Right before her husband’s birthday party started, Vanessa Lozada, an emergency room nurse at Texas Health Presbyterian Hospital Plano, received a call from a colleague. On the phone was Judy, a registered Sexual Assault Nurse Examiner (SANE) who specialized in pediatric sexual abuse and rape cases; she was panicked.
“Vanessa, I have a five-year-old, Spanish-speaking patient and there are no translators available. I know it’s your day off, but can you please give us two hours,” Judy pleaded.
“I was thinking, ‘It’s my husband’s birthday; we’re having people over,’” Vanessa recalls while sipping a cup of tea. “But I said to [my husband], she’s five years old. Who am I to say I’m not giving this girl a chance to tell her story?”
She rushed to the hospital. Vanessa sat down with the little girl and explained that she was a special nurse who needed to make sure all of her body parts were healthy. While performing the medical examination, the little girl told Vanessa everything about the abuse she suffered. As Vanessa was leaving, a police officer approached her.
“How did you get her to say that?” the officer asked. “We knew the sexual abuse had happened, and we’ve taken her to everyone. This is the first time she’s opened up.”
Vanessa was stunned.
“I wondered if I had a gift for speaking to these kids. I ended up testifying in court for that case and [the perpetrator] was charged. I saw the difference a SANE nurse can make. God forbid [what might have happened] if I hadn’t gone that day. She might have never opened up and would have never gotten justice; she could have gone back to that environment. It opened my eyes to the fact that I needed to become SANE certified.”
Becoming a SANE nurse takes two to three years of additional training. First, there are 40 hours of lecture-based courses on treating adults, and another 40 hours on treating children.
Then trainees shadow current SANE nurses during clinicals; they must assist on a specific number of adult and pediatric cases in order to become certified. Often, local trainees travel to hospitals all over Collin County because sexual abuse cases, especially for children, are sporadic. They might be called up to go anywhere within county limits at any time.
Registered SANE nurses travel to different hospitals regularly. Victims are never asked to move to a different hospital, the SANE nurse always goes to them. If victims are asked to relocate, the chances of them changing their minds and going home increases significantly.
SANE nurses can be called to any hospital within Collin County at any time; wherever a victim presents is where they stay to be treated. Having found the courage to seek help, if a victim is asked to move they may simply give-up and go home. It is important that the SANE nurse travel to them.
There are several different aspects to being a nurse versus a SANE nurse.
“When you’re a traditional nurse, you’re documenting everything so that you don’t have to go to court,” Vanessa explains. “That’s most nurses’ biggest fear: having to go to court to defend something. In the SANE world, we want to document everything in order to go to court and put the abuser in jail. In nursing school, they never teach you how to talk to a jury. People think, oh you’re the nurse, you just do the exams. Actually, I’ve been to court four times, but the process takes forever. One case I did last year won’t be in court for another two to three years.”
SANE nurses also have extensive training in collecting evidence for rape kits, as well as male and female genitalia anatomy. Vanessa treats patients as young as newborns to as old as 90, so she must know the difference between healthy and abused.
Since becoming a SANE nurse three years ago, Vanessa has seen countless cases, but few go to trial. Sometimes, it’s because the perpetrator took a deal from the DA, other times the victim chooses not to move forward.
“Some victims don’t want to tell the whole world what happened to them. The times I’ve been to court have been the most terrifying things ever. They try to make you mess up. They bring lots of studies, and say, ‘Well Ms. Vanessa, didn’t you hear about this study done in blah blah blah that said there would be no trauma because blah blah blah.’ It’s scary, but I always say that while I’m not familiar with that article, if you give me time I can read it and tell you what I think.”
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Vanessa is one of only 13 SANE nurses in Collin County. They get together every other month, along with police officers and the DA, to discuss cases, give each other peer reviews and to attempt to get closure.
“[Being a SANE nurse] is our side job to being a regular nurse,” Vanessa explains. “We don’t do it for the money. We do it because we care. A lot of people say that they could not get paid enough to do this job. Nobody wants to do it, especially when it comes to children.”
There have been moments where Vanessa has felt so completely defeated, she has thought about quitting.
“At the beginning, it took me weeks to emotionally process [a case]. The first time I went to court and saw the perpetrator, I realized he looked just like anybody else. We [think] that the bad people should look scary, but that’s not the truth. And whenever it comes to kids, sometimes after a case, I’m not functional. For me, it helps talking to my husband, who is a police officer. You learn that you do what you can. I’m just a piece of the puzzle.”
Because Vanessa is the only Spanish speaking SANE nurse in Collin County, she sees many cases where victims are afraid to come forward because of their, or a loved one’s, legal status. The mothers of victims often feel trapped in their marriages.
“They say, ‘I can’t leave my husband … he pays all the bills, what will I do?’ Or the mom knows, but she closes her eyes because that’s how she and her other five kids are fed and survive. A lot of the kids don’t report because their stepfather is the breadwinner, and the kid is scared because they think, what would my mom do, we’d live on the streets. That’s how [the abusers] get them.”
Vanessa hopes that eventually sexual abuse will no longer be a taboo subject. She tells her patients that the abuse didn’t happen because they were vulnerable; it happened because a bad person took advantage of them, and it can happen to anybody: boy, girl, man or woman.
“It takes one person with courage to speak up, and that’s hard when you’ve been beaten down so many times. I wish we could all give each other the courage to talk about it, to not keep the secret. Talking about it, maybe that will make them feel better—that’s my hope. If I can do something to help them feel a little better, then we’re doing our job.”
She also wants all hospitals to have designated spaces for rape and sexual abuse victims, like the Serenity Room at Texas Health Presbyterian Hospital Plano, which has calming music, snacks, toys and games for children, even a shower and a police interview area.
“At any other hospital, victims are in a regular bed. Being at the hospital because you broke a toe or because someone raped you, those are two different things. You wouldn’t want to be next to someone screaming or throwing up. As nurses, we want to make everybody feel like the most important patient, but we need to treat [rape and sexual abuse patients] differently.”
While this job reveals the darkest parts of humanity, Vanessa can’t turn her back on the victims.
“I had one patient that broke my heart completely. I cried with him through the whole process. Before he left, he gave me the biggest hug and said that I made a difference in his life. I remember saying to him, ‘You are my hero, because of you this won’t happen to anyone else and this person is going to jail.’ Those moments of, wow I made a difference, make it all worthwhile.”
If you or someone you know has been a victim of sexual assault and you need someone to talk to contact the hotline 24/7 at 1-800-799-7233.