As rates of sexual assault climb across Canada, nursing experts say there is a shortage of specially trained forensic nurses to properly care for victims.
Timely care from a well-trained forensic nurse can help stave off a cascade of post-traumatic effects, including depression, anxiety and even suicide, said Sheila Early, president of the Canadian Forensic Nurses Association.
"I always thought that as an emergency nurse, what I did was I put Band-Aids on these individuals. But as a forensic nurse, I helped them make that first step to whatever recovery that will come," Early said in a recent interview.
Sexual assault nurse examiners are forensic nurses trained to collect evidence from sexual assault and domestic violence victims, and to help them cope with trauma. They can also be called to testify in court. Their expertise requires hours of dedicated training — at least 60 hours in Nova Scotia, plus observation training in a gynecological practice, said Martha Paynter, an assistant nursing professor at the University of New Brunswick.
"Their evidence gathering is a very different type of nursing work," Paynter said in an interview. It's also "extremely traumatizing work," she said, "and it takes somebody who really wants to do it."
Despite the emotional toll and the extensive training they carry, sexual assault nurse examiner positions are often casual roles, requiring the nurse to juggle on-call hours on top of their full-time nursing jobs, said both Paynter and Early. In the midst of a health-care crisis and widespread nursing shortages, it's no wonder some provinces are struggling to find nurses who will take on the extra load, they said.
New Brunswick's Vitalité Health Network cancelled training planned for February because too few nurses signed up, officials confirmed in a recent email. In the health region covering Labrador and parts of northern Newfoundland, officials confirmed they too put off training the region's first sexual assault nurse examiners after too few nurses responded to a call for interest last year.
The Labrador-Grenfell health authority said it will issue another call for interest this week.
There are also forensic nurse shortages in Ontario and Saskatchewan, according to nurses unions in those provinces.
"Dedicated funding is required to ensure every sexual assault (and) domestic violence centre in Ontario can provide 24-7 access to (sexual assault nurse examiners) for survivors," said a statement from the Ontario Nurses’ Association, adding that it was "deeply concerned" about the shortage.
Meanwhile, Statistics Canada reports that the rate of police-reported sexual assaults in Canada rose by 18 per cent in 2021 compared to the year before, with the highest increases in Quebec, Newfoundland and Labrador and New Brunswick. In 2020, the rate of sexual assault in Labrador was six times the national average.
Paynter said nurses need to be given more flexibility to take on other duties and training.
"A lot of nurses would love to do this work," she said. "So how do we make the whole sector more flexible so that people can fit in these other things? We know that nurses are happier, they're most fulfilled when their scope is broadest."
Early said sexual assault nurse examiner expertise should be recognized as a specialty designation by the Canadian Nurses Association. That way, she said, there would be more funding for training and positions. The association did not immediately respond to a request for comment.
Early helped found British Columbia's first forensic nursing program in the early 1990s. In the decades since, change has been slow, but it has come, Early said, noting that some provinces are making efforts to offer full-time instead of casual jobs.
In Manitoba, health officials recently hired full-time forensic nurses after sexual assault victims were turned away from a Winnipeg hospital. The victims were told to avoid showering and come back when a specially trained nurse was available, said Darlene Jackson, president of the Manitoba Nurses Union.
New Brunswick's Horizon Health network is also expanding its forensic nurse examiner program in part by hiring full-time staff, officials confirmed Thursday in an email. The move comes after CBC reported last fall that an alleged rape victim was turned away from a Fredericton hospital and told not to wash until she could return when a forensic nurse was on shift.
Early said she's like to see more provinces make the job permanent.
"Violence is a public health-care issue. So why don't we deal with it on that level?"