Kathi Lewis works full-time as an emergency room nurse in Lakewood.
She also puts in extra time as a victim advocate and nurse for rape and sexual assault victims.
As a Sexual Assault Nurse Examiner (SANE) volunteer, Lewis takes on eight, 12-hour shifts a month to see patients in a large part of Pierce County, including the Gig Harbor and Key peninsulas in partnership with CHI Franciscan.
She started as a SANE nurse four years ago and has been working as a nurse professionally for almost 10 years.
“As most nurses, I want to help people,” Lewis said. “And the SANE program has a forensics aspect and critical thinking aspect that I enjoy. This lets me be there for victims.”
During a SANE exam, nurses use “rape kits” to collect evidence while showing empathy and compassion to the victim.
“These people are victims, but to me they are my patients,” Lewis said. “I treat them with kindness and help them if they choose to press charges or to find other resources.”
Nicole Stephens, a new trainer for the medical records system with CHI Franciscan, was a large part of how the SANE program started with the hospital group in Pierce County.
“I serve on the Sexual Assault Forensic Examination state task force in Olympia,” she said. “Once I started asking questions at CHI they wanted to start building more awareness around the issue. So I started advocating for SANE.”
The program serves St. Anthony Hospital in Gig Harbor and Harrison Medical Center in Bremerton, as well as any CHI Franciscan medical office. The Bremerton program is in-house; others are contracted through Rapid Sexual Assault Victim Exam (SAVE) Investigation, which employs Lewis.
When a victim of sexual assault or rape enters a medical facility the SANE nurse on shift is dispatched and usually arrives within 40 minutes to two hours.
“The examination takes about four hours, because it’s more than just taking a couple of swabs,” Stephens said. “They recount the event, making sure the victim’s story is captured because it can be used as evidence later if the victim chooses to press charges.
“Everything from the DNA evidence, the swabs, photographs of bruising and laceration and more. It can be a very timely progress.”
SANE nurses are trained to perform gentle but methodical exams to find evidence of assault. The evidence can be used in trials, and the nurses know they can be called as an expert witness if a case goes to court, Stephens said.
Lewis said she went to court as an expert witness for one of her victims.
“The case I went to court and testified for turned out to be a success for the victim,” she said. “Because every swab I took had the assaulter’s DNA on it.”
SANE nurses receive special training outside of their regular nursing education.
“Nurses are given a practicum, where they get to shadow existing SANE nurses,” Stephens said. “They also get continuing education. A lot circles around best practices and empathy, so we are not triggering our survivors but making them as comfortable as possible while we collect evidence.”
Stephens emphasized the importance of empathy when working with rape and assault victims.
“When victims first come in they are still in a flight-or-fight response or a shock response,” she said. “There is physically a lot going on that can cause long-term health issues. So this initial contact can start the healing process by simply validating the experience and letting the victim know it was by no way their fault.”
A SANE exam is important for the victim in the first five days after the assault because it can help identify perpetrators and help collect evidence on the number of assaults in the county, Lewis said.
The exams are free for victims and can lead to more consistent collection of evidence, Stephens said.
Lewis and other SANE nurses in Pierce County work with Rebuilding Hope, a victim advocacy group associated with the Sexual Assault Center of Pierce County.
A 2001 study of Washington State women found more than one in three reported they had been victims of sexual assault/abuse, according to the Rebuilding Hope website. National statistics indicate that one in five boys are sexually assaulted before age 16.
Rape and sexually assaults are under-reported across the country because of the fear of social backlash or lack of trust in the criminal justice system, according to the Rape, Abuse & Incest National Network.
“Many people choose not to report because they fear it will become a ‘he said, she said’ deal,” Lewis said. “I always encourage my patients to make a report, but I will examine them whether or not they choose to contact the police.”
Lewis said the most eye-opening thing for her after working with rape victims is realizing how widespread the problem is.
“Almost every patient I have was referred to us by a friend who was a victim that regretted not reporting,” she said. “It happens more often than we think. Almost all of my patients know someone else who was assaulted.”
Lewis said she hopes to see fewer people coming in with stories about others who chose not to report an attack, but will continue working with victims who choose to provide evidence and find expert help.
“I see myself retiring as a SANE nurse,” she said.