Ask Us Anything About… Sexual Assault

A woman sits on the floor, her face resting in her hands.

Sexual violence affects millions of Americans. According to the Rape, Abuse and Incest National Network, an American is sexually assaulted every 73 seconds. Deborah Medley, assistant nurse manager in the Emergency Department at Penn State Health Milton S. Hershey Medical Center, discusses the issue and how to get help.

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Barbara Schindo – Good afternoon and thank you for joining us You are watching Ask Us Anything About Sexual Assault. My name is Barbara Schindo. According to the Rape, Abuse and Incest National Network or RAINN, every 73 seconds in America, somebody is sexually assaulted. Sexual assault affects millions of lives and it’s scary, painful, traumatic and can have lifelong effects. Joining me this afternoon is Debbie Medley, and Assistant Nurse Manager in the Emergency Department at Penn State Health Milton S. Hershey Medical Center. Debbie’s here to answer your questions about sex assault, as well as the resources and help available at Milton S. Hershey Medical Center for sex assault victims. We do welcome your questions for Debbie. If you have a question, you can feel free to post it in the comment section right below this post. And we’ll get an answer for you whether you’re watching live or on playback. So Debbie, thank you so much for joining us. Let’s just start talking about you know, what is considered sexual assault?

Debbie Medley – Yes, so hello. Anything that is consensual sexual acts, sexual assault, including things where the person does not have the ability to consent. So anyone that is disabled or has no ability to consent, whether they’re developmentally delayed or anything else that which alter their level of consent. [inaudible] stuff like that.

Barbara Schindo – Okay, so according to the National Sexual Violence Resource Center, one in five women and one in 71 men are raped during their lifetime. So in 2008, though, the same resource center said that only 25% of sexual assault victims report their assault. So how can a victim of sexual assault report?

Debbie Medley – Well, there are a few ways that you can report and they do not all revolve around presenting to your local police department initially. If you’re in any immediate danger, of course, you should call 911 to request assistance. There is a national hotline, where you can call to get routed to your local sexual assault crisis center, resource centers. I can provide that number if you’d like. And then you can also arrive to any local emergency department to seek treatment for a sexual assault. And from there, we can help start the process of notifying local law enforcement.

Barbara Schindo – Okay, we will get kind of back to people who come to the emergency department in just a minute. Because I know we’re going to talk a lot about what resources are offered at Hershey Medical Center and we’ll talk about that. But before we get to that portion, talk a little bit more about what constitutes consent?

Debbie Medley – Consent so… to consent is any voluntary agreement to a sexual act. So verbal agreement, saying that you want to do that at any point you say no, that then becomes non-voluntary.

Barbara Schindo – Okay, thank you for that. So, now let’s get back to some of the resources offered at Hershey Medical Center and one of the things that is available there is that there are staff that are there called SANE trained, correct?

Debbie Medley – Yes.

Barbara Schindo – S-A-N-E, and that stands for Sex Assault Nurse Examiner. So we have this staff at Hershey Medical Center. What does that mean? Can you talk a little bit about that?

Debbie Medley – So in order to become a SANE trained nurse, you have to complete a… detailing all about adolescent and adult sexual assaults. So we… 41-hour course to learn about what they present like, how to treat them, how an exam is completed. And you learn about all your state regulations and documentations you have to perform. You also get specialized training with equipment, as well as time in the gynecology clinic to learn how to do proper speculum exam.

Barbara Schindo – Okay, you are watching Ask Us Anything About Sexual Assault with Debbie Medley, an Assistant Nurse Manager in the emergency department at Penn State Health Milton S. Hershey Medical Center. We welcome your questions for Debbie. If you have a question just post it in the comment field and we will get an answer for you. So talk a little about if a victim of sexual assault wants to seek treatment at the emergency department at Hershey Medical Center and they come to the emergency department, what can they expect? How does the SANE staff help them, you know, what’s the exam like? And you know, how do they help them feel safe and comfortable?

Debbie Medley – Absolutely. So you would present it like you would any time you arrive to an emergency department, you go through the same process. Initially you get seen and registered. You go to the triage they will then find out minimal details about the sexual assault. And they will then contact our trained nurses. So we are on call 24/7. There’s always one of us on call and we respond to the hospital within an hour of being notified of your arrival and that you’ve consented to have this exam completed. If you’re unsure we will also still come in and then we will discuss all of the options with you. So what that looks like is once you’ve come in with a sexual or concern for being assaulted, we are contacted. We arrived to the hospital. We start with a hello, introducing what this is ensuring that you consent to having this done. And then there’s actually a large number of consents we go through. Because you have the right to consent or decline any part of the exam and any part of the treatment. So, at any point, if you change your mind about anything, you can always change your mind, and you can always change your mind. You don’t have to consent to any — you don’t have to consent to the entire exam. You can consult to any one piece, or all of it, or none of it, essentially. So it’s very much in the victim’s control.

Barbara Schindo – Okay, and one of the things you had mentioned is for that sex assault victims who report some of the things that you do, as the SANE staff in the emergency department is help to facilitate a report to the police, if that is what the victim would like to do. How does that work?

Debbie Medley – So Pennsylvania actually has three different options for anonymous reporting. The first option is to report and anonymously report and obtain have the exam completed. The second is to report and hold. So you can report the assault, but you’re not ready to pursue anything. So then the local jurisdiction will hold the sexual assault evidence kit for the limited statute of limitations, the maximum allotment of time. And the third option would be if you do not want to report and you want to hold. So you’re able to hold the kit, again for the allotted amount of time for the maximum and allotment of a statute of limitations for your area. And essentially, we don’t file a report with the police. So everything remains anonymous. If you do options, one or two, everything remains anonymous, and you would be provided information to contact your police if you would like to then become not anonymous.

Barbara Schindo – So it sounds like a lot of what happens during the examination is very much up to the patient, to the victim to decide what they’re comfortable with. And you are there to help them kind of every step of the way, you know —

Debbie Medley – Yes with it.

Barbara Schindo – And another thing I just want to ask you is for victims of sex assault, it’s extremely traumatic, it’s, you know, it’s very difficult. A lot of people, you know, don’t want to report. And I’m sure that that could be very scary. If you decide you want to go to the emergency department and get this examination. So what does the SANE staff do, you know, to kind of ensure their safety and comfort of a victim?

Debbie Medley – So we currently, I’m sure people know, Hershey Medical Center’s Emergency Department has been under construction. One of the new pieces that we have in our new rooms that we have is the sexual assault examination suite. So we have an entire room and console room dedicated for these patients of this specialized population. So it is a private room. It is for this and only this. And it’s based where we allow them to talk, to share what they need to share. We provide them with an advocate if they would like. We always contact the YWCA to offer resources to the patient. And we just talk to them, you know. I mean, you want to maintain a compassionate, caring environment while you’re with these patients, because it is traumatic. You give them as much control as they’re able to do during these exams. We actually have — with our equipment, there is a clicker that they allows them to take their own photographs, should they agree to have photographs taken during the exam to allow them to have that little piece of control to start gaining some of that. So we very much make it about the patient and making them as comfortable as possible throughout the entire process.

Barbara Schindo – Very good. And we do have a question from Aileen, which I think that you may have just touched on here in your last answer. But Aileen is wondering, are patients placed in a separate private room after initial intake?

Debbie Medley – Yes. So initially, yes, you get your triage completed, and then they place you either in the same suite or into another room first. Because you have to get a medical clearance exam prior to ensure that you don’t have any medical needs that need met prior to having the sexual assault exam. So you would start in a private room at whether it’s the same suite or a different room. And then when the sexual assault nurse would take you to the same suite if you are not already there.

Barbara Schindo – Okay, and we have another question from Megan. Megan wants to know, what if a person is under 18? If it’s a teenager? Do they need to come with a parent? Can they come without a parent?

Debbie Medley – They can come without a parent because they’re the ones that would consent this type of exam. A parent cannot consent for their child. It has to be patient consent up to a certain age we, trained nurses are trained for 13 years and older. Anyone younger than that actually is done through our child protective team.

Barbara Schindo – Okay, Again, you are watching Ask Us Anything About Sexual Assault with Debbie Medley and Assistant Nurse Manager in the Emergency Department at Penn State Health Milton S. Hershey Medical Center. Debbie’s offering a lot of great information about the process for sexual assault victims who wish to report, who wish to come have an exam at Hershey Medical Center. Debbie you talked a lot about the same program. But we also — Hershey Medical Center is also involved in another innovative program called the Safety Center. This is a partnership with a Penn State College of Nursing. Can you talk a little bit about what is the Safety Center? What does that mean?

Debbie Medley – The Safety Center is actually a sexual assault forensic examination telehealth system. They provide us with 24/7 technical support. They provide us with a specialized technology that allows for a mobile coach to come into the rooms with us to perform all of our examinations that allows for excellent quality care for patients. And give the second set of eyes to ensure that we are following all the proper processes and making sure that we get all of the [inaudible] collected. They provide support to the patients as well as us. It’s called a mobile camera. It’s a very small — it’s almost like the size of the cell phone that allows us to get the magnification of a copper scope, which is a very [inaudible] camera that allows us to get that same magnification for very detailed, something you wouldn’t see to the naked eye. They are special trained. I was saying nurses, they have specialized training. They help us and provide us with training for our staff. And they are an excellent [inaudible].

Barbara Schindo – Good. It’s great to hear about all these resources because as we have both been saying, you know, this is very difficult, very traumatic, you know, something that it takes quite a bit of strength for somebody to decide that they want to do this after they’ve already gone through an extremely traumatic experience. So it’s very nice to hear that the staff at Hershey Medical Center is, you know, taking extra care and being extra cautious and any kind of leaving it all up to them, what they’re comfortable with, in a very safe and secure environment. Again, you’re watching Ask Us Anything About Sexual Assault with Debbie Medley, Assistant Nurse Manager in the Emergency Department at Penn State Health Milton S Hershey Medical Center. We are welcome your questions for Debbie. If you have a question, feel free to post that in the comment section. And we will get you an answer whether you’re watching this live or on playback. And I just lost my train of thought. No, what I was going to say is we also have — we have resources for some of the things that Debbie has mentioned that we will share in the comments. We have additional information about the Safety Center. We also have some information about the Rape, Abuse and Incest National Network, we can share those links in the comments. So there will be some additional information in there for you. And we do have another question from Megan. Just let’s see what. Yes, so Megan’s question is also about age. If they’re over 13, but under 18, is that a mandated reporting situation? Do you have to report to ChildLine?

Debbie Medley – Yes, we are mandated reporter. So any one under the age of 18, if it’s any type of abuse situation, concern for abuse, sexual assault, we report to ChildLine.

Barbara Schindo – Okay, and I have one more question for you as well. So, what about after the exam? You know, what programs are available to victims of sexual assault after they leave the emergency department at Hershey Medical Center? And how did the same trained nurses help facilitate things?

Debbie Medley – So every sexual assault that comes in we always offer to call the YWCA to get a patient advocate either via phone or when they’re permitted in the hospital, they arrive and are with the patient for however long they would like. They do a lot of the follow up services and there are laws and acts in place for Pennsylvania to get specialized care for these patients. If you actually go to the PCAR website, the Pennsylvania Coalition Against Rape, that actually has a lot of good information about the resources that are available. And the YWCA has a lot of follow up resources available for any patient of sexual assault.

Barbara Schindo – Okay, [multiple speakers]. Okay, great. So you can help facilitate any further care they may be looking for, asking for. And we do have another question from Connie. Connie wants to know, are there long term follow up mental services available for PTSD? Could you speak to victims post three, five, 10 years for, you know, if it doesn’t need to be somebody who was assaulted and then they have to immediately come see you are you able to help with folks who have been assaulted years ago? So we personally as an emergency department don’t do much in terms of those long term mental health services but the YWCA does and does help with long term follow up care with mental health services and follow up with getting aligned with meetings or anything else you may need in terms of mental health services. So those are available for anyone that has suffered this type of traumatic event or anything else that would be covered under the YWCA.

Barbara Schindo – Okay, Debbie, thank you so much for joining us today to talk about this topic. I know it can be very difficult. It can be very heavy. It can be, again, just a very painful and traumatic thing to go through. So very much appreciate your expertise and your insight and for any folks who are watching this on playback and there’s a question that has not been answered here, you still have the opportunity to post your question in the comment section and we will get an answer for you. So Debbie, again, thank you very much for joining us and thank you for watching.

Debbie Medley – Thank you for having me.

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