When Assistant Professor Andrea Sebastian, DNP, PNP, SANE-P, was a young nurse at Le Bonheur Children’s Hospital, she saw the same infant admitted to the hospital twice for abusive trauma.
“I thought, ‘This is where I can help’,” she said. “It was so heart-breaking to me that he was admitted two times for abusive injuries.” Dr. Sebastian, who is now an assistant professor at the UTHSC College of Nursing, began to do clinical work with the child abuse pediatrician at Le Bonheur and became part of the CARES (Child Advocacy and Resource Evaluation Services) team for the hospital. She went on to do postgraduate work as a pediatric forensic nurse examiner and attained her pediatric Sexual Assault Nurse Examiner (SANE) certification in 2020.
Forensic Nurses Week is Nov. 6-12, and it recognizes the important work of forensic nurses – registered or advanced practice nurses who have received specific education and training to provide specialized care for patients who are experiencing acute or long-term health consequences associated with victimization or violence. Dr. Sebastian leads a $1.5 million Health Resource Services Administration (HRSA) grant for the college that funds a much-needed expansion of Sexual Assault Nurse Examiner (SANE) training in the region. The training enables nurses to provide appropriate and sensitive care and evidence collection for patients who have suffered sexual assault. Once the nurses receive the training, they must accumulate 300 clinical hours before they can take the certification exam.
In the grant’s first year, 20 nurses from the 21-county West Tennessee area received training developed by the International Association of Forensic Nurses (IAFN), Dr. Sebastian said. That is a great improvement over the numbers prior to the grant, when there were just five certified SANE nurses in West Tennessee.
Dr. Sebastian estimates that 25 more nurses will receive training during the grant’s second year. The college also has established an Advanced Practice Forensic Nursing Certificate program that prepares licensed advanced practice nurses to provide forensic nursing care for assault survivors of all ages. In its first year, the certificate program will educate six nurses, with the goal of educating six to eight more by the second year. Applications are open for the certificate program at uthsc.edu/nursing.
James Fountain, RN, MBA, executive director of emergency services for West Tennessee Healthcare, is certain that the HRSA grant will make a difference in the counties covered by West Tennessee Healthcare (WTH). That system received a $198,260 sub-award through the HRSA grant that will allow him to place appropriate equipment for the assault exams in emergency departments throughout the system over the next two years. This includes two hospitals in Jackson-Madison County, as well as the hospitals in Dyer County, Martin, Milan, Camden, and Bolivar, Fountain said.
When he arrived at WTH in 2019, Fountain said there were three SANE-trained nurses in the system, and only one was certified. He set the goal of rebuilding the program. By the end of the grant’s first year, he will on-board eight to 10 newly-trained SANE nurses. Within three years, he expects the system to have 20 SANE-trained nurses. Fountain estimates that Jackson-Madison County General, which is a 700-bed hospital, has about 10 sexual assault cases each month, and he believes it is under-reported.
“This collaboration with UTHSC, IAFN, and us is our best chance of having a successful program and recruiting and retaining highly-skilled staff to care for these clients who have suffered traumatic experiences,” he said.
Lauren Plemons, MSN, RN, works on the Le Bonheur unit at Jackson-Madison County General Hospital and is going through the SANE training, which included live models at the Center for Healthcare Improvement and Patient Simulation (CHIPS) at UTHSC. The simulation enabled program participants to do a full physical exam and evidence collection as part of their training. Plemons acknowledges SANE nursing can be challenging but said, “If people are not willing to do this kind of work, how are the kids going to get the kind of help they need?”
Cassandra Revelle, MSN, RN, is also going through the SANE training program. She does SANE exams on call for Jackson-Madison County General Hospital and teaches full-time in the nursing program at Jackson State Community College.
Although Revelle had received some SANE training before, she said she has learned a great deal through the grant-funded SANE program. “It has closed many gaps for me. It’s been excellent,” she said.
Rural counties have a great need for access to this kind of care, she said. “We service so many counties and we would have individuals of sexual assault in Bolivar or Camden or in the surrounding smaller counties, and there was no one there for them and not enough SANES on call. They don’t exist. So the patients would have to come to Jackson Main for their care, or they potentially just would not come,” she said. “This grant affords our patients the chance of being seen in Camden or Bolivar. There just are not enough of us. This is going to help the community tremendously.’’