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Centra Southside President And CEO Addresses SANE Nurse Issue

Editor, The Herald:

For almost 90 years Centra Southside Community Hospital has had the privilege of caring for the residents of Farmville and the surrounding communities. In addition to our commitment to providing the highest level of quality for the patients who come through our doors seeking care, we have become increasingly focused on larger community issues that directly contribute to health – hunger, transportation, health education, early intervention, obesity, prenatal care, and wellness, just to name a few. The “Centra SCH Community Health Needs Assessment,” published on our web site, demonstrates our belief that if we are to remain true to our uncompromising focus on quality and service, we must:

• address the community needs that impact our health so we are no longer simply treating the sick, but instead are improving our community’s health, and

• collaborate closely with other community and regional partners including schools, places of worship, and even other health care providers.

Responsible hospitals can no longer be autonomous islands that provide all things to all people; instead we are part of a broader array of relationships and partnerships that allow us to provide our patients with the most appropriate care in the most appropriate setting. To that end, partnering with Centra in 2008 expanded the range of services available here in Farmville, and gave us access to skilled colleagues who can provide support for the types of patients seen less frequently in smaller towns like Farmville.

In recent months, the topic of sexual assaults has gained much needed attention in every community and on every college campus. This is a problem that threatens the most basic need for safety and security we all deserve. As the CEO of Centra, it is my responsibility to ensure that victims of sexual assault can be cared for by trained professionals compassionately, with dignity and respect, and in a manner that allows victims to begin the difficult and arduous process of healing and recovering. The team of physicians, nurses and other medical professionals at Centra Southside Community Hospital provides timely access to the finest level of care available and is experienced in offering support to victims whose injuries are not only physical but also emotional and psychological.

In addition to receiving immediate care at the Emergency Department in Farmville, victims are transported by ambulance to Lynchburg General Hospital for examination by a Sexual Assault Nurse Examiner (SANE), a specially trained nurse that provides at least two critical roles:

• Conducting a comprehensive physical examination including sensitive, compassionate intervention, while gathering evidence in a manner that ensures the integrity of the samples so the evidence will be admissible in court.

• Providing objective expert testimony in court in support of either the prosecution or the defense.

The SANE nurses located at Lynchburg General Hospital examined and treated 273 sexual assault cases in 2014, and were subpoenaed to appear in over 300 cases during that same time. It is critically important that SANE nurses stay proficient in the process of conducting exams and gathering evidence since their subsequent testimony often plays a pivotal role in criminal trials. In fact, litigators typically are trained to uncover any weaknesses in the SANE nurse’s capabilities as a method of discrediting their testimony – inadequate training, low volume of examinations, prior testimony experience, and improper use of equipment are just a few of the potential weaknesses targeted. Consequently, SANE nurses are most often located in population centers, like Lynchburg, where they will conduct a sufficient number of exams to keep their skills sharp, and have immediate access to the necessary equipment and other supporting resources.

If Centra were to locate SANE nurses in Southside Community Hospital’s Emergency Department, as has recently been suggested, we would be doing nothing short of abandoning our mission to provide Excellent Care…Every Time. In all of 2014, we treated and cared for 8 sexual assault victims in our Emergency Department in Farmville – far too many to ignore as a community issue, but far too few to support with an on-site SANE nurse, even one traveling from Lynchburg on an as-needed basis. Centra has thoroughly evaluated not only the options proposed by community members, but also a much broader array of alternatives identified by our own medical professionals who are on the front lines of care and who are the most qualified to speak on the topic. While we strongly encourage the community to suggest ways that we might improve any aspect of the care we provide, the community also rightfully entrusts Centra to be guided strictly by what is right for the patient, not by a reflex response to any group that generates media attention. Furthermore, portraying immediate access to a SANE nurse as the single most important aspect of care and treatment of sexual assault victims only oversimplifies a much more insidious community issue, overlooks the role of those medical professionals who are already caring for victims, and even potentially narrows the focus to the detriment of the SANE nurse’s ability to serve as an advocate for justice in the legal process.

Centra’s leadership does not take this issue lightly. I am personally deeply invested, having begun my career as a nurse with SANE training, but equally important, as a husband and father to two college-aged girls living away from home. There should be no doubt that I vigorously support all efforts aimed at prevention, safety, care of victims and reporting of sexual assaults. In addition to my personal views, I have sought the advice and guidance of hospital leadership, medical leadership, and the Centra Southside Community Hospital Board of Directors, and we are unified in our support of the current process and consequently will continue to care for sexual assault victims appropriately in our Emergency Department in Farmville, with SANE nurse examinations occurring in Lynchburg – for now. As our community changes and as technology advances, we will continue to migrate services to smaller community settings when those services can be provided in a manner consistent with the level of quality that is our standard.

Community leaders including the health system, schools, mental health professionals, local law enforcement, political representatives and the criminal justice system will have to broaden their view perspectives if we are to reduce the prevalence of sexual assaults. In order to affect meaningful change, these tragic events must be examined more broadly in context, including the upstream causes and predictors of sexual assaults, the unstable family environments that may contribute to violent behavior, the tendency of our culture to turn a blind eye to athletes and other potential role models guilty of such crimes, the need for sentences to match the severity of the crime, and the role of law enforcement in protecting our safety at school, at home and at work.

Respectfully submitted,

E. W. Tibbs, RN, BSN, MBA

Centra – President & CEO