Preserving dignity and reducing trauma

Preserving dignity and reducing trauma

Fourteen years ago, when asked what I did for a living, I would quietly say I am a Sexual Assault Nurse Examiner (SANE). By feeling like I needed to be quiet, I was unintentionally attaching shame to the victim. But it’s not their shame, so I won’t be quiet.

Today, I proudly discuss my career.

This wasn’t the path I envisioned for myself. While working as an emergency room nurse, I was presented the opportunity to become a SANE. A couple of days into the training, I felt totally out of my comfort zone and told myself the role wasn’t for me. But by the third day, something clicked when the instructor was explaining how devastating it can be for sexual assault victims to show up to a hospital and not be seen by someone properly equipped to care for them.

SANEs are committed to providing compassionate care while preserving dignity and reducing trauma. When a patient reports an assault, a SANE takes over their care, conducting assessments, documenting injuries and collecting evidence for law enforcement. They collaborate with community partners, including advocates who ensure there is a safe place for a patient to go upon discharge. SANEs may also be called to testify if a case goes to trial. Because of these responsibilities, SANEs receive highly specialized training.

The role of a SANE isn’t for everyone. Not every nurse is comfortable going to court or collecting evidence. Some are unable to care for a victim of violence because of their own trauma. We care for patients one at a time, assuring they feel heard. We need to understand the intricacies of some of the health problems our patients face. For example, certain HIV medication can only be given within 72 hours after an assault. This expertise helps make sure our patients are receiving the right care at the right time, just like it’s important that a cardiac nurse care for a cardiac patient.

I’m also a certified strangulation expert in four counties in Wisconsin. Many people who have been strangled or choked don’t realize the lasting impact an incident can have. They assume everything is okay once symptoms resolve. Strangulation doesn’t just affect the flow of air to the lungs but also the flow of oxygen to our vascular system through our carotid artery and jugular veins. Any time blood flow is stopped, the brain can bruise, potentially causing trauma to the brain in the short or even long term. There is research being conducted on the risk of stroke, Parkinson’s and early onset dementia among victims of strangulation. It’s important that victims undergo CT imaging while in the emergency department to ensure their vascular system is intact and there isn’t minor damage that could affect their future. After an abusive situation, we need to provide patients with a full picture of what’s going on in their body both inside and out.

Being a SANE has shaped the way I care for patients. I understand there is a reason behind a person’s actions and that I need to adjust my approach accordingly. To my fellow health care workers, be patient with every patient you come into contact with. You never know a person’s history. Always make sure your patient feels empowered in their decision making and involved in their care.

I’m grateful for the opportunity to care for some of our most vulnerable patients. My work as a SANE has significantly impacted the way I approach life and how I instill hope in my children. Every day, I ask my 6-year old where he saw hope that day. We talk about the fact that even though life is full of hard things, good things happen, too. He knows that each of us needs to carry hope with us to find a path forward.

Deanna Grundl is the SANE/Forensic Nursing Coordinator of Aurora Sheboygan, Manitowoc, Summit & Washington County.

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  1. Deanna you are an angel. What a gift of compassion you share with definitely the most vulnerable, traumatized patients. I had never thought about the additional physical wounds they sustain in an attack with strangulation. Unimaginable.

    And asking your son where he saw “hope” today is a beautiful conversation initiating question. Rather than just what made you happy today. Hope is bigger. Thank you for sharing this incredible story.

  2. Mary Ellen Soltys August 28, 2022 at 1:01 pm · Reply

    Thank you for hiring me in to this role. You are an amazing leader and one of the strongest advocates for SANE patients.

  3. I have had the pleasure of working with Deanna for many years. Her compassion for survivors of violence is impeccable. This article beautifully captures what the SANE nurse does and what the survivor goes through. Great Article thank you!!

  4. Thank you, Deanna, for this beautiful description of what a SANE is all about. I personally became a SANE a few years ago. I hope your story encourages more nurses to join our team, so more patient/victims can receive the very specialized care you give! There is definitely a continued need for more SANE personnel, despite the continuing education RNs receive, for it truly is the most beneficial care the victim can receive!

  5. Trauma-informed caregivers for the win! Trauma informed care should be a yearly mandatory requirement for all caregivers to understand the emotional and mental impacts of a patients medical situation. Trauma informed care can and should be applied to all patient situations, the SANE program is a regular reminder of how important it is an how much of a difference it can make in a patient’s life.

  6. Thank you for highlighting this very important role. I know our country needs more SANE’s and that many times there isn’t one for a sexual assault survivor who shows up to the ER. Thank you for doing this very delicate role and for your hope to survivors.

  7. I can say that I’ve had to have this examination happen and I can’t express the care and compassion and how you’re treated is crucial to whether it makes the experience more traumatic. It really does make a difference.

  8. Thank-you SANE for all you do and for making this service thrive through out the 4 counties! Your hard work and dedication is truly appreciated and you are a blessing to all who have been traumatize through assault. Keep up the good work!

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Deanna Grundl

Deanna is the SANE/Forensic Nursing Coordinator of Aurora Sheboygan, Manitowoc, Summit & Washington County.