In honor of Resilience’s 45th anniversary and our theme “Celebrating Resilience,” we’re celebrating the people who make #OurResilience possible and telling the stories of some of our biggest supporters.
This month we’re celebrating the Sexual Assault Nurse Examiners (SANEs) who partner with us to help us achieve our vision of a world free of sexual violence for everyone.
Serving as a SANE since 2012, Kindra Nelson is one of Resilience’s most important supporters. Keep reading to learn more about Kindra and click here to learn more about the 24-hour support we provide at 17 hospital emergency departments in Chicago.
When did you start working as a Sexual Assault Nurse Examiner (SANE)?
I began working as an AA [Adult and Adolescent] SANE in 2012
How is your work as a SANE nurse different from the work of a traditional nurse?
There is currently not much of a legal difference between what is required as an Emergency Department (ED) Staff Nurse and a SANE. Actually I was working as a Staff Nurse and had to perform the Medical Forensic Exam under the guidance of an ED attending. What that means is the attending MD [physician] pops their head in for the genital exam, the ED nurse is responsible for the rest of the medical forensic exam. My practice has improved exponentially through the years. I continue to learn more almost weekly as to how to obtain the most evidence and improve my documentation. Now, I am able to practice without the guidance of an MD as a SANE. Being a SANE has improved my understanding of the process of evidence collection, but most importantly, injury identification. It has been my experience that there almost is always something to find, you really just need to know how to look
Why did you decide to get trained as a SANE? What was your training like?
I decided to go to training because as a ED Staff Nurse it was my legal responsibility to perform the Criminal Sexual Assault Kit. Sure the box has instructions but it is really insufficient. As a baby ED RN [Emergency Department Registered Nurse] I completed approximately 10 kits my first year. I was terrified I was not doing what was best for the patient. After training I now know I was not. There are so many specific aspects to the medical forensic exam. As a SANE Coordinator I teach; forensic photography, alternate light source, injury identification, and the medical forensic exam. These courses were not offered to me as a staff nurse and I attended many trainings to be proficient. The content is difficult for current ED nurses to support and understand. The exam requires an ED RN, SANE, or QMP [Qualified Medical Professional] to be at the bedside continually for a minimum of an hour and a half. This is nearly impossible in a busy ED environment without an on call or staffed QMP. The entirety of the medical forensic exam will take 4-6 hours.
So what was my training like? How much time do you have? I don’t think it will ever end. I attended the 40 hr didactic training which included an online component and 3 days of 8 hrs in the classroom. Throughout the following 8 months I completed my clinical component including; the state Forensic Photograph course, visiting the crime lab, seeing an expert witness testify in court, completing 15 female and male genital exams, performing 4 medical forensic exams aka kits, and visited the Child Victim Advocacy Center as well as what is now Our Resilience. Over the following 8 years I have attended the state task force meetings, forensic Fridays, Emergency Nurse Association SANE sigma [a nursing course] meetings, and through the collaboration of other SANEs vastly improved my practice. What is impressive is I continually learn more.
How do you talk to friends and family about your work with survivors of sexual violence? Are there any conversations that stand out to you?
I talk about how I feel. I tell my partner I had a rough case today and am felling particularly vulnerable because it affected me in whatever way. It is my experience not the patient’s that I share. I’ve grown in my ability to describe my emotions due to my work as an ED RN and as a SANE. You may be surprised to learn that nurses have what is called vicarious trauma. This is the emotional trauma people experience through helping others. It is real and difficult to hold/handle for an entire career. It is why the ED has the highest level of burnout and turn over.
What are the most challenging moments you’ve experienced while working with survivors?
This question is hard to answer regarding privacy laws and the confidence I share with those I provide care. I will tell you that a number of survivors have difficulty with the process of evidence collection as it triggers what has happened to them. When a survivor has a triggering moment because of something I am doing, that is the most difficult thing for me. Of course every aspect of the kit is explained and specifically consented but a person can never truly know how they will respond to swabbing such tender parts of their body.
Tell me about a time when working with survivors made you feel hopeful.
Hmm, hopeful… I don’t know that I experience that. So few survivors actualize justice. Out of 1000 rapes only 5 perpetrators will ever be incarcerated. The statistics are awful. I will say knowing I did everything possible to reduce retraumatization while collecting the most evidence possible makes me feel better for the survivor. I know I am one of the best people to meet on the worst day of your life. This knowledge is because I attend trainings and am active in the SANE community.
How has your relationship with Resilience impacted your work as a nurse?
My relationship with Resilience has greatly impacted my practice as a SANE. I am more sensitive to the needs of survivors because of their support. We approach the patient as a team. I know I have a ally for myself, as well as the patient, with me in the room. I love knowing that someone will follow up and care for the survivor.
What do you wish more people working in healthcare knew about supporting survivors of sexual violence?
Oh gosh, everything. What I have the largest issue with is the question, “Is it a real one?” Statistically people do not make up the fact they were sexually assaulted. We need to start by believing. It is not our job as healthcare professionals to determine if a sexual assault occurred. It is our job to care for our patients.
Is there someone who embodies resilience who has had a strong influence on you?
The person who most embodies resilience to me is Chere Hamilton. She continues to strive for excellence in her practice as an ED RN with every patient population that presents to our Level 1 trauma center. Somehow through years and years of service she maintains her sensitive approach to staff and patients alike. “Kill em with kindness.” That is not only a line told to me by her in my orientation as my preceptor, it is what she practices everyday. So when I think of resilience it is Chere’s face I see first. Thank you for coming to work everyday and giving your all. It does not go unnoticed.