Major drop in sexual assault nurse examiners in N.B. since 2015

The province has seen a dramatic drop in the number of nurses able to examine and gather evidence from victims of sexual assaults in hospitals, members of the legislature were told Thursday.

The Horizon Health Network has 26 sexual assault nurse examiners, according to interim president and CEO Margaret Melanson.

That's down from around 40 in April 2021, according to Health Department numbers quoted by Green MLA Megan Mitton, and not all hospitals had someone available around the clock.

"This is a program obviously with gaps, that is fragmented," Melanson told the public accounts committee.

And the Vitalité Health Network went from 40 nurses trained in the service in 2015 to 14 today, CEO Dr. France Desrosiers said. Those 14 nurses cover eight hospitals.

"We are playing with fire," Liberal MLA and health critic Jean-Claude d'Amours said, questioning how 14 nurses could possibly provide the service at all those hospitals all the time.

Both health authorities said the COVID-19 pandemic complicated their efforts to train more nurses to provide the service.

"We suspended this training during COVID-19 but what we did not suspend was sexual assault," Progressive Conservative MLA Andrea Anderson-Mason said.

Despite the dwindling numbers, Vitalité has managed to maintain the service with no gaps, Desrosiers said.

"Our patients don't go to the nurses. Our nurses go to our patients, and they cover a huge territory …  so we can offer a 24-7 service," she said.

"They work very hard, they're very dedicated, and they've been able to ensure 24-7 service since they've been there. There's been no shutdown or cut or reduction to service." 

The shortage of SANE nurses became the latest example of strained health services in the province after a sexual assault victim went public with her experience at Horizon Health's Dr. Everett Chalmers Hospital in Fredericton.

The woman told CBC News that she was turned away at the emergency department and told to make an appointment for the next day because there was no SANE nurse on duty that night. She eventually saw a nurse who was called in after a police officer insisted on it.

The evidence gathered in such an exam can be crucial to getting a sexual assault conviction in court.

Horizon Health has launched a review of its SANE staffing.

"I would be very interested to liaise with Vitalité and the provincial coordinator and determine if there are best practices that we should be capitalizing on within the Horizon Health Network as well," Melanson told reporters.

The 26 nurses in Horizon provide the service in its five regional hospitals in Moncton, Saint John, Fredericton, Miramichi and Waterville. The nurses in Moncton also cover Vitalité patients in that health zone.

Melanson told the committee 300 exams are done every year and there have been 63 at the Fredericton hospital since April.

Desrosiers said the smaller number of nurses in the SANE program is a reflection of the staffing crunch in health care overall.

"There are human resource challenges everywhere. There are other units in real difficulty that are extremely important for patient survival."

Vitalité saw 152 nurses quit their jobs in 2021-22 for reasons other than retirement. They cited workload and a feeling there was a lack of support for them.

The nurses who left had an average age of 34, meaning they might have worked for two or three more decades had they stayed.

Desrosiers said the drop in SANE nurses is mostly due to retirements, maternity leaves and training challenges during the pandemic.

The health authority tries to train nurses in the program each fall, and those with the training must do three hours of education a month to maintain their status.

Desrosiers said it's "an option, absolutely" to train all nurses in the exam, but those who do it usually have to spend two or three hours with a victim and that's not feasible in a busy emergency department.

Anderson-Mason said it was important to be careful discussing the shortage.

She said there's been so much attention paid to emergency department and ambulance problems that some people feel they're being told not to seek emergency care even when they need it. 

"We do not want to go down the same road when it comes to sexual assaults," she said. "We want to make sure we continue to emphasize the message that if you are a victim of sexual assault, it's important to report." 

Earlier this year, the province's SANE coordinator said there were 80 nurses trained to do the examination.

Melanson said she couldn't explain what that number is relative to the 26 nurses in Horizon and the 14 in Vitalité.

"I can't speak to those particular numbers," she said.