Hospital offers safe space for sexual-assault victims

Sexual-assault victims will have increased privacy at Kalispell Regional Medical Center, thanks to the facility’s dedicated suite that provides a private entrance, exam space, waiting room and shower facilities.

The Sexual Assault Nurse Examiner (SANE) suite was completed Aug. 7 as part of the hospital’s expansion of its emergency department.

The multiphase, $14 million project began in 2014, and is slated to wrap up next June. The second phase of the project is ongoing, and involves building a new patient entrance along with a six-bed triage area with a projected finish date of Christmas this year.

Once complete, the expansion will increase the size of the emergency department from 8,000 square feet to more than 37,000 square feet with an annual capacity of between 35,000 and 40,000 patients.

The original ER was built along with the main hospital in 1976 and was designed to accommodate 9,000 patients per year. It was expanded in 1991 to 13 rooms with an annual capacity of 13,000 patients.

For the past decade, however, the hospital has seen more than 20,000 patients in the ER each year, prompting yet another expansion.

Hospital staff made do by seeing patients in alcoves separated by curtains, and even hallways, which presented privacy issues.

“Our space [was] just super cramped, very old, outdated,” Kalispell Regional Director of Emergency Services Mae Stubbs said.

The Kalispell Regional Healthcare Foundation launched a campaign in 2012 to raise money to update the ER facility. Of the $14 million raised, $5 million was generated internally from board members, staff and volunteers who wanted to see the new space take shape.

“This ER really belongs to this whole place — this community and all the people that work and live here,” Stubbs said.

The SANE suite, one of 31 rooms in the new ER, previously was divided into two spaces: pediatric sexual-assault victims were seen upstairs, while adults were seen downstairs. The new and larger suite allows the hospital to localize equipment and provide patients with a private entrance.

“In the old ER, if a woman came in with an acute sexual assault…we’d be walking her right through the whole ER,” Stubbs said. “So everybody would see — not like we would all know why she was there — but the sense that you have after something like that happens is that everybody knows what’s happened with you. It wasn’t very private.”

Another new addition to the suite is a shower unit.

“That’s the first thing rape victims want to do, is take a shower and get all that stuff off of them,” SANE Program Coordinator Debbie Mulcahy said. “If they haven’t taken one already, then we have a space for them where they can do that.”

A waiting room is also contained within the suite, which doubles as an interview space. Child victims undergo what’s known as a forensic interview, where a professional interviewer asks questions in a non-leading, unbiased manner in an attempt to extract the truth from the child without influencing them. These conversations are videotaped in order to limit the number of times a child has to be questioned about the incident.

Mulcahy said Kalispell Regional sees an average of 80 sexual-assault victims each year, including both adults and children. Ten years ago, she said the number was roughly half that — between 40 and 50 victims.

In 2013, 305 rapes were reported to Montana law enforcement agencies, but experts agree that rape is one of the most underreported crimes and numbers are thought to be very conservative. Of the victims in 2013, over 80 percent were white females while 10.8 percent were Native American women. Fewer than 3 percent of victims were male, Montana Department of Health and Human Services data showed.

The suite itself wouldn’t be complete without qualified staff. Kalispell Regional employs seven SANE-certified nurses who are specially trained to collect evidence and complete an assault-specific medical exam. The program got its start in 2005 when the Kalispell Regional Healthcare Foundation paid for four nurses to undergo training. When it comes to juvenile victims, the SANE program works in partnership with the Child Advocacy Center — a multidisciplinary team under the umbrella of the Flathead County Sheriff’s Office that works to investigate incidents of child abuse.

“There was a definite need for it. That’s why we started it,” Mulcahy said. “We have lots of child-abuse cases here in our community. Child sexual abuse, physical abuse, neglect — all kinds of things that nobody wants to believe that are here. Every year we see more and more kids.”

When a sexual-assault victim comes to the hospital, the patient first undergoes a basic medical exam where vitals are taken and a medical history is gathered. SANE nurses are on-call 24/7 and are dispatched to the hospital if not already on scene. If the victim is over the age of 18, they are given the option of choosing whether or not they want to report the incident to the police. If they choose to do so, a SANE nurse will contact law enforcement and gather information about what happened. The nurse then will complete a sexual-assault kit to gather evidence if the act occurred within a five-day period. If an adult victim does not wish to report the assault immediately, they can still go through the evidence-collection process and send the evidence to the Montana Department of Justice in Helena. The department will hold the kit for up to a year, should the victim choose to make a report at a later date. Also as part of the exam, victims are given antibiotics and emergency contraception. The entire process can take up to four hours, so having dedicated nurses on call is a major benefit. That way, other ER staff can focus on patients who come through the door without having to worry about completing a lengthly exam at the same time.

“Patients get much better care,” Stubbs said.

The SANE nurses see patients from across the region, including Browning, Libby, Ronan and Polson.

Mulcahy said the program is a costly, but necessary endeavor. The program’s annual budget is approximately $100,000, Stubbs said.

“We’re not a money-maker for sure, but it’s a huge community service,” Mulcahy said. “If we didn’t have this program here, we’d be sending all of our patients elsewhere to be seen.”

Reporter Mackenzie Reiss may be reached at 758-4433 or mreiss@dailyinterlake.com.