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Illinois taking action as sexual assault survivors face ER delays
More than 400,000 people experience sexual violence in the U.S. each year, but many survivors face delays or are turned away from emergency rooms that lack specially trained nurses. A Unit 32 special report examines the nationwide shortage of Sexual Assault Nurse Examiners, the impact on survivors, and how new Illinois laws aim to improve access to timely, trauma-informed care.
CHICAGO - RAINN, the nation’s largest anti-sexual violence organization, says more than 400,000 people experience sexual violence in the U.S. every year. But for too many survivors, the trauma doesn’t end there.
RAINN also says they are often turned away from some hospital emergency rooms, because those facilities cannot offer the help these patients need. That’s due in part to a lack of specially trained nurses to care for them.
What we know:
In a Unit 32 special report, Leslie Moreno examines how this nationwide shortage is affecting victims and what’s being done to fix the problem in Illinois.
"The most important part of this job is making sure that every survivor feels safe when they come to the emergency room to request a sexual assault kit," according to Nicole Martin, a registered nurse who works in the emergency room and operating room at Loyola Medicine.
For the last two years, she's been picking up extra shifts as a SANE nurse, treating sexual assault patients.
While Loyola Medicine launched its own SANE nursing program two years ago to make sure the needs of these patients are met at their facilities, that isn’t always the case at other hospitals.
According to the International Association of Forensic Nurses (IAFN), there is a national shortage of these specially trained nurses.
"There's no mandatory database identifying who is a practicing sexual assault nurse examiner or forensic nurse and where they are located," said IAFN CEO Jennifer Pierce-Weeks. "So, we have data based on our membership numbers. That we know that somewhere in the neighborhood of 25% of U.S. hospitals have some form of forensic nursing program."
The Illinois Attorney General's office oversees the state's Sexual Assault Nurse Examiner (SANE) program. Its goal is to increase the number of SANE’s working in Illinois by providing high quality, consistent education and support for registered nurses and other professionals who work with sexual assault survivors.
The attorney general’s office says there are currently only 885 SANE nurses throughout the state.
"The impact really can't be minimized, but it starts from when a victim or survivor first reaches out to help and first goes to a hospital or a clinic expecting to receive care and support there and instead is met by someone who can't help them, and they're told to go someplace else," said Stefan Turkheimer, Vice President of Public Policy at the Rape, Abuse and Incest National Network (RAINN).
"They're told they can't change their clothes, they have to find an Uber, they have to figure out a hospital that does have a SANE, or they have to wait in an ER waiting room for hours for a SANE to show up," Turkheimer added.
RAINN is the largest anti-sexual violence organization in the U.S.
"There's a common misconception in the United States is that all medical facilities can help victims of sexual assault by having a sexual assault nurse examiner present and available. But the reality is that many places do not, even the places that you would expect to have them. And there isn't a complete list for survivors to check, so they have to go to the ER and hope."
Local perspective:
A new law that just took effect on Jan. 1 is ready to change that in Illinois.
"A victim who appears at an emergency room and says they have had an assault of some kind, if there's not a SANE there, that hospital then is obligated to provide transfer to a treatment hospital where there is a SANE," said State Sen. Julie Morrison, D-29th District. "And they should work in conjunction with that other hospital that will be receiving the patient to help with the transport and any other information that would be helpful for that victim."
That’s just one of the changes Senate Bill 1602 makes to Illinois's Sexual Assault Survivors Emergency Treatment Act. Morrison is the bill's initial sponsor.
"I just think that someone who has gone through the trauma of being assaulted should have a very clear path to getting help. It should be a coordinated effort with the hospitals and with law enforcement, if necessary, to help bring this person to a place where they receive immediate treatment and also the follow-up care," Morrison said.
Other changes under the new law include hospitals treating sexual assault patients within 90 minutes and having a SANE nurse available. If treatment hospitals don’t provide a SANE nurse within 90 minutes, that is a violation of the new law and subject to Illinois Department of Public Health enforcement.
Under the new law, all hospitals are legally required to be listed with the IDPH as either a treatment or transfer hospital.
"Our program started mostly because it was the right thing to do," said Savanna Sadam, coordinator for Loyola Medicine’s SANE program. "Additionally, because some legislation came down in January of 2024 where all hospitals that were registered as treatment facilities for sexual assault needed to have coverage 24-7."
"In 2024, our three hospitals saw 160 patients. We're trending up over the past few years. So we see our fair share," Sadam added.
According to RAINN, every 71 seconds, a sexual assault occurs in the U.S. Every 9 minutes, that victim is a child.
Even though Loyola has a designated SANE program, Sadam says it is still a hard position to fill.
"Currently, we have 14, 15 certified SANE nurses. We have about another 17, 18 in training. We don't have anyone that works 24–7 as a SANE nurse, but we do have nurses that work in an on-call capacity," Sadam said.
Sadam says the long and difficult training these nurses have to complete as well as burnout from the job are contributing to the shortage.
It’s a position that does critical work on several levels.
"And if you don't get to someone who can provide yes, the counseling, yes, the medical care, but also the evidentiary collection, you're essentially handicapping that person for their entire recovery, which is why it's so important to have a SANE there," Turkheimer said.
Even though SANE stands for "sexual assault nurse examiner," these nurses help many different types of survivors.
"Any victims of violence, victims of crime, we take care of them. So that's sexual assault, of course, but also domestic violence. Child abuse, human trafficking, elder abuse, strangulation, gunshot wounds, stabbing, anything that might need evidence collection or very specific documentation of injuries and sequence of events," Sadam said.
More Resources:
To find out which hospitals have sexual assault treatment or transfer emergency rooms, go to the Illinois Department of Public Health website.