1. Boatright, Anne C. MSN, RN, SANE


In this month's Magnet(R) Perspectives column, Anne Boatright, MSN, RN, SANE, describes her efforts to develop a comprehensive forensic nursing program at Methodist Hospital in Omaha. Ms Boatright transformed a sexual assault nurse examiner (SANE) program into one that provides 24/7 coverage at Methodist's 2 SANE locations and cares not only for victims of sexual assault but also for the victims domestic violence, sex trafficking, strangulation, elder abuse, and neglect. Her work extends beyond the walls of Methodist to the community, where she serves as a core member of the Nebraska Human Trafficking Task Force. She works collaboratively with the Federal Bureau of Investigation and helped Nebraska state senators draft legislation to create a sexual assault payment program. In recognition of her determination to make a difference for victims of violence, she received the 2016 National Magnet Nurse of the Year Award for Transformational Leadership.


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The first time I sat with a woman who had been raped, I struggled with how to provide her with the appropriate care she so desperately needed. I lacked the basic training to support her in the most critical moment of her life. The experience motivated me to seek formal education and training to become a sexual assault nurse examiner (SANE) so I could provide comprehensive and compassionate care to sexual assault victims in their time of greatest need.

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I joined Methodist Hospital as a SANE nurse in 2009 and was fortunate to be given the opportunity to assume leadership of the SANE program in 2011. The Methodist Hospital and Methodist Hospital Foundation had started the program back in 2003 to care for victims of sexual assault. After serving for some time as the program coordinator, I noticed a trend with forensic nursing programs nationwide: they were expanding to reach all victims of violence. Furthermore, I recognized that there was a lack of services for victims of some types of violent assault in the Omaha metropolitan area. I knew that it was imperative that we, at Methodist, also expand our scope of care to meet the needs of those in our community. Although we knew that the challenge would be great, because of the outstanding and unwavering support of hospital leadership, and a generous endowment, we were confident that we would succeed.


In 2014, we formally expanded to include victims of not only sexual assault but also domestic violence, sex trafficking, strangulation, elder abuse, and neglect, ultimately doubling the number of patients to whom we provided care. When the program began, there were 10 nurses and 27 patients. Today, as the only forensic nursing program in the state of Nebraska, we have 32 nurses and see more than 400 patients annually.


Consequently, our success has expanded beyond our hospital to the statewide level. In 2015, I testified in support of a bill to set up a statewide fund to pay for rape kits at hospitals throughout Nebraska. As part of this legislation, we created a statewide SANE coordinator role. By working together on these initiatives, we have helped break down barriers and improved coordination with various officials and agencies across the state.


Every time someone seeks care, it is an opportunity to change the cycle of violence. It is an opportunity to provide community-based resources that can help individuals recover. Almost 100% of patients who come to our program accept advocacy, which is linked to increased safety and better outcomes. The advocates with whom we work sit with the patient and help find safe housing, a social worker, or a crisis counselor. Our advocates are specially trained and come from various community organizations. Recently, to improve response time and overall patient support, we opted to provide space to house advocates at our hospital. Because they are on-site, they can provide immediate comfort and support to victims of violence until the forensic nurse arrives.


At Methodist, we want to be sure that we can help every patient who needs us. This year, we have initiated efforts to create a specialized clinic, staffed by forensic nurses, to increase the standard of care for strangulation victims and look at long-term implications. These patients enter our hospital through the emergency department and follow up with their primary care physicians. However, not every primary care doctor has the tools and resources to meet their needs. We want to build the means to bridge that gap and say, "You have made it through the crisis, now what do you need?" After a visit or 2 to our clinic, they can return to their primary physician or continue to see our nurse practitioner, whatever helps them recover.


Having attended the most recent Magnet(R) conference and seen and heard the amazing work Magnet nurses do, I consider myself very fortunate to work in a Magnet-recognized organization. My leadership skills have grown over the past several years, and I have really focused on supporting my people in the same way that my hospital supports me. When I have a vision, the hospital not only wants to hear it but also leadership partners with me to make it happen. I also seek to be a servant leader and give my staff the same type of voice.


I am always urging my nurses to expand their horizons. It is important that they feel comfortable enough to say, "Here's something I read in a journal," or "Here's something I learned at a conference, we should do it." I want them to own these ideas and move them forward. For example, 1 nurse suggested that we put numbered stickers on the photos we take to keep them in order. It was a simple, inexpensive change that increased nurse satisfaction and improved outcomes. Another nurse developed a mentor program within the SANE program. These are our Magnet moments, when nurses take things to a new level for the betterment of themselves, our institutions of care, and most importantly, the patients who we serve.


In a Magnet environment, the overarching goal is to give nurses at the bedside the ability to make big-picture changes. We improve patient outcomes and improve life for everyone in our community. That is the core of what Magnet is. When your hospital believes in it and makes sure it is ingrained in every aspect of the culture, incredible things can happen. It allows those with "boots on the ground" to identify problems and devise solutions that transform care.


Methodist Hospital's Forensic Nurse Examiner Program is the best evidence of how clinical nurses' leadership skills can make a difference. I am passionate about the program and always look for ways to improve the lives of those affected. We continue to change the culture to support victims of crime and alter the way people in the community treat victims of crime. This is just a start; there is so much more that we can do.