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Tuesday, March 24, 2020  Spokane, Washington  Est. May 19, 1883
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Legislature considers funding sexual assault nurse training in Eastern Washington, where access is limited

Vials of evidence in a sexual assault case are labeled and sorted in this photo from 2015. There’s a shortage of nurses, especially in rural areas, who are trained to administer rape kits to victims of sexual assault. A move is underway in the Washington Legislature to find funding for more nurse training. (Pat Sullivan / AP)
Vials of evidence in a sexual assault case are labeled and sorted in this photo from 2015. There’s a shortage of nurses, especially in rural areas, who are trained to administer rape kits to victims of sexual assault. A move is underway in the Washington Legislature to find funding for more nurse training. (Pat Sullivan / AP)

WSU could get a pilot program to train nurses to become sexual assault examiners in Eastern Washington if funding for the proposal is allocated in the Legislature’s supplemental budget this month.

Advocates of the program say it could help fill a need in Eastern Washington, where hospitals, particularly those in rural counties, have limited or no staff trained as sexual assault nursing examiners.

Most counties in Eastern Washington have one or no hospital with nurses trained to collect evidence from sexual assault victims. For example, there are no hospitals with such trained staff in Douglas, Ferry, Lincoln, Columbia and Garfield counties.

This could mean that after receiving initial care at a hospital, a patient in such a rural community might have to drive to another hospital in another community to have a trained nurse administer a rape kit.

Rep. Gina Mosbrucker said she and other lawmakers are in the midst of negotiations and will know by next week whether or not $50,000 to begin a pilot program at WSU will be added to this year’s budget.

Regardless of what happens this session, the Yakima County lawmaker said she is not letting go of the WSU program for future legislation and that she wants nurses in the state to be able to receive their certification from the International Association of Forensic Nurses.

Currently, the state’s only sexual assault nursing examiners, or SANE, program is at the University of Washington’s Harborview Medical Center, where officials there believe they should be the only program in the state, the Seattle Times reported this week.

With authorizing legislation and funding, WSU could become the second program statewide to offer training to registered nurses to become SANE-certified.

Mosbrucker said negotiations are ongoing, including with Harborview officials, to come to a solution.

“We won’t let it go until it happens,” she said late Tuesday. “We are working on the path.”

In Eastern Washington, the WSU College of Nursing is interested in offering a SANE program, but legislative efforts to get funding stalled in the 2019 session. Last year, WSU conducted a small survey of nurses in Spokane and surrounding counties about training, said Wendy Williams-Gilbert, associate professor at the WSU College of Nursing.

Seventy percent of the 56 nurses who responded had never attended a SANE training. Of those, 80% had considered training, but the two largest barriers were travel and time off from work.

This small survey reflects the reality of Washington state’s overall “patchwork of responses” to sexual assault that a Department of Commerce report also found.

“What is clear nationally, and from Washington’s history, is that a patchwork approach does not ensure access statewide,” the report says.

Nurses typically have to travel to Seattle to get SANE training. Trainings are not offered regularly, and can be costly. If a nurse wanted to do an online course instead, a $500 program certified by the International Association of Forensic Nurses is available. Also, a nurse could go out of state to get the training, with an in-person component as well, but would have to travel to Colorado.

Williams-Gilbert says the need for patients in some parts of Eastern Washington to travel to have a trained nurse administer a rape kit discourages them from doing so. She doubts that most patients would want to seek additional care at another hospital to get a kit completed.

“We don’t want to retraumatize people,” Williams-Gilbert said. “How do we ensure that if something happens to somebody on the worst day of their life that they have the right nurses?”

Eastern Washington needs more trained staff, even in the Spokane area, said Jennifer Jordan, SANE nurse and educator at MultiCare Deaconess Hospital.

“The Eastern Washington area is very underserved when it comes to training,” Jordan said. “We are at the mercy of Harborview.”

Harborview Medical Center conducted a training last October in Spokane at Deaconess, where seven nurses got certified, Jordan said. That brought the hospital’s numbers up to nine trained staff at Deaconess and two at Valley Hospital. Jordan estimates there are 20 to 25 SANE-trained nurses in Spokane. Providence did not provide its number of trained staff members.

Accessibility to training is a real problem, whether because of finances or travel or both, Jordan said.

“It’s a five-day training course, it’s expensive, and if you don’t live there, it’s the extra added expense of food, travel and hotel, and almost every hospital does not pay for that training,” Jordan said.

MultiCare Deaconess will pay for its emergency department nurses to receive SANE training, but not all hospitals do. Nurses working in rural environments or in critical access hospitals, where they are already often working in short-staffed environments, might have difficulty taking a week off work to do training in Seattle or elsewhere.

Jordan hopes WSU can begin a program to train nurses east of the Cascades to make up for the need.

The program would cost $47,832 the first year of implementation and $39,158 each year afterward, according to a fiscal note on the 2019 legislation that did not gain traction.

Williams-Gilbert, with WSU College of Nursing, said Harborview’s SANE program was ahead of its time and has been considered a gold standard for decades. She said a program at WSU College of Nursing would allow for a second option in the state with a rural focus.

“I want to make sure that regardless of where you live in the state, you have access to the care you need, when you need it,” Williams-Gilbert said.

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