Adult and Adolescent Sexual Assault Patients in the Emergency Care Setting

Patients seeking carein the emergency setting after sexual assault are an at-risk, vulnerable population. It is imperative that they have access to and receive patient-centered and trauma-informed care that addresses their medicolegal and psychosocial needs (Plichta, Clements, & Houseman, 2007). Patient-centered care is respectful of and responsive to individual patient preferences, needs and values, ensuring that patient choices guide all clinical decisions (Committee on Quality of Health Care in America, 2001). Trauma-informed care involves understanding the connection between presenting symptoms and behaviors, on the one hand, and the individual’s past trauma history, on the other (Hodas, 2006).

Comprehensive care for these patients requires extensive planning, education and expertise on the part of emergency care providers and their collaborative partners (Sampsel, Szobota, Joyce, Graham, & Pickett, 2009). The emergency nurse is a key member of this team and instrumental in coordinating access to appropriate healthcare providers, collaborating with community-based victim advocates, social workers, and law enforcement personnel (Cybulska, 2013; Linden, 2011). Many nurses have education and certification in the expanded practice role of sexual assault nurse examiner (SANE) in order to provide care in an empowering setting, different from traditional medical care that often left patients feeling re-victimized (Cybulska, 2013; Linden, 2011). The SANE completes a time sensitive examination that includes: assessing, treating and documenting injuries, identifying risks and providing preventative treatment for negative health outcomes associated with sexual assault including exposure to infection, unintended pregnancy, and long term psychological and physical sequelae, collecting evidence, maintaining the chain of custody, safety planning, and providing support with appropriate community referrals (Plichta et al., 2007; Sampsel et al., 2009; Cybulska, 2013). Immediate medical and psychological care directly impacts the patient’s wellbeing and contributes to the beginning stages of the healing process (Plichtaet al., 2007; Cybulska, 2013; Linden, 2011). Successful physical and emotional outcomes, as well as potential prosecution of sexual offenders, require emergency care settings to be prepared to provide competent care and referrals for the sexual assault patient (Plichta et al., 2007).