Every 73 seconds, somebody is sexually assaulted in the United States. In addition to the immediate pain and terror, an assault can leave trauma that lasts a lifetime. Having dedicated, supportive care during a forensic exam at the emergency department and resources in place for the days, weeks and months following an assault are critical to the recovery process.
Reporting an assault
According to the National Sexual Violence Resource Center, one in five women are raped during their lifetime, but only one-quarter of sexual assault victims report their assault. The U.S. Department of Justice reports that the closer the relationship between the victim and the offender is, the greater the likelihood that the rape or sexual assault will not be reported. But even in assaults when the attackers were unknown, more than half of the women attacked do not report their assaults.
“It’s a very traumatic event,” said Debbie Medley, assistant nurse manager in the Emergency Department at Penn State Health Milton S. Hershey Medical Center, who is specially trained to work with patients who have been sexually assaulted. “It takes quite a bit of emotional strength for somebody to decide that they want to report it and seek help.”
Medical providers, social workers and government officials have created multiple avenues to make getting help and reporting the crime less stressful.
“If you are in any immediate danger, you should call 911 to request assistance,” Medley said. “But there are ways to report the assault other than just picking up the phone and calling 911 or your local police department.”
The Rape, Abuse and Incest National Network’s national hotline connects callers with a trained staff member from a local sexual assault service provider. Additionally, the Pennsylvania Coalition Against Rape (PCAR) partners with a network of rape crisis center programs to help victims of sexual violence throughout the commonwealth. Among its services, PCAR offers free and confidential crisis counseling 24 hours a day.
Someone who has been assaulted can forgo any calls to a hotline and instead go directly to any local emergency department to seek treatment. Some hospitals, like Hershey Medical Center, have sexual assault nurse examiners (SANE) who have received special training to work with patients who have been sexually assaulted.
“To become a SANE, we complete a 41-hour course to understand more fully the fears, concerns and immediate needs of these patients and the best way to conduct the exam and provide treatment,” Medley said.
What to expect at the ER
Arriving at an emergency department is almost always stressful, but for those who are seeking care for a sexual assault, it can be terrifying. Helping a patient feel safe and in control throughout their experience at the emergency department is critical.
Hershey Medical Center’s newly expanded emergency department features a dedicated sexual assault examination suite designed to separate sexual assault patients from the hustle of the main patient triage and waiting areas.
“This suite is only for victims of sexual assault,” Medley said. “We provide them with privacy from when they first arrive.” The sexual assault nurse examiner on-call will respond within an hour to meet with the patient. During this time, the patient will undergo a medical screening exam to ensure that their medical needs are met before the forensic exam. The SANE nurses also arrange for a sexual assault victim advocate to meet with them if they would like. “We always contact the YWCA to offer resources to the patient,” she added. “And we just talk to them. It’s so important to have a compassionate, caring environment for these patients because what they’ve gone through is so traumatic.”
Medley stressed the importance of providing patients with as much control as possible during the forensic exam.
“Among the equipment in our dedicated exam room, we have a clicker that enables the patient to take their own photograph, should they agree to have photographs taken during the exam,” Medley said.
Sexual assault nurse examiners also know the state’s regulations and required documentations for sexual assault cases and know how to facilitate a report to the police — if that’s what the victim wants.
“Even though the assault will be documented by us, it doesn’t mean that a report must be filed with the police,” Medley said. Pennsylvania law allows victims of sexual assault to have the sexual assault evidence kit collected and tested anonymously — without their name attached to it.
“They can have that reassurance that they’ll get the medical treatment they need, when they need it. They’ll get connected to support services to help them navigate the emotional trauma of their assault. And they’ll have the peace of mind that while they might not want to report the crime yet, we have the evidence kit if they ever change their mind.”
- The Rape, Abuse and Incest National Network (RAINN), 800-656-HOPE (4673)
- Pennsylvania Coalition Against Rape, 888-772-7227
The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.