{"id":1473,"date":"2020-02-17T09:02:29","date_gmt":"2020-02-17T17:02:29","guid":{"rendered":"http:\/\/sdc.wastateleg.org\/dhingra\/?p=1473"},"modified":"2020-10-20T16:55:51","modified_gmt":"2020-10-20T23:55:51","slug":"washington-needs-more-sexual-trauma-nurses-but-who-trains-them-becomes-a-statewide-debate","status":"publish","type":"post","link":"https:\/\/senatedemocrats.wa.gov\/dhingra\/2020\/02\/17\/washington-needs-more-sexual-trauma-nurses-but-who-trains-them-becomes-a-statewide-debate\/","title":{"rendered":"Washington needs more sexual trauma nurses, but who trains them becomes a statewide debate"},"content":{"rendered":"<header class=\"article-header \">\n<div class=\"article-dateline\">From <a href=\"https:\/\/www.seattletimes.com\/seattle-news\/politics\/sexual-assault-victims-continue-to-be-turned-away-from-hospitals-so-why-does-harborview-not-support-more-training-programs-for-nurses\/\">The Seattle Times <\/a><\/div>\n<div><\/div>\n<\/header>\n<div id=\"div-gpt-ad-right\" class=\"dfp-ad ad ad-right u-fr ml-15 mb-15\" data-google-query-id=\"CO7S6cCH2ecCFQt-YgodxxYJTg\"><\/div>\n<div class=\"article-body e-content\">\n<div class=\"article-byline\">\n<div class=\"byline-text single_author u-dib\">\n<div class=\"title vcard\">OLYMPIA \u2014 In Washington, victims of sexual assault continue to be turned away from hospitals that don\u2019t have specially trained nurses who can administer rape kits \u2014 a problem contributing to what state officials are calling a \u201cpatchwork response to sexual assault.\u201d<\/div>\n<\/div>\n<\/div>\n<div id=\"article-content\" class=\"article-content entry-content\">\n<p>A 2019 Department of Commerce\u00a0<a class=\"content-link external\" href=\"http:\/\/www.commerce.wa.gov\/wp-content\/uploads\/2019\/12\/Report-SANE-Final.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">report<\/a>\u00a0found that nine counties across the state have no hospitals with Sexual Assault Nurse Examiners (SANEs). Nineteen counties have only one hospital each with SANEs. There are 290\u00a0SANEs practicing in the state, but rural counties, many of which are in Eastern Washington, continue to be underserved.<\/p>\n<p>Now, state lawmakers are attempting to fund the training of more SANEs in rural communities.<\/p>\n<p>Advocates say a program should be created\u00a0and funded at Washington State University. But the UW\u2019s Harborview Medical Center is balking at the idea, arguing that they should remain the sole training program, and that an additional program would jeopardize its already unstable funding.<\/p>\n<p>Rep. Gina Mosbrucker, R-Goldendale, introduced\u00a0<a class=\"content-link external\" href=\"https:\/\/app.leg.wa.gov\/billsummary?BillNumber=1942&amp;Initiative=false&amp;Year=2019\" target=\"_blank\" rel=\"noopener noreferrer\">a bill<\/a>\u00a0last year to fund a SANE training program at WSU, and is pushing for the funding again this year in the form of a budget proviso, as lawmakers are halfway through their 60-day session.<\/p>\n<p>\u201cThere\u2019s been pushback from Harborview Medical Center, which is very frustrating,\u201d Mosbrucker said.<\/p>\n<div class=\"ad-container u-ofh u-bg-dark-off-white full-width-inset mb-4 mt-4 pt-0 ad-container-multiple body1\">\n<div class=\"ad-container-inner mh-auto u-df flex-nowrap\">\n<div id=\"div-gpt-ad-body1c\" class=\"dfp-ad ad ad-multiple\" data-google-query-id=\"CNLfsc2G2ecCFdMCrQYdtbALXA\">\n<div id=\"google_ads_iframe_\/81279359\/seattletimes.com\/seattle-news\/politics_4__container__\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>This is not the first time the UW has opposed an expansion in WSU\u2019s medical education. In 2015, the Legislature approved the creation of WSU\u2019s medical school, which had intense opposition from the UW, which had previously monopolized medical education in the state. Some lawmakers who had to mediate the spat saw it as a\u00a0<a class=\"content-link\" href=\"https:\/\/www.seattletimes.com\/seattle-news\/wsu-approves-medical-school-plans-despite-uw-objections\/\">territorial feud<\/a>.<\/p>\n<p><strong>\u201cUs or them\u201d<\/strong><\/p>\n<p>In Washington, 45% of women and 22% of men experience sexual violence in their lifetime, according to the Commerce report. But just a fraction of victims report their assaults, often citing, among other factors, how re-traumatizing the process can be.<\/p>\n<p>Administering a rape kit involves performing an invasive forensic exam that can take hours. Yet, they are recognized as being vitally important in helping preserve DNA evidence in sexual assault cases that land in court.<\/p>\n<p>As part of Harborview\u2019s training, nurses undergo five days of trauma-informed training, learning how to administer the multistep forensic exams. Nurses are given in-field experience and are trained on how to testify effectively when a rape kit is introduced as evidence in court.<\/p>\n<p>Some advocates say Harborview\u2019s monopoly on SANE training has led to the regional disparity in access to SANEs.<\/p>\n<p>Once or twice a year, Harborview\u2019s SANE program travels to a rural community to provide training, but the trainings are abbreviated and less in-depth.<\/p>\n<div class=\"ad-container u-ofh u-bg-dark-off-white full-width-inset mb-4 mt-4 pt-0 ad-container-single\">\n<div class=\"ad-container-inner mh-auto u-df flex-nowrap\">\n<div id=\"div-gpt-ad-body2a\" class=\"dfp-ad ad ad-single\" data-google-query-id=\"CI-jl63-2OcCFa4C-QAdbc0Ljg\">\n<div id=\"google_ads_iframe_\/81279359\/seattletimes.com\/seattle-news\/politics_5__container__\">If nurses in rural communities want the full, five-day training, they must travel to Seattle. Mosbrucker, who is from a rural county of about 22,000 people, says that\u2019s not good enough.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>\u201cThese are rural, small hospitals that don\u2019t have the ability to call in another nurse and to send you to Harborview,\u201d Mosbrucker said. \u201cPlus, they have to take care of daycare, plus they have to pay for a hotel \u2026 we can just do so much better as a state.\u201d<\/p>\n<p>Because of these barriers, some rural nurses are administering rape kits with informal and inadequate training, according to the Washington State Nursing Association. The association says these nurses fear losing their licenses, but administer rape kits anyway so that rape survivors aren\u2019t turned away.<\/p>\n<div id=\"userMessagingInset\" class=\"user-messaging animate loaded\">\n<div>\n<div class=\"NewsletterSignupInset \">\n<div class=\"copy-wrapper\"><\/div>\n<div class=\"button-wrapper\">WSU\u2019s College of Nursing has been pushing to start its own pilot training program with the eventual goal of getting accredited by the International Association of Forensic Nurses (IAFN) \u2014 something Harborview\u2019s program doesn\u2019t have.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>According to Kim Day, grant projects director at IAFN,\u00a0 there is no reason why a state, especially one as geographically divided as Washington, could not have multiple training programs.<\/p>\n<p>Terri Stewart, Harborview\u2019s SANE program director, argued that a second training program may not be up to Harborview\u2019s standards, and that the programs are \u201cexceptionally expensive.\u201d<\/p>\n<div class=\"ad-container u-bg-dark-off-white full-width-inset mb-4 mt-4 pv-2\">\n<div class=\"teadsNative\">Stewart said there should only be one program \u2014 \u201cus or them.\u201d<\/div>\n<\/div>\n<p>However, Wendy Williams-Gilbert, program director for the WSU College of Nursing, says other kinds of nurses are trained in different nursing schools throughout the state and country.<\/p>\n<p>\u201cJust think about how many nursing programs we have, and they all produce good nurses,\u201d Williams-Gilbert said. \u201cThat argument is a weak argument.\u201d<\/p>\n<p>Stewart would not disclose the cost of Harborview\u2019s program, but the Department of Commerce estimated that a more \u201crobust, reliable state-level training,\u201d with more frequent trainings, more locations, and scholarships to cover travel expenses would cost $375,000 annually.<\/p>\n<p>Williams-Gilbert said WSU would need $50,000 from the state to start its pilot program.<\/p>\n<p>Lawmakers are currently working on a supplemental budget, which would adjust the current $52.4-billion, two-year state operating budget they passed last year.<\/p>\n<div class=\"native-ad-article u-bg-dark-off-white full-width-inset mb-4 mt-4 pt-0\">\n<div class=\"ad-container-inner mh-auto u-df justify-content-between flex-nowrap\">\n<div id=\"ntv1103139-0-97379\" class=\"native-story ntv1103139-0-97379 ntvClickOut\">\n<article class=\"ntv-story\">\n<div class=\"results-story-body\">\n<p>Williams-Gilbert said the college already has the community support, with volunteers offering to help start the program. She added that the college has reached out to Harborview in order to collaborate, to no avail.<\/p>\n<\/div>\n<\/article>\n<\/div>\n<\/div>\n<\/div>\n<p>\u201cI was shocked,\u201d Williams-Gilbert said. \u201cI assumed we would all just work together because it\u2019s so important for our communities to have these hospitals.\u201d<\/p>\n<p><b>Moving forward<\/b><\/p>\n<p>Last year, lawmakers passed\u00a0<a class=\"content-link external\" href=\"https:\/\/app.leg.wa.gov\/billsummary?BillNumber=1016&amp;Year=2019&amp;Initiative=false\" target=\"_blank\" rel=\"noopener noreferrer\">a bill<\/a>\u00a0limiting the amount of time hospitals can delay telling a sexual assault victim that they cannot, in fact, administer a rape kit. Untested or destroyed rape kits have also been a topic of\u00a0<a class=\"content-link\" href=\"https:\/\/www.seattletimes.com\/opinion\/editorials\/more-to-do-on-sexual-assault-justice\/\">discussion.<\/a><\/p>\n<p>But the issue of hospitals being able to administer kits in the first place remains unresolved.<\/p>\n<p>Last year,\u00a0Commerce report concluded that in order to address the lack of SANE availability and access, Washington needs a \u201cmore robust, state-wide approach.\u201d<\/p>\n<p>It cites Massachusetts, which has a state-wide SANE program funded with $3.8 million from the state budget. The state has 178 SANEs and 29 hospitals staffed with SANEs, according to Joan Meunier-Sham, director of Massachusetts\u2019 SANE program.<\/p>\n<div class=\"ad-container u-ofh u-bg-dark-off-white full-width-inset mb-4 mt-4 pt-0 ad-container-single\">\n<div class=\"ad-container-inner mh-auto u-df flex-nowrap\">\n<div id=\"div-gpt-ad-body5a\" class=\"dfp-ad ad ad-single\" data-google-query-id=\"CIWj44WH2ecCFQrLWwodomkJwQ\">\n<div id=\"google_ads_iframe_\/81279359\/seattletimes.com\/seattle-news\/politics_6__container__\">For more isolated hospitals, \u201cteleSANEs\u201d are available to provide video-chats while rape kits are administered, so that no victim is turned away from a hospital, Meunier-Sham said.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Although Massachusetts only has one training location, Meunier-Sham said it\u2019s not an issue in the relatively small state, as nurses rarely have to drive more than two hours for training.<\/p>\n<p>\u201cOur program often gets looked at as a golden standard across the country,\u201d Meunier-Sham said.<\/p>\n<p>Oregon has a statewide certification system and multiple training locations. But its sexual assault forensic task force says there\u2019s still a lack of SANE-trained medical staff.<\/p>\n<p>Without a statewide system, Washington is struggling to get hospitals to coordinate sexual assault care. Currently, SANEs can only administer rape kits at hospitals they have been contracted with, Stewart said.<\/p>\n<p>\u201cWe can\u2019t even send a nurse to the UW without a contract,\u201d said Stewart about Harborview.<\/p>\n<div class=\"ad-container u-ofh u-bg-dark-off-white full-width-inset mb-4 mt-4 pt-0 ad-container-single\">\n<div class=\"ad-label font-micro u-tc u-mid-light-gray u-sans pv-10 u-upper\">Sen. Manka Dhingra, D-Redmond, is sponsoring <a class=\"content-link external\" href=\"https:\/\/app.leg.wa.gov\/billsummary?BillNumber=6158&amp;Initiative=false&amp;Year=2019\" target=\"_blank\" rel=\"noopener noreferrer\">a bill<\/a>\u00a0that would require the Office of the Attorney General to create a task force with the ultimate goal of developing protocols for hospitals to have \u201ccoordinated community\u201d responses when rape victims present.<\/div>\n<\/div>\n<p>Dhingra said the hope is that every hospital, whether they can administer a rape kit or not, will have a plan to help victims in a timely and trauma-informed way, letting victims know their resources and helping them get to a facility that can provide proper care.<\/p>\n<p>Andrea Piper-Wentland, executive director of the King County Sexual Assault Resource Center, expressed support for the bill, saying hospitals\u2019 responses to victims is a \u201ccritical point\u201d where individuals need to be connected to all of their resources.<\/p>\n<p>While testifying in favor of the legislation last month, one woman told lawmakers that after being raped, the closest emergency room \u201cshrugged their shoulders and said \u2018we don\u2019t do rape kits here,\u2019\u201d telling her instead to go to Harborview.<\/p>\n<p>\u201cI was drugged and was in no position to drive, and I could not afford an ambulance, so I went home,\u201d she said.<\/p>\n<p>Another survivor testified that the emergency room she went to after being raped couldn\u2019t administer a rape kit, and sent her \u201con her way as if I was asking for brunch reservations.\u201d<\/p>\n<p>\u201cI sat in front of her (ER staffer) sobbing,\u201d she said. \u201cYou\u2019re left to figure it out alone in trauma.\u201d<\/p>\n<p>Senate Bill 6158 has passed the senate and is scheduled for a public hearing in the House Feb. 20.<\/p>\n<p>By Claudia Yaw<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>From The Seattle Times<\/p>\n<p>OLYMPIA \u2014 In Washington, victims of sexual assault continue to be turned away from hospitals that don\u2019t have specially trained nurses who can administer rape kits \u2014 a problem contributing to what state officials are calling a \u201cpatchwork response to sexual assault.\u201d<\/p>\n","protected":false},"author":16,"featured_media":1474,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"disable_featured_image":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[28],"tags":[],"class_list":["post-1473","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-the-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Washington needs more sexual trauma nurses, but who trains them becomes a statewide debate - Sen. 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