Nova Scotia Health Sexual Assault Nurse Examiner (SANE) Leader, Susan Wilson.

By Emma Keevill

One in three women experiences sexual assault in their lifetime.

While these crimes are not always reported to police, there is support available through Nova Scotia’s Sexual Assault Nurse Examiner (SANE) programs that provide options and care to people who have experienced recent sexual assault or abuse.

“It is difficult to quantify the impact of the COVID-19 pandemic on sexualized violence,” said Nova Scotia Health Sexual Assault Nurse Examiner (SANE) leader, Susan Wilson.

“We know that stress and isolation increase both the risk and degree of violence, with known increases in sexual violence, domestic violence, and femicide (domestic homicide of women) across Canada. What we don’t know is the impact the pandemic may have had on assault reporting.”

Wilson shared that it is not yet known whether the pandemic may have prevented some women from reporting assault.

“It may have hidden opportunities for reporting for some, in this “shadow pandemic” of violence throughout the COVID-19 pandemic,” she said.

“Home is the most dangerous place for those in abusive situations, particularly women and children. While necessary restrictions were put in place to mitigate the spread and health-related impacts of COVID-19, the isolation experienced because of these restrictions, including social distancing, working from home, and access to services or others for help can impact the ability to identify abuse, safely disclose and report, potentially further increasing risk of violence, harm, and lethality.”

To learn more about the SANE program and how to access it, visit nshealth.ca/sane.

The SANE program is comprised of registered nurses who have completed specialized education and clinical preparation in medical forensic care for those who have experienced sexual assault. SANEs provide an immediate response to people who would like supportive care, including medical attention, information about resources, as well as the option to have forensic evidence collected, within seven days of a sexual assault.

Each of the SANE programs has a team of SANEs, most of whom work full-time or part-time in other diverse areas of healthcare throughout the province in addition to on-call work with the SANE program.

“The nurses that show up every day to be available for this work and to help provide 24/7 on-call coverage are going above and beyond their other work, family and life commitments, especially through the pandemic. They are truly amazing,” said Wilson.

Each program also has a dedicated SANE coordinator responsible for local program management and supporting their teams, are actively involved with community partners, and also function as part of the SANE team, providing direct SANE response.

Over the SANE program’s 20-year history in Nova Scotia, it has been able to provide 24/7 response for people who have experienced sexual assault or abuse. That impeccable track record was put to the test due to added pressures amid the pandemic with limited availability of some SANEs due to schedule changes as a result of being redeployed to other areas, childcare challenges and more.

“On-call rosters have been significantly impacted throughout the pandemic in some cases, which has presented some challenges, but the programs have been able to continue providing 24/7 response,” said Wilson. “I am proud of their commitment to this work and tremendously grateful that uninterrupted care continued to be available to those in need by these specialized nurses.”

In Wilson’s current role, she helps SANE service providers across the province with complex issues as needed and ensures they feel supported in their work.

“Every situation is unique and sometimes we need to work together to provide the best possible care for individuals and not add further trauma,” said Wilson.

Wilson says she fell into the work a bit accidentally, or perhaps it was fate, during her career as an ICU nurse but eventually found it to be her “life’s work.”

Wilson works in close partnership with the SANE service providers and helps with SANE program expansion across Nova Scotia through implementation support and the development of policies, as well as education, and training for all the nurses that come into this work. Wilson also collaborates with her colleagues within the health care system as well as government and non-government partners to help set standards for best practices and response to violence across the province.

The SANE program is now available province wide. The continued expansion of the program throughout the pandemic is something that Wilson and her colleagues are proud of. The most recent expansions of the SANE program include:

• • Roseway Hospital in Shelburne delivered by the Tri Country Women’s Centre SANE program, available as of Feb. 1, 2021
• • Colchester East Hants Health Centre in Truro, delivered by the Victorian Order of Nurses (VON) SANE program, available as of Feb. 1, 2021
• • Cumberland Regional Health Care Centre in Amherst, delivered by the VON SANE program, available as of Feb. 8, 2021
• • Musquodoboit Valley Memorial Hospital, delivered by the VON SANE program, available as of Aug. 1, 2021
• • Victoria County Memorial Hospital in Baddeck, delivered by Every Woman’s Centre SANE program, available as of Oct. 1, 2021

In Nova Scotia, the SANE program operates within a community-based model, the first and only of its kind in Canada. This model fosters a partnership between Nova Scotia Health and five community-based SANE service providers that help respond within their regions: Antigonish Women’s Resource Centre and Sexual Assault Services Association (Antigonish), Avalon Sexual Assault Centre (Halifax), Every Woman’s Centre (Sydney), Tri-County Women’s Centre (Yarmouth), and VON (Truro).

“Services provided through our community-based model are more specific to the unique needs of the communities they serve. Many of the organizations we partner with have additional services that support the work of the SANE program, such as additional medical or follow up options, trauma therapy, advocacy support, or support workers, or are closely connected to these services, making the overall care journey more seamless for the patient,” said Wilson.

“For example, some of the service providers have a specific emphasis and strong understanding of violence, gender-based violence and trauma. This translates not only to better support for those who have experienced the violence directly, but also to those who are exposed to the violence through the nature of their work, experienced as vicarious trauma.”

The community-based model also ensures each case is responded to by two nurses – with a focus on supporting the individual as well as the detailed examination and reporting. “This method supports best practice, with better support, collaboration, mentorship and retention across the program and mitigates vicarious trauma to the nurses through a trauma-informed approach,” said Wilson.

November 25 launched 16 Days of Activism Against Gender-Based Violence. Approximately ninety per cent of SANE patients are women.

“Violence against women has far-reaching health, social, economic, and generational impacts beyond the individual level, extending to families, community, and society. This time provides the opportunity for focused attention to this crucial issue, to educate, discuss and promote awareness, prevention, and early intervention strategies in our places of gathering - work, school, recreation, communities, and beyond,” said Wilson.

Additional resources:

Key statistics on gender-based violence in Canada: women-gender-equality.canada.ca

Nova Scotia Domestic Violence Resource Centre: nsdomesticviolence.ca