4 sex assault nurse examiners resign in wake of premier's comments

At least four sexual assault nurse examiners have resigned from an already understaffed program in the wake of comments by the New Brunswick premier and a health authority executive about a Fredericton victim being turned away, which one nurse described as a "slap in the face."

Two nurses have left the sexual assault nurse examiner (SANE) program in the Fredericton area, the Horizon Health Network confirmed.

Another two have left the program in the Upper River Valley area, said Horizon spokesperson Kris McDavid, while Fredericton SANE nurse Janet Matheson said the actual number is three.

"It's just the feeling of disrespect that we got and by not getting a public apology, we just felt disrespected," said Matheson, who is still with the program.

CBC News reported in September that a woman who had been sexually assaulted was told to go home because no one was available to examine her until the next day.

Premier Blaine Higgs described the incident as "unacceptable" and "reflective of a process guided by very poor decision-making and a lack of compassion."

Matheson said her colleagues "stepped aside … pretty well right after [a] big provincial meeting," attended by SANE and Horizon officials.

"You've got to support your staff, got to be loyal to your staff."

Opposition calls for apology

In the legislature Wednesday, Rob McKee, leader of the Liberal opposition, called on Higgs to apologize because "lowering staff morale is only going to be making the problem worse."

"We have to acknowledge the workers in the system doing great work with the resources they have, and I'm asking this premier to stand up here today and apologize to restore staff morale in this province."

Higgs acknowledged the "great work" health-care staff and officials are doing, but he refused to apologize.

He said he would hate to think of one of his four daughters being raped and seeking help at an ER, only to be turned away.

"It's a matter of social conscience," he said.

"I think we all need to hold ourselves to a higher account — no matter what we do — to make decisions that are [in] the best interest of people that need us when they need us the most. And so, Mr Speaker, I know it hurts. But boy, that rape victim, that was beyond, beyond a situation."

McKee said he too feels for the victim. As a lawyer, he said, he knows how important the forensic exams, commonly referred to as rape kits, are for criminal proceedings, but they're also "essential for victims to get services and treatments that they need," which include a medical exam, medications to prevent pregnancy and sexually transmitted diseases, compassionate support, and resources for followup.

He blamed the situation on the government's "inaction on health care" and asked what the plan is to increase SANE staffing levels, noting they announced a projected provincial surplus $100 million more than expected.

Higgs replied, saying it's "unfortunate that the opposition wish to make this a political issue."

"It's not a political issue, Mr. Speaker. It's not something to gain points on. It's a very serious situation."

Health Minister Bruce Fitch said the government has already made "significant investments" in health care and recruitment.

He also announced the hiring of a new executive director of health workforce planning.

Kelsey MacDonald will "support recruitment initiatives across the health-care and long-term care systems," according to the Department of Health.

Asked for details about the new role and how it differs from previous recruitment efforts, spokesperson Adam Bowie said MacDonald will work closely with recruitment teams from the regional health authorities, the extramural program, Ambulance New Brunswick, and the long-term care sector to attract employees to a variety of positions.

Stands by comments

Outside the legislature, Higgs told reporters he stands by his comments.

"Whomever was there that night made a choice," he said.

Asked how he feels about the role his comments may have played in the resignations, Higgs said people should not lose sight of the "crux" of the situation — a woman, 26, was turned away from Dr. Everett Chalmers Regional Hospital's emergency department because no trained nurse was available to perform the exam, which involves the collection of physical evidence that is admissible in court.

The victim, who is not being named by CBC News, said she was told to go home overnight, not shower or change, and to use the bathroom as little as possible to help preserve any evidence until an appointment the next day.

She did get the exam a couple of hours later when a police officer intervened and Matheson was called in after working the night shift, but the story triggered public outrage and garnered national attention, including from Prime Minister Justin Trudeau who called it "horrific."

Felt 'thrown under the bus'

Horizon interim CEO and president Margaret Melanson echoed Higgs's comments and told reporters that what happened was "unacceptable" and it prompted a review of how the program is administered.

At the time, Matheson said the sexual assault nurse examiners felt "thrown under the bus," wanted a public apology, and more nurses trained to provide the critical service to victims.

Pressed by reporters Wednesday on whether he and the Horizon leadership bear some responsibility, given the shortage of nurses trained to perform the exams, Higgs replied, "Absolutely."

"That's why we're going through great effort here to make fundamental changes in how our system is managed, how it operates, how we react … and allowing people to make decisions in a timely fashion, right on the spot."

Still, he maintains the situation could have been handled better.

"My assessment would be you would not turn the rape victim away and say, 'Come back tomorrow,'" he said.

"If we can't provide the full care that we want to, what can we do? I mean because the police brought the young lady back to the hospital and she was treated and looked after. So I guess that says it right there, right?"

Green Party health critic Megan Mitton said it's "unacceptable" for Higgs to blame the nurses and also called for an  apology.

"What happened was, you know, unacceptable, but it's not their fault. It's the staffing shortages," she told reporters.

"The premier's trying to share responsibility for his comments with everyone and say everyone needs to take responsibility. He needs to take responsibility for what he said and stop demoralizing these really important workers who work so hard.

"This is the worst recruitment and retention strategy I could imagine."

Schedule now 'horrendous'

The resignations leave just Matheson and two others to try to cover the Fredericton area 24/7, either on staff or on call, on top of their regular nursing shifts.

"Our schedule now just looks … horrendous," said Matheson, 69, a nurse for 45 years.

As a team of five, the Fredericton SANE nurses used to manage to cover about 90 per cent of the hours, she said. "I couldn't even guess what the percentage is now, [but] the three of us are going to try and cover as much as we can."

The Upper River Valley area has two SANE nurses left, along with the co-ordinator for that area, the Horizon spokesperson said.

He did not immediately respond to questions about any other resignations in other regions, but Matheson said she was on-call in Fredericton last Saturday and performed the forensic exams for two victims from the Saint John area.

"So they're certainly facing difficulties too," she said.

Plan expected within weeks

As of Sept. 15, Horizon had only 26 sexual assault nurse examiners. That's down from about 40 a year ago.

Horizon is "working on a plan to enhance the SANE service and develop a more robust and sustainable program that will best leverage the skills of our expert nurses to meet the needs of survivors," said Greg Doiron, vice-president of clinical operations.

The program review is expected to be completed "in the coming weeks" and the results will be shared with the minister of Health, he said in a statement.

Horizon is continuing to meet with its SANE co-ordinators and teams to "gather valuable information and feedback" as part of this process, said Doiron.

"We are fully committed to strengthening our program and providing the best possible care to our patients," he said.

As it stands, SANE coverage in the Fredericton area "remains stable," said Doiron.

A forensic examination can be offered to female victims up to a maximum of 96 hours after a sexual assault, according to standards set out in in the provincial SANE program. For male victims, the limit is 72 hours, he said.

"Survivors of sexual assault are encouraged to have a forensic examination performed as soon as possible within these parameters. … Our SANE nurses have extensive training in performing these examinations safely and with compassion."

"We would like to recognize and sincerely thank our emergency department staff and our SANE nurses for continuing to provide safe and quality care to patients under challenging circumstances," he added.

Increased awareness is positive

Matheson said she attended the first of what have become weekly meetings and described it as "good."

"There was again, no apology. But [Doiron] vowed to work with us … to see how we can make some changes," she said.

"Everybody talked about the impact on them … of this story coming out the way it was. I just never thought it would ever go this far. This, you know? It's crazy."

She has heard from people across the province and in other provinces since the story went "viral," she said, and she's getting "lots of love and support" from nurses and doctors in particular.

Overall, the media attention has been good, she said, "because maybe a lot of people didn't understand the program or even knew that it existed.

"I'm hoping that … some positive things will come out of it. I'm certainly hoping that.

"In the meantime, I will keep on doing my cases."