Embattled sexual assault nurse examiner program stays source of concern

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This article was published 15/07/2023 (826 days ago), so information in it may no longer be current.

RECENT departures from the sexual assault nurse examiner program at HSC and the lack of a province-wide expansion have advocates concerned about gaps in patient care.

“It truly breaks my heart — because this program would be running right now had they listened to us in the first place, instead of shutting us out and ignoring us,” said Katie Stark, who worked as a sexual assault nurse examiner on a casual basis for 11 years at the Health Sciences Centre in Winnipeg before she and six other nurses quit the program in March.

The resignations, which accounted for all of the experienced casual nurses in the program’s staffing pool, save for six new hires, caused upheaval.

“When we all left, I think we had hoped that it would bring about a change for the good,” she said this week.

However, since then, the program has lost another two nurses and its program co-ordinator. A manager working remotely from Alberta resigned, and another HSC manager who had been involved in overseeing the program ceased that role.

Despite provincial promises the SANE program would be fully staffed by summer, it hasn’t been able to expand to other Manitoba communities.

Now, if a forensic nurse is not on shift, Stark said, there’s a lack of follow-up care for patients who present to the ER showing signs of suffering intimate partner violence.

“This really just comes down to, we want the survivors and Manitobans to be cared for properly. That’s the biggest thing. And that’s why we still talk about it and we’re still passionate about it, because we just care so much for this population.”

Stark said she resigned after months of feeling unsupported and unheard in the position.

After the provincial government promised in April 2022 to add more staff and expand the program, Stark said she and other nurses were hopeful. They started speaking up to leadership about what they program could be, and met with Health Minister Audrey Gordon in late November 2022.

The program had been running short-staffed, with gaps in coverage owing to lack of nurses that resulted in sexual assault survivors being turned away, told to come back later without washing, or made to wait for hours until an examiner nurse was on shift.

Stark said she and other nurses suggested solutions, such as having nurse practitioners, on-call physicians, medical residents or gynecological specialists fill in. She said their pleas were ignored.

A coverage model involving nurse practitioners and on-call doctors has since been implemented.

“The program desperately needed permanent positions, and yet, staffing the program was getting harder. It’s hard enough to be on call constantly, to be working in this program as a second job and to see how people are victimized by gender-based violence. This is hard, emotionally taxing work,” she said.

“Due to the increasing needs, more and more often, patients were turned away… We were embarrassed that this was even happening. You just couldn’t go home at the end of your shift if a patient needed care and we all knew there was no one scheduled after us. The ethical dilemma was crushing.”

The situation got worse after the forensic nurses began advocating publicly, speaking out to media, Stark said.

Seven from the 13-nurse casual pool resigned March 21-22.

Speaking to the Free Press earlier this month, Dr. Manon Pelletier, the program’s interim medical director for adult services, said HSC was actively hiring to fill the vacancies. As of late June, four of the unit’s seven nursing positions were filled.

Pelletier framed it as a rising-from-the-ashes situation, saying at the time: “It’s an incredible team and it’s only gotten better since everything kind of shifted, and with the resignation of staff, it’s allowed us to kind of rebuild from the ashes.”

Heather Didora worked in the SANE program for about five years. She said it wasn’t an easy decision to resign and the former forensic nurses want to see the program succeed.

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“Ultimately, fighting for months and months and months to be heard by this government and the employer, and not being heard just finally took its toll on many of us,” Didora said.

“We sincerely hope that this program is getting back on track,” she added. “There’s just such a gap in services without it.”

Although exams are being conducted by other professionals, there’s been no specialized follow-up care, which the sexual assault nurse examiners were trained to provide, Manitoba Nurses Union president Darlene Jackson said.

“That is the care that’s been sort of falling through the cracks. Yep, they’re getting their exams, but for many survivors, they are not receiving that additional follow-up and support, mental health support and psychological support they need.”

katie.may@winnipegfreepress.com

Katie May
Multimedia producer

Katie May is a multimedia producer for the Free Press.

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