Demand for sexual assault nurse examiner services rises as staffing drops

The number of people seeking sexual assault nurse examiner services at Horizon hospitals is on track to exceed the past two years, while the number of nurses trained to perform them is dropping.

A total of 143 people have accessed sexual assault nurse examiner (SANE) services between April 1 and the end of September, according to data provided by Horizon.

If that trend continues, the number could reach about 286 by the end of 2022-23.

By comparison, 225 SANE patients were recorded in 2021-22 and 240 in 2020-21, the data shows.

In 2019-20, there were 327 victims of sexual violence or domestic violence who requested the services, which include forensic exams, commonly referred to as rape kits, medical exams, medications to prevent pregnancy and sexually transmitted diseases, compassionate support and resources for followup.

Four sexual assault nurse examiners have resigned since Sept. 12, when CBC News reported that a 26-year-old woman who had been sexually assaulted was turned away from the Fredericton ER because no one trained to perform the exam was available.

The victim, who is not being named by CBC News, said she was told to go home overnight, not shower or change, and to use the bathroom as little as possible to help preserve any evidence until an appointment the next day.

The nurses who resigned — two from Fredericton and two from the Upper River Valley area — felt "disrespected" by comments by the premier and Horizon CEO, according to Janet Matheson, a member of the Fredericton unit. "You've got to support your staff," she said.

Premier Blaine Higgs had described the incident as "unacceptable" and "reflective of a process guided by very poor decision-making and a lack of compassion."

Horizon now has 22 nurse examiners. That's down from about 40 last year, interim president and CEO Margaret Melanson has said.

There are eight nurses in the Moncton area, six in Saint John, three in Fredericton, three in Miramichi, and two in the Upper River Valley.

They provide the 24/7 service, either on staff or on call, on top of their regular nursing shifts.

Matheson, 69, said she and her colleagues in Fredericton and the Upper River Valley will pick up as much as they can to try to cover the gaps left by the resignations.

"It won't be perfect. It won't be 100 per cent. It won't even be 90 per cent now," she said.

A Horizon review of the program, triggered by the Fredericton woman's case, is expected to be completed "in the coming weeks," Greg Doiron, vice-president of clinical operations, has said.

Horizon is "working on a plan to enhance the SANE service and develop a more robust and sustainable program that will best leverage the skills of our expert nurses to meet the needs of survivors," he said in a statement.

"A few people" have expressed interest in being trained, according to Matheson. "Whether that really comes to fruition, who knows?"

Matheson, who has been a nurse for 45 years and sexual assault nurse examiner since 2006, says it's not for everyone. In addition to the specialized training and being on call, it requires continuous education and can be difficult emotionally, she said, noting the victims are sometimes children.

The Vitalité Health Network also provides sexual assault nurse examiner services. It has 14 nurses covering eight hospitals, down from 40 trained nurses in 2015.

Vitalité did not immediately respond to a request for 2022-23 statistics, but it served 177 SANE patients in 2021-22. That's down from 214 in 2020-21 and 182 in 2019-20.