off-site SANE center for sexual assault examinations. In fact,
a recent survey by Nevada Rural Hospital Partners shows that of 25 Nevada
hospitals, only two, or 8%, do the exams on site—and one of those
is Sunrise Hospital in Las Vegas, which provides SANE exams for all other
Las Vegas facilities.
Once law enforcement activates the SART team, victims in Humboldt County
are transported to the Reno SANE facility, usually by WDVS advocates,
within hours of their presentation at the HGH Emergency Department, and
following any necessary examination and treatment of other wounds or bruises
that may have occurred during their attack.
WDVS Program Director Stephanie Johnson said advocates are highly trained
to provide safety, comfort, rest—anything a victim may need during
such a high-stress time.
“We completely abide by our clients’ wishes,” she said.
“Our job is to provide support in a way that continues to allow
them their dignity and their choice in everything they do.”
In fact, Johnson said many victims do not present until well after evidence
retrieval can take place; others do not wish to undergo the SANE process.
The number of people assaulted is much higher that those who choose to
undergo the SANE process.
“We are here to support any person who needs advocacy,” she
said. “The Sexual Assault Response Team’s job is to help victims
know they are not alone.”
Maher acknowledged that transporting victims to a SANE facility two hours
away in Reno is not ideal. “It’s an unfortunate circumstance
after victims have suffered a terrible injustice,” she said. And
yet, it’s the only way to ensure that victims’ needs are met
while also ensuring that authorities have the greatest chance at presenting
Establishing a local SANE RN would require the successful completion of
an approved course of study (40 hours for certification as an adult examiner,
or 64 hours for a course that combines both adult and pediatric certification)
as well as maintenance of proficiency, as required by current standards
of nursing practice.
It’s not an impossible curriculum except that training would need
to take place at the SANE facility in Reno, and according to Marissa Brown,
the Workforce and Clinical Services Director with the Nevada Hospital
Association, even Reno nurses are having difficulty obtaining competencies.
There are currently four trained nurses in Washoe and an additional four
more in training. Together they oversee 20-25 reported cases per month,
and yet one nurse, for instance, has been training for months and has
only had two cases—which falls far short of the required 40 hours
of needed training. Brown indicated that adding additional trainees from
rural facilities like Humboldt would burden the system, not help it.
But Maher said that’s only half the story. Because Humboldt County
only averages two to three sexual assault victims each year who agree
to the SANE process, the low volume of exams would not only make it impossible
for a local SANE to maintain proficiency but to provide “expert”
testimony during a court proceeding.
As Brown said, “This sets the nurse up for failure due to inexperience.”
Banner Churchill Community Hospital in Fallon, for instance, used to work
with the Naval Air Station, which has a SANE RN. However, that person
only saw five to six victims each year, which was too low to develop competencies,
so Fallon now also transports to the Reno center, as do Reno’s own
Humboldt County Hospital District Board of Trustees Chairman JoAnn Casalez
said the hospital is dedicated to doing everything possible to help with
evidence recovery in the most compassionate, private manner possible—“which
is why we currently have the system in place that we do,” she said.
“The future might hold something different,” she added, “but
for now, this is the best way we can support and advocate for local victims.”
Casalez, a former director of Winnemucca Domestic Violence Services, said
she hopes that one good thing that will come from the latest controversy
is an increase in public awareness that will lead to more reports of sexual assault.
“We want more victims to feel comfortable coming forward,”
she said, “and we want them to know that they are not alone; they
have an entire response team, including Humboldt General Hospital, that
is standing by, ready to lend support.”
For more information on the Humboldt County Sexual Assault Response Team,
or SART, please contact Winnemucca Domestic Violence Services at (775) 625-1313.