At least two sexual assault nurse examiners are going to stop picking up extra shifts to help bridge gaps in the program, and others may be poised to leave after recent comments by the premier and the head of Horizon Health Network have made them feel "thrown under the bus," according to one nurse.
Janet Matheson, a sexual assault nurse examiner at the Dr. Everett Chalmers Regional Hospital in Fredericton, says the "dedicated," "compassionate" nurses in the SANE program want a public apology, and more nurses trained to provide the critical service to victims.
Matheson was responding to media coverage of a CBC story Monday about a sexual assault victim who was turned away from the Chalmers emergency room and told to schedule an appointment for the next day.
The 26-year-old woman, whom CBC News is not naming, said she was still in shock after being told to go home overnight, not shower or change, and to use the bathroom as little as possible in order to help preserve any evidence.
Premier Blaine Higgs issued a statement, describing the situation as "unacceptable" and "reflective of a process guided by very poor decision making and a lack of compassion."
Horizon interim CEO and president Margaret Melanson also told reporters that what happened was "unacceptable" and triggered a review of how the program is administered. "There will be follow-up undertaken with those working within this program, reinforcing the on-call scheduling," as well as contingency plans, she said.
More to the story
In a Facebook post, Matheson, a registered nurse for 45 years, said it's "disheartening to see that once again, Horizon management has failed to publicly support its staff by choosing instead to throw the ER nurses and now specifically sexual assault nurse examiners, under the bus."
It's also "discouraging" Melanson and Higgs made public comments "that were misleading and painted nurses in a negative light either because they were in a rush to avoid taking responsibility and putting the blame where it belongs, or because they simply didn't take the time or make the effort to find out the true story," she wrote in the post, which has been shared more than 1,000 times and has generated about 150 comments, as of Thursday night.
Matheson suggested there's more to the story.
"There are details about this case that would undoubtedly change the public's opinion of what happened from the perception left by the CEO and the premier, but we are handcuffed from sharing them by privacy restrictions," she wrote, referring to the system, not the victim, she clarified during a CBC interview, without elaborating.
"At the very, very least, CEO Melanson should find the courage to say publicly and to the premier, 'No Mr. Higgs, what occurred that night wasn't the result of a lack of compassion, it was the fault of a system failing under its own weight because of the government's inability to fix it.'"
There's nobody that feels worse that there was nobody on call than our team. - Janet Matheson, SANE nurse
Matheson confirmed to CBC she was the nurse who ended up being called in that night to help the victim after a Fredericton Police Force officer intervened.
The 69-year-old, who retired in February from 45 years of full-time nursing but went back on a casual basis, had just gotten into bed after finishing an evening shift around midnight. She arrived at the hospital within about 25 minutes to perform the forensic examination, she said.
Only five SANE nurses are on the Fredericton team and they manage to cover 90 per cent of the 24/7 hours, said Matheson, but none were on call that night.
"I just want to say, look, I work with an amazing team of five nurses and we have an amazing co-ordinator and … we try to do as much on call as we possibly can.
"And I just felt that that all got kind of swept away, you know, because [of] the sensation of, you know, like, yes, she was turned away," she said.
"There's nobody that feels worse that there was nobody on call than our team."
From a forensic standpoint, the exam could wait until the next morning, according to Matheson. But "it's a traumatic event and emotionally, she needed the case done that night."
Want to provide best possible care
The premier's suggestion that what happened showed a lack of compassion by staff was "nothing short of a slap in the face" to the nurses, whose compassion is the attribute that motivates them to "continuously go the extra mile," said Matheson, a member of the program for 16 years.
Being a sexual assault nurse examiner on call means they have to "drop everything, day or night" when a victim shows up at the hospital, she said, noting many work full-time and have families.
"And why do we do it? Because we care, and we want to provide the best possible care to people on their worst possible day."
"Never do we forget there's a victim. She or he or whoever, they're utmost in our mind."
The "hurtful" comments have not been good for morale, she said, fighting back tears.
At least two nurses — one in Fredericton and one in the Upper River Valley — "have already said, 'I'm not picking up more time until we get our apology'" from Higgs and Melanson.
"And maybe some are writing resignation letters."
She is not among them — not yet. "I super care about this program."
Victim defends nurses
The victim says she was sad to see the nurses blamed because they work hard and were just following policy when they sent her home.
"I think we all have nurses in our lives that we love and care about and know how totally exhausted they are, and how many extra shifts they're picking up just to cover the regular amount of need that we have in our communities.
"And so, that women are willing to be trained and come in on top of their regular overscheduled schedules to help women who have experienced this means a lot."
She contends the program needs more trained nurses — "and the need is not something we can ignore."
That's why she decided to speak out about her experience, to help make sure it doesn't happen to anyone else.
She's been overwhelmed and humbled by the public support and national attention her case has received, including Prime Minister Justin Trudeau calling it "horrific," she said.
"I think I feel safer as a woman to know that when something that shouldn't happen happens to me, no one sits around and is OK with it, but people speak out and make sure that the right thing happens."
She's "cautiously optimistic" about Horizon's ongoing review of the program, she said, after receiving a call from Melanson.
"I think it shows that the policy has been harmful to women, and I'm glad that it's being updated. And I look forward to being informed when that's been changed so that I'm the last woman that this ever happened to — even if I wasn't the first."
CEO commends dedicated staff, cites 'system issues'
Melanson confirmed calling the victim. "I commended her for coming forward. I commended her for her bravery and for speaking out," she told reporters Thursday.
"And as a woman and as a member of the community, I assured her that this is something that is being taken very, very seriously by Horizon, that we have introduced now a very clear process improvement that will be occurring within this entire program."
She did not provide any details.
Asked about concerns raised on social media by health-care workers who feel they're being blamed and suggestions that there's more to the story, Melanson said she commends the nurses who participate in the program.
They "have a great deal of dedication," she said, during a break in a public accounts committee at the legislature, where Horizon and Vitalité officials fielded questions from MLAs about the health system, including the SANE program.
"I would also say that this particular circumstance — and we're very pleased the victim has come forward and shared her story with us — emphasizes gaps and issues in our system. And I certainly do not want in any way to make anyone feel as though there is any type of scrutiny or worse, any blame to be applied to any of our staff.
"Our staff are dedicated individuals who often carry out this work after long hours of busy shifts because they are committed to this program and very committed to the population and the need for this type of service."
As to whether she told Higgs the problem was not a lack of compassion, Melanson said she and Horizon trustee Suzanne Johnston met with him on Wednesday.
"We covered a number of different issues and certainly the premier and others are aware that there were system issues behind this particular circumstance," she said, without providing any other details.
Job not for everyone
Matheson said she hopes to see more nurses trained — at least two or three more for Fredericton alone, which would reduce the amount of on-call work required.
Not everyone can do it, she said, and many drop out. It requires extensive training, continuous education and it's difficult emotionally, she said, noting the victims are sometimes children.
It's also time-consuming. In addition to the forensic examination to obtain evidence for police investigations and the medical exam, the nurses also provide compassionate support, medications to prevent pregnancy and sexually transmitted diseases, and resources for follow-up. If a case makes it to court, they might also have to testify.
Being a SANE nurse takes four Cs, she said. "You've got to care, you've got to have compassion, you've got to be competent, and you've got to maintain confidentiality."
Since she posted on Facebook Wednesday morning, a few people have reached out to her to inquire how to get trained, she said. "So you know, maybe some good things will come out of this."
In the meantime, Matheson wants to reassure people the Fredericton SANE program is good and they should not hesitate about going to the Chalmers ER if they're sexually assaulted. "We realize how serious it is."