Rape and sexual assault victims in Tulsa, Oklahoma found themselves re-victimized by insufficient medical resources to properly respond to their traumas. In order to press charges, a rape victim must receive a physical examination to obtain forensic evidence that is critical in the prosecution of the perpetrator. However, Tulsa's emergency rooms were so overburdened in the late 1980s that rape victims often had to wait up to twelve hours to receive medical attention. Emergency room physicians were overwhelmed by life-threatening emergencies and were reluctant to perform rape examinations because of their time-intensive nature, sometimes requiring up to three hours. Since exams were most often performed by male physicians who were under tight time constraints, the victims received very little emotional support. While the rape victims waited for treatment in the emergency room, they were not allowed to drink, shower, or change clothes to prevent any alteration of physical evidence. During the entire process, the responding police officer could not leave the victim's side, keeping the officer from his work for hours. In 1991, Tulsa's five private hospitals terminated medical examinations of all rape victims, greatly alarming sexual assault victim advocates within the community.
In response, a collaborative effort between the local medical community, the police and sheriff's department, the district attorney's office, and Call Rape, a local victim advocacy organization, resulted in the conception of the Sexual Assault Nurse Examiners Program (SANE). Implemented in 1991, the SANE initiative provides low-cost forensic medical examinations for post-pubertal male and female sexual assault victims in Tulsa and surrounding counties. Instead of being subjected to chaotic emergency rooms, sexual assault victims now have a safe haven at the Hillcrest Medical Center, where SANE volunteers have created a compassionate environment for both the victim and the victim's family.
SANE utilizes a comprehensive inter-agency approach to the response of sexual assaults so that all the needs of the victims are addressed. When Tulsa police receive a rape report, they notify Call Rape, which provides a SANE nurse and a rape crisis counselor to support the victim. Both the advocate and the nurse meet the police officer and the victim at the SANE exam room at Hillcrest Medical Center. The procedure is performed immediately in an area designated and equipped solely for rape examinations. The nurse examiners use forensic techniques to collect physical evidence from the body and clothing of rape victims in order to apprehend and successfully prosecute the rapist. While the victim is examined, the police and the victim's family are provided with a comfortable waiting area with coffee, snacks, and telephones. In addition, a male SANE volunteer provides counseling for the family of the victim. After the examination, the victim can shower, change into fresh clothing, and receive follow-up information for counseling and medical treatment.
By removing the rape victim from the emergency setting, both time and money are saved. Hospitals charge upwards of $600 per exam, while SANE exams cost a mere $150, a significant reduction. As of 1994, SANE had examined and treated over 500 victims, serving 58 percent of reported rape victims in the area. In every case where the SANE forensic nurse testified as an expert witness, the perpetrator was convicted, demonstrating the influence of the forensic exam in the courtroom. Most importantly, SANE has allowed more rape victims to obtain medical exams following the trauma. Prior to 1992, only 17 percent of reported rape victims received a medical examination, but during the period between 1992 and 1994, 27 percent of victims received exams, suggesting improved access and a growing awareness among rape victims of the importance of forensic evidence in prosecution.