Vitalité will train more sexual assault nurse examiners to address shortage

Vitalité has 13 active sexual assault nurse examiners and four unfilled maternity leave/sick leave positions. (wavebreakmedia/Shutterstock - image credit)
Vitalité has 13 active sexual assault nurse examiners and four unfilled maternity leave/sick leave positions. (wavebreakmedia/Shutterstock - image credit)

Vitalité Health Network hopes to deal with an ongoing shortage of sexual assault nurse examiners by training more of them this winter.

It plans to offer a training course in February, and already has three nurses registered, said Sharon Smyth-Okana, senior vice-president of clinical programs and nursing.

"We are working in close collaboration with talent acquisition advisors to support the recruitment initiatives," she said in an emailed statement.

Unlike the Horizon Health Network, Vitalité does not intend to hire any full-time sexual assault nurse examiners, Smyth-Okana said.

Earlier this week, Horizon announced plans to hire full-time sexual assault nurse examiners, who will now to be known as forensic nurse examiners as part of a rebranding, instead of relying largely on full-time nurses being on-call in addition to their regular duties.

There is and will always be a [sexual assault nurse examiner] a phone call away. - Sharon Smyth-Okana, Vitalité's senior vice-president of clinical programs and nursing

The change stems from an internal review triggered by a CBC report that a Fredericton rape victim was turned away from the Dr. Everett Chalmers Regional Hospital because no one trained to perform the exam, commonly referred to as a rape kit, was available on staff or on call until the next day.

The woman, 26, whom CBC is not naming, said she was instructed to go home overnight, not shower or change, and to use the bathroom as little as possible to help preserve any evidence.

27 fewer examiners than in 2015

Vitalité currently has 13 nurses trained as sexual assault nurse examiners (SANE) who work on call to provide the 24/7 service, each covering a huge territory, travelling as needed to meet with victims of sexual violence and intimate partner violence.

That's down from 40 nurses trained in the service in 2015, president and CEO France Desrxcosiers said last month, when fielding questions from MLAs about the health system, including the SANE program.

The COVID-19 pandemic complicated efforts to train more nurses to provide the service, according to Vitalité and Horizon officials.

Despite the dwindling numbers, Vitalité has managed to maintain the service with no gaps, Desrosiers said.


Two fully trained sexual assault nurse examiners are "coming back" to Vitalité, as of November, said Smyth-Okana.

She did not elaborate, but did say no Vitalité sexual assault nurse examiners resigned in the wake of comments made by Premier Blaine Higgs about the Fredericton case. Higgs described the incident as "unacceptable" and "reflective of a process guided by very poor decision-making and a lack of compassion," prompting at least four of Horizon's sexual assault nurse examiners to resign.

Vitalité has four unfilled SANE maternity/sick leave positions, Smyth-Okana said.

New regional co-ordinator post pending

A full-time regional co-ordinator position for the SANE program was created this summer, but Vitalité is "awaiting approval to post that position," she said.

"As recently highlighted in the media … the SANE program in New Brunswick is facing challenges related to staffing and standby coverage, exacerbated by the current nursing shortage. A full-time regional co-ordinator will be able to ensure an [eight]-hour coverage per day in the health zone where the co-ordinator will be nominated," in health zones 4, 5 or 6.

"The rest of the coverage will be ensured by on call SANE/FNE nurses," Smyth-Okana said.

Horizon plans 'ease of access' training

Horizon officials could not be reached Friday about their training plans.

But the development of a "streamlined" provincial education strategy is among the sweeping changes Horizon announced to its sexual assault nurse examiner program, stemming from the review.

The strategy will include "technological solutions to enable ease of access and to ensure effective and efficient onboarding of all [forensic nurse examiner] personnel," officials said.

Horizon plans to add about seven full-time equivalent forensic nurse examiners. The breakdown includes:

  • Moncton area — 2.8 registered nurses, Class A, full-time equivalents

  • Saint John area — 1.8 RNCAs FTEs

  • Fredericton area — 1.8 RNCAs FTEs

  • Miramichi area — 0.4 RNCAs FTEs

  • Upper River Valley — 0.4 RNCAs FTEs

This will guarantee coverage for 16 hours per day in Moncton, Saint John and Fredericton, and eight hours per day in the Upper River Valley and Miramichi, said Greg Doiron, vice-president of clinical operations, who led the review.

Horizon also hopes to add or increase program co-ordinators in all five areas.

It will cover the extra $1.16 million annually in staffing costs until the end of this fiscal year, and the provincial government will "hopefully be assisting" with ongoing costs.

Teghan Beaudette/CBC
Teghan Beaudette/CBC

Other plans include forming a provincial governance committee, and rebranding the program as forensic nurse examiner services to better reflect the specialized training and skills required and the types of patients served.

Forensic nurse examiners provide specialized nursing services and trauma-informed care to victims of sexual violence, intimate partner violence, and any maltreated individual, including men, women, teens, children, seniors and members of the LGBTQ community.

In addition, FNEs are trained in conducting a medical forensic exam, including evidence collection, providing courtroom testimony and showing compassion and sensitivity toward survivors.

Vitalité also intends to change its program name to forensic nurse examiners "to better reflect the work," upon approval of the Department of Health's acute care branch, said Smyth-Okana.

"Despite the challenges that the health system is going through, please do not hesitate to seek help," she urged.

"If you present yourself to the emergency department and there is no SANE/FNE nurse on call, a regional or provincial co-ordinator will be called and a plan will be made to ensure best care for you in a timely manner. Also, do not hesitate to call ahead.

"There is and will always be a SANE/FNE nurse a phone call away."