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Bill Klaproth (Host): The numbers are horrifying; one out of every six American women has been the victim of an attempted or completed rape in their lifetime according to National Institute of Justice and Centers for Disease Control and Prevention. And sadly, the reality is, it’s very common for sexual assault survivors to decline to report the offense to police. So, what are the barriers to reporting sexual assault and what to do if you have been sexually assaulted and are unsure on whether or not to press charges. To help us sort through this is Stephanie Knewbow, a Registered Nurse, Clinical Coordinator and Director of the Emergency Department at Pullman Regional Hospital. Stephanie, thank you for your time.

Stephanie Knewbow, RN (Guest): Thanks Bill. I’m glad to be here today.

Host: Stephanie, this is really an important topic. So, let’s start with this. What should someone do if they have been sexually assaulted?

Stephanie: Well, I think the first thing they want to do is make sure they report immediately to the nearest hospital or call the police for help. The police can also help guide them to the hospital or get them where they need to be. They want to make sure that they don’t take a shower, they don’t want to take a bath, try not to wash themselves. They don’t want to brush their teeth or rinse their mouth. If they have any wounds, we don’t want them to wash those or do anything with those either. And we encourage them to try not to eat or drink or go to the bathroom before they get to the hospital either.

And then when they get to the hospital, we are going to want their clothing that they had on. So, we encourage them to leave those clothes on and then we’ll gather them when they get to the hospital.

Host: And how many days after can you collect evidence?

Stephanie: It’s important to remember that we can collect evidence for up to five days after, but really getting to the hospital as soon as possible is the best for the evidence collection.

Host: Well that makes sense. And I would imagine someone who has been sexually assaulted, their very first inclination is to get home, change, shower but what you’re saying is don’t do that; get yourself to the police station or the hospital as is.

Stephanie: Exactly. We don’t want you to wash off even though that is kind of – you’re going to feel like that’s what you are going to want to do first.

Host: So, Stephanie what are some of the barriers to reporting sexual assault?

Stephanie: It seems like a lot of the barriers have to do with victim blaming. A lot of victims, they think it’s their fault that this all happened. So, they are afraid to report it. They think there might be some backlash. But we really encourage our patients to not feel that way. We always call an ATV – we call it an ATVP counselor which is Alternative to Violence Counselor. We call one once they get here and we have them talk to them and we really just help you through the whole situation.

Host: So, speaking of helping someone through the situation; women out there have to know there are people ready to help at hospitals and police stations. So, tell us about a sexual assault nurse examiner or SANE, S-A-N-E. What type of training do they receive?

Stephanie: Yeah, so our training for the nurses here, they do a 40 hour training and that’s through a gal at Harborview in Seattle. They teach us all the state regulations and laws in regards to how to collect the evidence appropriately. And we do call a SANE nurse when you arrive at the hospital.

Host: And what does a SANE exam include?

Stephanie: The SANE exam consists usually you start with a medical screening exam by the physician. That’s just kind of a look over to see if you are injured anywhere, to see if we need to do x-rays or lab work. And then the SANE nurse will come in and they will use swabs to collect samples and we will those to the state crime lab. We sometimes have to do a little bit more testing. We may have to take some photos if you have any injuries. And then the doctor will discuss taking some prophylactic medications that can help prevent STDs and if you need to take like a Plan B pregnancy pill after the assault as well. But the doctor will discuss that with the patient and kind of decide what’s the best treatment for them.

Host: So, is this confidential?

Stephanie: Yes. The patient, we check you in of course under your name at the hospital, but all of our patients that come to the hospital are confidential. And then we keep it confidential. We only let people who have to know, know your name like the ATVP counselor; we tell them your name if you agree to talk to them and you want them to be involved. And then the police will get the SANE kit and will have your name on it, but that’s all they know. They don’t know anything about the assault unless we tell them more information.

Host: And how long does the whole process take?

Stephanie: The process can differ a little bit between patients, but the evidence collecting portion only takes about 30 minutes to an hour depending on how many swabs they are going to do and then the rest of the time is really spent seeing the physician and getting the medical screening exam and maybe some other follow up work that you need.

Host: So, regardless of whether or not a woman wants to press charges; which we certainly want her to do that, but if she is unsure at that point; first thing she should do before making that decision is go get the SANE exam; is that correct?

Stephanie: Yeah because we really encourage you to get it since we only have those five days to get that evidence. We can do the SANE exam and you don’t have to press charges at that time. But if you change your mind say two weeks later; it’s going to be too late to get any of the evidence. So, we really encourage you come to the hospital, collect the evidence and then we at the hospital will help you kind of work through if you are going to press charges and also the ATVP counselor, they’ll help you work through that as well. So, we don’t tell you whether or not you have to press the charges or not. That’s kind of up to you. But we do help you work through the situation.

Host: So, for someone that is unsure on whether or not to press charges; what are some of the things you help with?

Stephanie: We collect the evidence and send it to the police and then the ATVP counselor will really talk to them about kind of what happened and we of course, will listen to their story. But we can just help give them more information to where they can follow up and kind of give them the support they need, if it is kind of the victim blaming, they are afraid of. We really try to offer that support to encourage them to at least get the exam and then possibly press charges if we think that should happen.

Host: So, from the outside, it would seem that this is an easy decision to press charges, but from what you’re saying, it’s not.

Stephanie: Yeah, it’s a really hard decision for the women to make and we also – once they meet with ATVP and if they are kind of still hesitant to decide if they are going to press charges; we can let the prosecution or like the attorneys know and they also can talk to them and tell them if there is a case there and if that is something that they can move forward with. But we, at the hospital, encourage you to come in and get that evidence collected right away.

Host: And that is first and foremost. So, Stephanie if you could wrap it up for us. What else should we know about sexual assault treatment?

Stephanie: I think the biggest thing is just for women and men, whoever has been assaulted, not to be afraid to come into the hospital and if you’re unsure where to go, you can go to our home page. There’s a little bit more information there. But we really encourage you like I said to get that SANE exam right away and then we can work through kind of the other issues after we collect the evidence.

Host: Stephanie, thank you so much for your time and talking with us about this very important topic. And for more information, please visit www.pullmanregional.org, that’s www.pullmanregional.org. And if you found this episode helpful, please share it on your social channels. Again, please share this on your social channels and share it with your family and friends as well. And be sure to subscribe to the Health Podcast in Apple podcasts, Google Play or wherever you listen to your podcasts. And check back soon for our next episode. This is the Health Podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.