Exploring How Sexual Assault Nurse Examiners Practise Trauma-Informed Care

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Authors

Poldon, Suzanne

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thesis

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eng

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nursing , nurse , sexual assault nurse examiners , trauma , trauma informed care

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Abstract

Sexual violence is an over-arching term describing sexual acts where consent is not freely given. Registered nurses employed as Sexual Assault Nurse Examiners (SANEs) provide care to help address the medical and legal needs of victims/survivors of sexual violence. Trauma-informed care (TIC) is an organizational approach recommended in the care of individuals who have experienced trauma, however, little is known about how SANEs use TIC in their practice. The purpose of this study was to understand how SANEs incorporate trauma-informed approaches in the care of adult and post-pubescent adolescent victims/survivors of sexual violence in Ontario, Canada. The research question was addressed with a qualitative interpretive description approach. Sexual Assault Nurse Examiners employed in Ontario were purposively recruited to participate in semi-structured interviews. Eight consenting participants completed interviews, which were recorded using online teleconferencing. Interviews were transcribed verbatim and analyzed using qualitative data analysis as outlined by Miles, Huberman, and Saldana. The methods of enhancing the trustworthiness of the research included, for example, member checking and verbatim transcriptions, reflexivity activities, and frequent peer debriefing. Six main themes emerged: (1) the importance of understanding the patient’s experience; (2) personalized connection: developing a safe nurse-patient relationship; (3) choice: the framework of how we do things; (4) re-building strengths and skills to support healing and post-traumatic growth; 5) a wonderful way to practise: facilitators and benefits of trauma-informed practice; and (6) challenges to trauma-informed practice. The main themes were expanded into sixteen sub-themes. Overall, the findings help our understanding of how the principles of TIC are incorporated into the practise of a sample of SANEs. From the findings, four summary key points are discussed: (1) valuing trauma-informed care; (2) choice as a paramount priority; (3) the need for education and continuing competence; and (4) the realities and vicarious trauma. The results of this research indicate the need for support of providers who deliver TIC, and for education about TIC beginning in undergraduate curriculums. More research about this topic is warranted to strengthen the evidence base for trauma-informed practice in SANE programs and across health care settings.

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