Manitoba forensic nurses raise alarm over hiring for program to help sex assault victims

Two Manitoba nurses who work with victims of sexual assault and intimate partner violence say they're worried about how funding for the program is being used. 

The sexual assault nurse examiner (SANE) program is made up of specialized forensic nurses who collect evidence that can be used in sexual assault investigations, but they mainly work on a casual basis and often have jobs in other areas of the health system.

Earlier this week, the Manitoba Nurses Union raised concerns after it was learned that some victims presented at Health Science Centre when a nurse examiner was not on site, and were sent home and told not to change clothes or shower until they could be examined.

"We recognize that this is exceptionally difficult for anyone who has undergone a trauma of this nature and we are extremely committed and passionate about making significant improvements to this service so that this no longer occurs," Shared Health chief nursing officer Monika Warren said Friday during a news conference.

Manitoba Shared Health is in the midst of overhauling the program, bringing in permanent staff, but nurses who currently work with SANE say the way the new positions are classified limits their ability to care for victims.

The province has created seven new permanent positions for the program, which will be renamed the forensic nurse examiner program.

Five nurses have been hired, and a manager is expected to begin working in the coming weeks.

When those positions were initially posted, however, they were listed as Nurse 3 positions, which have the ability to move between facilities to meet patients, and must go through an interview process to be hired.

Those job postings were later revised as Nurse 2 positions, which are restricted to working at one facility, and jobs are allocated based on seniority within Shared Health, and not necessarily based on experience as a forensic nurse.

Heather Didora, a nurse who works with the program, said it is "retraumatizing" when victims show up at a hospital other than HSC and are told they must go somewhere else.

"We have had situations where they choose not to come see us, so patients are being missed and not seeking that care, because that's just one more barrier they have to get through to be able to see us," she said.

Between April 1, 2022, and Jan. 24, 2023, 764 patients presented to the program. In 14 of those cases, a forensic nurse wasn't available to provide the care needed. 

Shared Health says nine were able to be examined later the same day, one patient had to return the next day, and four ended up declining an exam. 

The province announced last year $640,000 annually to support the program and hire permanent positions.

Ashley Stewart, another nurse who works with the program, worries the nurses hired might not have the necessary experience. 

"Without that forensic nursing experience [it] could take anywhere between six months to a year before they can start seeing patients independently," said Stewart. 

Warren said the initial posting of the jobs as Nurse 3 positions was a mistake, and after reviewing the roles and responsibilities, Shared Health determined the jobs were consistent with a Nurse 2 position. 

"This proposal and this stage of our stabilization around the service, or building it up, was not intended to have HSC nurses travel to other sites," Warren said.

"Unless there was an extreme situation, the intent is for these staff to stay in our hub site, which is HSC, and support via Telehealth those that are referring in from other sites."

The service might get to a point where it can support nurses travelling to other facilities, but a decision has not been made yet, Warren said.