LAS VEGAS (KTNV) — It's no secret there's a nationwide nursing shortage, but there's one specific type of nurse that local advocates say the Las Vegas valley especially needs more of: forensic nurses.
Forensic nurses collect evidence after someone has been harmed and give testimony that can be used in court to prosecute the perpetrators of the abuse. Sexual Assault Nurse Examiners (SANE) are a type of forensic nurse who work with survivors of domestic and sexual violence.
Advocates say the problem is that only one hospital in Clark County — UMC — has a SANE program, and it only has one primary SANE. A spokesperson for UMC told Channel 13 they have two other SANEs fill in if the primary one is not in.
Liz Ortenberger, the CEO of SafeNest, a local organization that supports survivors of domestic and sexual violence, said the valley desperately needs more forensic nurses amid rising concerns about intimate partner violence. Ortenberger said even Washoe County — which has just a fraction of the population of Clark County — has more SANEs.
"Clark County has 2.4 million people. We are up to 3 million people on any given weekend. It's simply not enough," Ortenberger said.
Since UMC is the only hospital in Clark County with a SANE program, she said some survivors are having to travel a far distance to get this important healthcare — and often in the same clothes they were traumatized in, to preserve evidence for the exam. On top of an already difficult experience, she said transportation and childcare are other things these survivors often have to consider when making that trip to UMC.
"A survivor has a couple of options — one is to go and wait in the emergency room at UMC for the time that it takes to get the exam. I have reports of people waiting 4 hours. I have reports of people waiting 18 hours," Ortenberger said.
She said the other option is for the survivor to decline the exam, and their abuser may never be brought to justice, should they choose to press charges.
"We are all at higher risk when perpetrators of strangulation are not being given a felony charge and they're not getting the appropriate sentence for the crime," Ortenberger said. She said SafeNest sees on average about 120 strangulation victims per month.
"We, as a city and a county, have got to grow into the space of being able to provide appropriate victim services," Ortenberger said.
UNLV Director of Doctoral Education, Candace Burton, has worked as a forensic nurse in several states and said the lack of forensic nurses in Clark County surprised her.
"That's woefully inadequate. I was just sort of shocked when someone told me that. Most places the size of Las Vegas would have a least a couple of different medical teams at different medical centers," Burton said.
Burton said it's a difficult specialty that can take a toll on the people who do this important work, but it's also incredibly rewarding being there for people when they need it the most.
"For some people, it's incredibly emotionally difficult because you're dealing with traumatized people. Someone has literally probably just had the worst day of their life if they come to be your patient when you're a forensic nurse," Burton said.
She said there are several likely reasons why other hospitals in Clark County don't have a SANE program.
"We have a nationwide shortage of nurses. Forensic nursing is a difficult specialty, so the shortage within our practice is even greater, and the fact that it's difficult to get teams set up. This is not exactly a moneymaking practice. We're not doing outpatient surgery or something, because the state pays for the exams," Burton said. "They really don't understand that there's no money that comes in with it. It's really healthcare that people deserve. It's not a profit-generating service, so a lot of hospitals don't want to deal with that."
She said to begin addressing this problem, we need a training program.
"If you have a local training program, that helps a lot. I ran a training program in California. I would love to start something like that here, because it's difficult to get the training if you just want it by yourself," Burton said. Channel 13 asked her if she'd be interested in starting one here.
"We are talking with SafeNest. This actually just came together as a result of you contacting me, in fact," Burton told Channel 13. She said she and other folks at UNLV are looking into pursuing some possible grant funding with the hopes of using that money to potentially start a training program here.
"Hopefully we're going to be able to do some good work together," Burton said.
SafeNest CEO Liz Ortenberger said it's really going to take a multi-pronged approach to fully tackle this problem. She said the state also needs to streamline how hospitals can bill the government for these exams, since they're free for survivors. She said she'd also like for hospitals to be required to have a forensic nurse on staff if it receives Medicaid dollars or other government funding. Those two things are on Ortenberger's legislative agenda for 2025, and she said she's encouraged by the latest talks she's had with local healthcare and government leaders.
Meanwhile, UMC officials are hoping other local hospitals step up to share the workload. A spokesperson from UMC shared the following statement:
We hope other hospitals in our community follow UMC’s lead and work to develop Sexual Assault Nurse Examiner programs, further improving access to this critical service that is currently only available at UMC. Victims of sexual abuse shouldn’t have to worry about traveling to a specific hospital to receive the care they deserve.
In addition to UMC’s primary Sexual Assault Nurse Examiner, we also have two additional Sexual Assault Nurse Examiners who provide coverage when needed. These trusted nurse examiners offer unparalleled expertise while caring for community members and visitors alike.
UMC performs approximately 60 to 100 sexual assault examinations each month. Each examination takes an average of about four hours to complete.
Channel 13 reached out to two of the other, largest hospital systems in the valley to see if they're exploring the possibility of starting a SANE program.
A spokesperson from Dignity Health-St. Rose Dominican provided the following statement:
Given the highly specialized requirements surrounding staff training and the legal ramifications relating to the collection and storage of evidence while following the necessary chain of evidence, in conjunction with the necessary physical space and infrastructure requirements, St. Rose Hospitals have elected to fully endorse the detailed and comprehensive SANE program established at UMC. Our goal is to provide timely and compassionate care that includes counseling the patient regarding the UMC program and mechanisms to gain entry. The financial requirements are substantial and we respect the gold standard status and very high conviction rate achieved by the UMC program.
Channel 13 also reached out to Valley Health System. A spokesperson told us they are not exploring this at this time.
