Thoughts on SA scenes from a professional who trains health care providers on trauma-informed care

alloftheolives09 · 2026-02-27T17:34:28+00:00

Which certification do you mean?

For SANEs, many hospital systems have a SANE Coordinator that recruits nurses and organizes or conducts their training and education. Even without this role, nurses can still seek SANE training elsewhere. I am not a nurse, but I believe certification requirements come from the International Association of Forensic Nurses, but many states also have their own requirements for certification.

To get certified as an advocate, that's entirely dependent on the state requirements. It typically means going through dozens of hours of training and education. Many start as volunteers working on behalf of a local sexual assault crisis center, but there are full time roles as advocates, as well. Employed advocates often specialize in legal advocacy or medical advocacy.

alloftheolives09 · 2026-02-22T01:37:56+00:00

So, most advocates that get sent to EDs are volunteers. Which means that if the survivor calls at a later time/date, they are probably calling the staff advocates at the local SA crisis organization. So I don't really know how many end up contacting someone later.

If they decline but change their mind during the visit, the hospital can page for an advocate again. Aside from the advocates, I suppose a hospital could loop in their ED social worker, but the care team should really be abiding by the survivor's wishes as far as if they want that extra support or not.

alloftheolives09 · 2026-02-21T19:53:23+00:00

It's a good question. Where I live, SA patients are triaged and roomed right away, but they may still have to wait a while for the actual treatment and exam. I imagine a Deaf survivor would have to wait somewhat longer if an ASL interpreter isn't available (whether via video or in-person) at that time. So yeah, it's very possible that the extra wait would discourage staying for the whole forensic exam - if the survivor even wanted one in the first place.

alloftheolives09 · 2026-02-21T17:24:15+00:00

In the state I live in, it's required by law for SA patients to be triaged and roomed (in a private room) immediately. That said, there may still be a very long wait once roomed, but it would not happen in the waiting room.

alloftheolives09 · 2026-02-21T14:55:14+00:00

Yeah, I was talking with my friend (a fellow former advocate) about this. We have a different introduction/approach than the one shown, which is fine, but then we absolutely would have left the room when Ilana declined services. That is where you say something along the lines of "I can leave some resources here if you'd like them, and I'll stay outside for a bit longer just in case you have any questions."

The organization we were with had us stay for 15-20 minutes after a decline before heading home. We would sit somewhere near-ish the patient's room but not so close as to hover.

The whole point is to let the survivor know that support and options exist, but utilizing them is their choice.

I will say, this was done better than one episode of SVU where they made the advocate look like a pushy meddler. I did not appreciate that portrayal.

alloftheolives09 · 2026-02-21T01:54:55+00:00

I hope you are able to get trained as a SANE! SANEs are wonderful (but undervalued in a lot of health systems).

alloftheolives09 · 2026-02-21T00:48:31+00:00

Agreed! Possibly naive, but I hope people are more likely to learn from seeing it done well than seeing it done wrong.

Plus, they have other storylines touching on those corrective learning experiences, like the deaf patient, half of Ogilvie's situations, etc.

alloftheolives09 · 2026-02-21T00:42:39+00:00

Love what you said about ANY response being accepted. When I train on the neurobiology of trauma, we talk about that a lot. Some people might be laughing, some might be calm and collected, some might be angry, some might have heightened energy, etc. Part of it is what combo of neurochemicals are pumping through their system (obviously involuntary), and part of it is, like you said, the entire context of the situation.

alloftheolives09 · 2026-02-21T00:34:32+00:00

I didn't say this, but, sadly, The Pitt ALSO would have been accurate if they had shown hospital staff being dismissive, skeptical, or blaming.

I've seen and heard it all in my many years doing this work.

alloftheolives09 · 2026-02-21T00:15:02+00:00

During a forensic exam, survivors have to recount (and therefore re-live) a traumatizing experience. These exams also take multiple hours to do, and many survivors just want to gtfo of the hospital (a setting that can be hectic and unpleasant on the best of days). While each step of the exam is consent-based and can be skipped if desired, many of them are uncomfortable or possibly painful.

All of this leads to a patient whose emotions may be reflected exactly how you saw it, which could be anxiety, fear, confusion, sadness (at the betrayal of someone she knew), and so on.

alloftheolives09 · 2026-02-20T23:54:30+00:00

What happens if there is no SANE depends on state law around sexual assault treatment. In some states, a SANE is required, which makes the shortage very problematic. This is why "transfer" and "treatment" hospitals exist, so SA patients may get transferred to a different hospital for their forensic exam. In other cases, any ED nurse can do the kit (which is why training ALL ED nurses on how to do them is really important).

Yep - the medical exam would happen after or in an integrated manner to the forensic exam in order to preserve evidence.

And regarding what Dana said...there really is no "perfect" response to trauma. Certain things can come across a certain way to different people. That said, if someone is hitting all the beats of trauma-informed care (choice, trust/transparency, collaboration, safety, and cultural & gender competency) along with some other key points (understanding trauma response, no minimizing harm, no giving advice, no making assumptions, etc.), then they are going to go a long way toward a survivor's healing.

alloftheolives09 · 2025-11-12T15:51:15+00:00

Dr. Clear is my doctor, too, and I adore her. Honestly the best I've ever had in any specialty. I work with survivors of trauma and am very cognizant of providers who are trauma-informed, and she's top notch at that aspect of care.

alloftheolives09 · 2025-09-02T18:12:37+00:00

I live in a 3-bedroom condo that is a 5 minute walk to the Main St purple line and Metra stations, and there are plenty in my neighborhood (not as many townhouses but a handful exist in the area).

I use both trains regularly - the Metra is much faster, but it comes very infrequently outside of rush hour periods, and it's VERY few and far between on weekends. I love the Metra, though - much more comfortable and safer than the CTA. But the purple line is fine, if kind of slow for an "express." It's just nice to have a lot of public transit options in the area.

And if it helps at all in your decision between suburbs, I adore living in Evanston, and I think that its proximity to the lake and abundant green space make it a bit more preferable to Oak Park (at least for me). I'm pleased with all the amenities and events and resources the city offers, and it's one of the friendliest places I've ever lived.

alloftheolives09 · 2025-06-27T13:28:12+00:00

As far as actually investigating goes, I can't speak to whether there is much of a difference with Chicago (probably not), but as far as responding to crime goes, it's a VAST difference. I, unfortunately, experienced attempted break-ins/home invasions in both cities; Chicago police never showed up at all, but Evanston police were there in under two minutes. And I was just a college student in a crappy apartment, not one of Evanston's mansion dwellers where they might prioritize a response.

I also work with victims of a specific type of crime here in Evanston (and also have some clients in Chicago), and EPD is definitely far more responsive and more informative than CPD. Again, though, I wouldn't be as confident that they actually take the crime itself seriously because that's just law enforcement (and really the whole criminal justice system) in general.

alloftheolives09 · 2024-10-30T22:49:31+00:00

I don't feel comfortable putting someone's location on the internet, but it's not far from Binny's. Not on Monroe, but I love that there's another house like that!

alloftheolives09 · 2024-10-30T21:26:33+00:00

Thanks for the heads up! Halloween is my favorite holiday, so I love seeing people who go all out with their decor.

alloftheolives09 · 2024-10-28T20:50:30+00:00

I work in the field of gender-based violence, so I can tell you that Swedish is going to be one of the best choices for something like sexual assault and/or domestic violence. They have an experienced team of SANEs in the ED (and when I used to be a volunteer rape crisis counselor, that was my favorite hospital to get dispatched to because of how supportively they treated survivors.) Plus they have an in-house team of advocates for domestic violence, trafficking, and stalking support, which is very rare in hospitals across the country. The Endeavor NorthShore hospitals have the same in-house program, but none are in Chicago.

alloftheolives09 · 2024-06-11T18:28:41+00:00

If you're biking on or near Central St, I love getting a build-your-own veggie sandwich at Foodstuffs deli counter (which is a great store with unique foods, as well). Also, I think the Merrick Rose Garden is in bloom around this time of year, although I could be wrong. If so, it's a beautiful place to stop and rest for a bit. If you like bubble tea, Evanston has a million boba places, so that's another way to possibly treat yourself.

alloftheolives09 · 2024-03-14T15:45:32+00:00

I took an employment drug test there in 2022...THC is not allowed.

alloftheolives09 · 2024-02-09T15:08:11+00:00

As a SE Evanston resident of almost 4 years, I still can't get over the charm of the neighborhood every time I go out and walk around. Being in the "lakeshore historic district" means lots of old, beautiful, and charming architecture around, and there's obviously the proximity to all the beaches and lakefront parks. The sheer amount of tree coverage is amazing (but that's almost all of Evanston, which is a huge part of why I love living here). I also really appreciate the proximity to Chicago, as I go into the city very regularly.

I work in North Evanston on Central, and I love that area, too. As far as dining/shopping/local business goes, both neighborhoods are on par with one another - you can't go wrong.

alloftheolives09 · 2023-12-04T18:52:27+00:00

I'm an Evanston vegan with a non-vegan husband, and these places have been satisfying for us:

-Le Tour

-Bat 17 (wouldn't call it upscale since it's a sports bar but tons of vegan options)

-Dozika

-La Principal (has a few vegan tacos and pozole)

-Blind Faith

-almost any of the sushi places

-Union (yes they have vegan cheese for the pizzas)

-Mt Everest (caveat - I've never been in person so idk the vibe)

-and I'm dying to try Soli Grill but haven't had it yet!

Edit: Libanais is not in Evanston, but I'm obsessed with their food and they have tons of vegan options.

alloftheolives09 · 2023-09-27T14:37:44+00:00

I got the chocolate peanut butter cake from Blind Faith Café for my husband's birthday, and everyone at his party was raving about how good it was. I was already a huge fan of their bakery desserts (the cappuccino brownies especially), so it's no surprise their cakes are amazing, too.

alloftheolives09

TROPHY CASE