Chris Puglia
Northern News Services

Yellowknife (Nov 15/02) - Confusion, fear, blame and guilt are some of the emotions felt by victims of sexual assault.

Speedy medical attention is critical, something nurse Sheila Laity would be achieved by having a trained sexual assault team at Stanton Territorial Hospital.

Nurse Sheila Laity displays a rape exam kit now used at Stanton Territorial Hospital. - Chris Puglia/NNSL photo Post-rape timeline - Victims arrive either on their own or after referral from victims services, the RCMP or social services. - As quickly as possible, the patient is brought into a room to provide privacy. - The patient is examined to ensure there are no life-threatening injuries. - Patient is asked if they wish to proceed with the collection of forensic evidence. Consent has three parts. 1: Medical examination to determine injuries. 2: Examination of injuries with potential to be forensic evidence (such scratches, bites). 3: Consent for divulgence of forensic evidence to RCMP. The three stages are agreed to separately. - The patient is then asked for a medical history, followed by a sexual history, including history of assault (such as anal penetration, vaginal penetration, oral penetration and number of assailants). - The collection of forensic evidence begins with the opening of the rape kit. Once the kit is open the examiner must remain with it until it is released to the RCMP. - Clothing is collected first. Patient undresses on a large mat since while they are undressing evidence might fall out of their clothing. Pertinent clothing is collected, such as underwear or a torn shirt. - Bites, scratch marks and clothing are used to find DNA evidence (saliva, semen). Injuries are recorded technically and specifically -- location, size, colour, severity. - Victim's blood is taken as a base. Follow-up appointments are scheduled to test for STDs. - Examined for physical signs of involuntary sex such as tearing or bruising. Specimens are taken from inside patients to look for DNA that doesn't belong. - Following exam and collection of evidence a discussion on contraception ensues. In most sexual assault cases no form of contraception was used by the attacker. - Patients can opt for the "morning after" birth control pill. Preventative medication can also be take to protect from certain STDs like gonorrhea and chlamydia. - The examiner must then ensure the victim is supported following the exam, that they have somewhere safe to go and have people around them. Schedule follow-up counselling victims tend to blame themselves. - Evidence is then turned over to the RCMP in case it is subpoenaed by the court. * Information provided by Sheila Laity, a nurse at Stanton Territorial Hospital who is trained in sexual assault response. Timeline is in regard to a female victim because a majority of victims are female.

"These people deserve to be treated quickly," she said.

Because a doctor can be tied up for over an hour looking after a sexual assault case, victims are not always seen as emergencies.

Laity is one of two nurses in Yellowknife trained in sexual assault response.

The development of a sexual assault response team (SART) was a need identified during a workshop held at the Capitol Theatre last week.

Laity said an SART would ensure two things: victims would be seen quickly and it would ensure they are being looked after well equipped, trained staff.

Under the SART system, a team of on-call nurses tend to sexual abuse examinations, rather than tying up emergency staff.

"I worked with a physician a couple of weeks ago who had never seen the (sexual assault) kit."

Another advantage would be nurses dedicated to sexual assault cases build a proficiency for conducting the exams and collecting physical evidence.

Patients would also be treated within an hour of being reported, a fact Laity believes is crucial.

"How would you like to be a female in dirty clothing, or clothing that you have been assaulted in, sitting in our waiting room between two RCMP? It's a very public thing. It almost makes them victimized a second time. They need privacy. They don't need to be stared at," said Laity.

Edmonton example

Kathleen Soltys, a member of the Edmonton SART, spoke about the success of their program during last week's sexual assault workshop.

"When an emergency room is busy, a nurse and a doctor would have to be taken out of circulation for an hour and do the exam," said Soltys.

Aside from freeing up emergency staffs' time, the Edmonton SART has also provided continuity.

"When you do the exam consistently it's a lot easier," said Soltys.

The SART began operating in Edmonton in 1999. Soltys said is has been very effective.

"We did an evaluation after the first year. The emergency physicians said that we were something they couldn't do without because they could focus on more serious patients," she said.

Setting up a SART requires 50 hours of nurse training plus a practicum. "Mount Royal in Calgary does a distance education course for it," said Soltys.

To set up a team in Yellowknife, Laity said four to six nurses would have to be trained.

"We don't have a huge number of assaults and someone could take a half, or a week of call. Most weeks would go by and you would not respond once," she said.

Other goals

Dr. Andre Corriveau, chief medical officer, said the workshop was important.

"The focus is to increase awareness and the need for people to work collaboratively. That way, we can hopefully identify some gaps and start standardizing protocols and then we can work from a template," said Corriveau.

Dana Heide, the director of integrated community services for the Department of Health and Social Services, said an action plan will be developed to address gaps identified at the workshop.

Corriveau said he couldn't commit to whether an SART would be set up at Stanton or not.

"We would have to look at things and what the size would be and cost out how sustainable it would be," he said.