Mary McGee, a nurse in the Emergency Room at Prisma Health North Greenville Hospital, is one of the nurses enrolled in the SANE training funded by the grant.

Mary McGee, a nurse in the Emergency Room at Prisma Health-North Greenville Hospital, is one of the nurses enrolled in the SANE training funded by the grant.
Image Credit: College of Behavioral, Social and Health Sciences

GREENVILLE — Clemson University’s School of Nursing and Prisma Health-Upstate are collaborating to increase and retain sexual assault nurse examiners (SANE) in seven Prisma Health emergency departments in Greenville, Pickens, Oconee and Laurens counties.

The training program is funded by the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services. It is expected to total $949,396 over three years to support standard SANE training as well as extra training components developed by the project team.

The program is led by a multidisciplinary team of Prisma Health nurses, emergency services leaders and researchers from Clemson.

“This training will be important to Upstate nurses who will ultimately impact patients and their families,” said Ann Wetsel, associate director of the School of Nursing. “We at the School of Nursing are excited to be a part of this training.”

Wetsel, who leads the project, will be working with:

  • Ellen Kennedy, sexual assault nurse coordinator at Prisma Health-Upstate;
  • Cassie Mueller, nurse manager in the Prisma Health Greenville Memorial Hospital Emergency Department;
  • Greg Hair, director of emergency services at Prisma Health Greenville Memorial Hospital;
  • Sharon Holder, a research assistant professor in the youth, family and community studies department at Clemson and a Clemson University School of Health Research embedded research scientist in the Prisma Health Department of Psychiatry;
  • Susan Bethel, manager of nursing scholarship and research at Prisma Health-Upstate, and;
  • Veronica Parker, director of the Center for Research on Health Disparities at Clemson and a professor in the School of Nursing.

The School of Nursing and Prisma Health are collaborating with Upstate Area Health Education Center, a health care-provider training site, to provide hybrid training that includes online and in-person education, as well as hands-on work in the simulation space located in the Clemson University nursing building.

“This training allows the best opportunity for our nurses to learn using our equipment in a familiar environment and receive a comprehensive training experience that is also specific to the area they serve,” Kennedy said.

The goal is to increase the number of trained sexual assault nurse examiners by 20 and the number of certified sexual assault nurse examiners by nine at Prisma Health so health care facilities in Greenville and surrounding counties will have 24-hour, seven-day-a-week coverage for patients. A certified nurse has the same training as a trained nurse examiner, but is required to complete 300 hours of clinical care and take a certification exam.

Prisma Health-Upstate’s SANE program is one of nine in the state, said Sabrina Gast, Statewide Forensic Nurse Examiner Coordinator with the South Carolina Victims Assistance Network. These nine programs only cover 22 hospitals.

Within their roles as sexual assault nurse examiners, nurses could stay with their patient from two-eight hours, providing care, examinations as well as maintaining evidence for law enforcement.

Sexual assault nurse examiners could stay with their patients from two-eight hours, providing care, examinations and maintaining evidence for law enforcement.
Image Credit: College of Behavioral, Social and Health Sciences

Sexual assault nurse examiners provide care to victims of sexual assault or violence and their families, Kennedy said. They are registered nurses who have gone through specialized training in law enforcement procedures and victim support. Nurse examiners could stay with their patients from two to eight hours, providing emergency contraceptives, forensic exams and physical examinations, as well as maintaining evidence for law enforcement.

In 2018, Prisma Health-Upstate’s nine sexual assault-trained nurses provided care to 185 sexual assault patients, with 95 percent going to Prisma Health Greenville Memorial Hospital, Kennedy said.

Kennedy said the need for these specialized nurses is not only felt in the Upstate, but throughout the entire state. While there are trained SANE nurses in South Carolina, according to the International Association of Forensic Nurses, there are only 18 certified SANE nurses in the state and only one certified sexual assault nurse examiner in the Upstate.

One factor contributing to the shortage that the team has identified and will address is nurse burnout. Kennedy said that the job is difficult, because every time these nurses are called in, it’s for a traumatic experience.

“You’re collecting evidence from the very young to the elderly,” Kennedy said. “The youngest patient I’ve worked with has been less than 6 months of age. We have training on the mental health of the victim, but there is little focus on the mental health of the nurses.”

The grant also provides support for additional training that will focus on how nurses can cope and decompress while off the clock to prevent burnout, said Holder, who will be leading this component of the training.

“An important focus is retention of SANE-trained nurses by meeting their needs for self-care and work-life balance,” Holder said.

Kelli Clune, a SANE training instructor, led the first in-person education session within the grant-funded SANE training program.

Kelli Clune, a SANE training instructor, led the first in-person education session within the grant-funded SANE training program.
Image Credit: College of Behavioral, Social and Health Sciences

Another factor the team has identified is the availability of training for sexual assault nurse examiners. Training is held once a year and nurses have to travel to participate in the 40-hour program, which can be difficult with work schedules, Kennedy said. She expects the difficulty of attending training to be reduced for Prisma Health employees with the hybrid option. The grant will also provide resources to SANE-trained nurses who want to become certified, such as review courses and materials.

Other aspects of the training provided by the grant include collaboration with the chaplain services at the hospitals and more awareness and collaboration with community resources, such as advocacy centers that can help the patients after they leave the emergency rooms. Kennedy said that having an advocacy center involved with training of the SANE nurses allows better overall care and environment for the patient, as well as safer, more effective follow-up.

“Research shows that victims will not always realize the full impact of this trauma for six to nine months. By that time, the patients are long-gone from our ER and it’s difficult for the department to contact them from a legal standpoint,” Kennedy said. “Working closely with community resources allows each member of the partnership to see what the others can (and cannot) do within their scope of practice.”

Through the collaboration with the School of Nursing and through the use of expertise in simulation, the training program team hopes to make Prisma Health a clinical training site to support SANE training and certification for nurses by the end of the three-year grant.

Clemson University School of Nursing
The Clemson University School of Nursing is committed to prepare nurses for professional practice, leadership in health care and to advance nursing knowledge. The school offers a Bachelor of Science degree in nursing, a Ph.D. in healthcare genetics, a doctor of nursing practice, Master of Science in nursing, an accelerated second degree nursing program and an RN/BS completion program as well as a global health certificate program.

Prisma Health-Upstate
Prisma Health-Upstate, formerly Greenville Health System offers patients an innovative network of clinical integration, expertise and technologies through its academic health system, eight medical campuses, tertiary medical center, research and education facilities, community hospitals, physician practices and numerous specialty services. Prisma Health-Upstate, by itself a 1,627-bed system, is home to 16 medical residency and fellowship programs, as well as partnership efforts such as the University of South Carolina School of Medicine Greenville and the Clemson University Nursing building. Visit ghs.org to learn more.

Upstate Area Health Education Consortium
Upstate Area Health Education Consortium is part of the South Carolina Area Health Education Consortium located at the Medical University of South Carolina (MUSC) in Charleston and includes four statewide regional centers. Upstate AHEC’s administrative offices are located in Greenville. Other AHEC locatio­­­ns include centers in the Lowcountry, Mid-Carolina and Pee Dee regions. SC AHEC is part of the National AHEC Organization (NAO), established by the Federal government in 1971 to ensure appropriate healthcare to rural areas of the United States. Today, in addition to providing the best possible healthcare through education and training, NAO is devoted to providing jobs and building a strong healthcare workforce. The mission of Upstate AHEC is to be the bridge linking students to health care careers, health professions students to our communities, the health care workforce to continuing education and our communities to better health.Visit www.upstateahec.org to learn more.