Special Teams Would Ease Trauma of Rape Victims in Hospitals, Courts : Task force: Teams of nurses and counselors are proposed. They would work with doctors, police and the victim so that evidence gathering is efficient and private.


The way a rape victim is treated by hospitals immediately after she is attacked plays a crucial role in bringing the rapist to justice, health officials say.

Often, the treatment is insensitive and slow, with rape victims placed in crowded emergency rooms. The result, the officials say, leaves such a bad taste that women are sometimes reluctant to rely on large bureaucratic systems to bring the rapist to justice.

A group in San Diego is trying to change that. It is offering rape victims a way of treatment that officials hope will handle women with sensitivity and efficiency, and keep them involved in pursuing their attackers through the court system.


Most San Diego County rape victims wait hours in a crowded room before being examined for evidence by an emergency room doctor who is already under a lot of pressure. A woman can be made to feel the victim all over again because her rape is not considered a life-threatening medical emergency.

The San Diego County Regional Sexual Assault Evidentiary Examination Task Force hopes to change the system by forming rape response teams throughout the county.

The teams, consisting of specially trained nurses and rape counselors, would be on call 24 hours a day and would examine women in a specially designated area after she arrives at the hospital.

“If they (rape victims) know they don’t have to go through a long wait at a hospital, and there’s a team there sensitive to their needs, they will be more likely to report it,” said Laurie Mackenzie, a member of the task force and also director of the rape crisis center at the Center for Women’s Studies and Services. “That has to help the prosecutability of a case.”

Task force member and Deputy Dist. Atty. Robert Sullivan praises the concept of training nurses to perform post-rape evidentiary examinations.

“We haven’t had cases compromised that were handled in the emergency room, but the emergency room doctor has other priorities,” Sullivan said. “You get more adequate detail from a nurse practitioner than from a high-pressured physician. It’s important that exams be conducted in a timely manner, because evidence is lost the longer you wait.”

The task force is composed of representatives from the district attorney’s office, County Health Services, the Social Services Department, the Sheriff’s Department, local police departments and women’s centers.

County Supervisor Susan Golding, chairwoman of the task force, said the group’s main responsibility is to make recommendations to the County Board of Supervisors, hospitals and law enforcement agencies that would help establish the teams. The task force has up to 3 1/2 months to make recommendations, and will meet to discuss measures for establishing the teams.

The task force was formed after a Rancho Santa Fe rape victim had to wait nine hours for a post-rape evidentiary examination because two local hospitals refused to administer it, Golding said. “It is absolutely unconscionable that a woman would wait nine hours for an evidentiary examination,” she said.

Golding said she doesn’t foresee significant financial obstacles in implementing the teams countywide. The examinations are paid for by either law enforcement agencies or by the local government where the rape occurs. The task force is more concerned with emergency room overload and the lack of training emergency room physicians receive in administering evidentiary examinations, Golding said.

The task force aims to establish Sexual Assault Response Teams at the six local hospitals that now administer post-rape evidentiary examinations in the emergency room. A response team at Pomerado Hospital in North County is its model. Rape victims there are seen in a private room by a trained nurse and a victim advocate, who acts as a counselor, giving emotional support to the woman through her examination and beyond. A police officer or sheriff is also present during the examination to handle the legalities.

“We need to make sure that the victim isn’t victimized again by the system,” said Patti Seneski, Pomerado’s response team coordinator. “We (at Pomerado Hospital) feel the victims are getting excellent care. This is an environment that should feel very safe and nurturing.” The hospital has handled 25 rape cases since the program began Sept. 1, she said.

The Pomerado program is modeled after one in Santa Cruz County, where felony charges increased 78% the year after the teams were established in 1987.

If the teams are implemented countywide, they will be overseen by the management of the individual hospital. And because many task force members are representatives of designated team hospitals, officials believe a lot of the work has already been done.

Task force member Randy Rolfe, senior vice president and administrator at Sharp Cabrillo Hospital, said financial barriers could arise if the board of supervisors decides to form an organization that would oversee all of the teams. But funding should not be a significant problem because the response team concept is growing in popularity, he said.

Rolfe said that the response team concept is welcomed by the hospitals that treat rape victims because most emergency room doctors find the cases difficult and are averse to giving the exams. Sharp Cabrillo is one of seven hospitals that administers the exams and is looking forward to having a rape response team.

Hospitals that perform evidentiary examinations are expected to embrace the response team concept because it will relieve emergency room doctors from having to later testify in court on behalf of the victim. Rolfe said the task force is unsure if it will implement the teams at hospitals that don’t perform the rape examinations. But, even if it does, the only costs incurred would be to train nurses and for exam equipment.

Emergency room exams cost an estimated $380 each, while the estimated cost of examinations administered by Sexual Assault Response Teams is $580. The response team exams cost more because the teams use specialized equipment such as a higher-powered microscope and cameras that take better pictures of victims’ injuries. And better equipment makes for better evidence, Seneski said.

Kathleen Healey, a detective with the San Diego Police Department’s sex crimes unit, said law enforcement agencies are lauding the program, despite its increased costs, because it relieves sheriff’s deputies and police officers from waiting hours in an emergency room with a rape victim.

“It’s better because the officers and the victim don’t have to wait hours upon hours for the examination,” Healey said. “And we don’t want victims to change their minds about prosecuting. It needs to be done quickly, outside of the emergency room.”

Healey said that, in some cases, women who have waited hours in emergency rooms have decided not to prosecute.

Examining rape victims in hospital emergency rooms doesn’t seem to be advocated by any organization, including hospitals. Alvarado Hospital in San Diego had a contract to do post-rape evidentiary examinations with the Police Department about seven years ago, but the contract was discontinued. Administrators there realized that the emergency room was not a good place for post-rape examinations because the doctor couldn’t offer much seclusion to the victims and she was shielded only by thin curtains, said Tom Berger, marketing and public relations director for the hospital.

“It became very clear, very soon, that this was not the proper environment,” Berger said. “And it was an added indignity to the sexual assault victim.”

Emergency room doctors cannot tend to a rape victim who is not seriously injured when other patients are dying, said Mary Margaret Loehr, emergency room physician at Scripps Hospital in Chula Vista, and a member of the task force.

“For a lady who has already been psychologically traumatized, it is much better to have an empathic examiner,” Loehr said. “You’re just not going to get that in an emergency room setting.”