Joan Carson, RN, CEN, SANE- A, SANE-P, is a registered nurse at the UVM Medical Center and clinical coordinator for the Vermont Sexual Assault Nurse Examiner Program.

Joan Carson, RN, CEN, SANE- A, SANE-P, is a registered nurse at the UVM Medical Center and clinical coordinator for the Vermont Sexual Assault Nurse Examiner Program.

As the snow finally begins to recede and the days get longer, I feel a sense of optimism and ease. Yet, there is a silent disease that is not easily visible. This is the silence of sexual assault and abuse.

One thing I notice in my work as an Emergency Department RN is that patients who experience trauma begin the process of recovery by talking about it. They explain the details of a car accident in great detail; they go over the chronology of a traumatic illness. They tell it to their loved ones and friends and they tell it to the doctors and nurses who care for them. It seems as though the telling of the story is a way to make the event real and to make the trauma manageable.

In my work as a Sexual Assault Nurse Examiner, the same phenomenon occurs. A survivor of physical or sexual assault needs to tell the story and needs someone to hear the words and reflect back the words and the feelings of the patient. Believing the survivor helps them recover and listening to the survivor’s account of what happened helps them recover. With sexual assault, though, there are very few places where this can be done safely and without shame. Sexual assault and abuse is shrouded in silence and shame.

The one piece of information that has tremendous impact on a person’s long-term health is the one thing that they are least likely to share: history of sexual assault or abuse. Important studies published in the last few years, including the Adverse Childhood Experiences (or, ACE study) show the link between early traumatic experiences and risk of significant health problems such as diabetes, heart disease and early death. We know that one in four women and one in six men experience sexual abuse in their lifetime. In any given roomful of people, it’s likely that someone has been through this trauma.

In our work as Sexual Assault Nurse Examiners, we start the process of healing from trauma by believing the survivor and giving them the space to tell what happened. We bear witness to their fear and pain and shame. We help them get connected with support groups and counseling services that will give space to their trauma and acknowledge the sometimes difficult navigation through the legal and medical systems.

We also take time to educate medical providers and staff about sexual and domestic violence in order for them to increase the likelihood that a patient might share this important, yet often hidden, piece of information.

In doing so, we bring visibility to a silent pain – by truly seeing our patients, we help them start the process of healing.

Joan Carson, RN, CEN, SANE- A, SANE-P, is a registered nurse at the UVM Medical Center and clinical coordinator for the Vermont Sexual Assault Nurse Examiner Program. The UVM Medical Center’s SANE program includes a Pediatric SANE Program as part of the University of Vermont Children’s Hospital.

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