ENA
National Awards
Demystifying Treatment and Legal
Options After Sexual Assault
UPMC Video Honored by ENA
Ateam of nurses from the University of Pittsburgh Medical Center will accept ENA’s Media Award at Emergency Nursing 2016 in September for the video “After a
Sexual Assault.” The creative motivation for the team was
entirely altruistic.
With grant money from the Beckwith Family Foundation, the
nurses embraced an opportunity to improve patient education
after a sexual assault. “After an incident, patients are in crisis
mode and have lost a great deal of autonomy,” said Lisa Simonian,
DNP, CRNP. “Just the thought of a forensic exam is understandably
terrifying, and this can prevent us from collecting the evidence
we need. We were hoping to defuse that anxiety.”
Following the best practices of facilities that have presented
sensitive information to patients via a video while waiting for
the sexual assault nurse examiner to arrive, UPMC hired a video
production company and set out on its first multimedia voyage.
Patient education was the primary goal, but the team soon
realized that the video was a service to colleagues as well. “The
methodology for the sexual assault examination has changed so
much in the past 20 years since I was a baby nurse,” Simonian
said. “At that time, there was a lot of horror and fear because we
didn’t do the exam on a daily basis. Now the SANE is a respected
professional who does this on a daily basis, and ED nurses can
breathe a sigh of relief.”
Casting Call
The nurses had to not only develop on-camera personas but
ensure an accurate representation in the portrayal of patients.
A male actor appeared as a patient in one of the first encounters
with a nurse. “We specifically wanted a diverse cast,” said Valerie
Krasneski-Schreiber, MS, RN, CEN, SANE-A. “Sexual assault
affects all races and genders. It was important to us that no
patient felt like an outsider.”
To comply with the federal Prison Rape Elimination Act, some
correctional facilities approached UPMC about a memorandum
of understanding and legally formalized the service agreement
under which the hospital provides SANEs for examinations of
victims in the facilities.
“This has made a huge difference in terms of our male
population,” Simonian said.
Promoting Patient Choice
Regardless of demographics, a key theme in the video is the
patient’s right to make choices throughout the sexual assault
exam and legal process.
For instance, patients often resist the exam, yet it’s vital for any
police report. “Nobody likes to go to the gynecologist,” Simonian
said. “If you’ve just lost the ability to say yes or no to sexual
activity and somebody at the hospital wants to examine you, it
can almost feel like a second assault.”
An equally daunting notion is that of giving a report to police
officers. “It’s uncomfortable to recount your story to a nurse after
a sexual assault, but it’s another matter entirely having to share
the incident with uniformed officers, male or female,” said Debra
Shane, MSN, RN, SANE-A. “Talking to law enforcement can be
intimidating, and our patients are in a very fragile state, especially
after having a sexual assault exam and kit collection. Sometimes
we negotiate immediate evidence collection but give the patients
an extra day before meeting with law enforcement.”
Krasneski-Schreiber said the video affords patients the time to
process the next steps. “We want patients to know they have
choices and a say in how we do things. People don’t always
realize that when they come to the ED.”
From left to right, Debra Shane, MSN, RN, SANE-A; Valerie Krasneski-Schreiber, MS, RN, CEN, SANE-A; Lisa Simonian, DNP, CRNP; Janet M.
McFarland, BSN, RN, CEN, SANE-A; and Tammy Bimber, MSN, RN, CEN,
SANE-A/P