CTB: Can you tell me a little bit about how the SANE program got started?

Bell: What was happening here in Tulsa is that rape victims went to any one of the five hospital emergency departments. Law enforcement came out, and then they sat and waited their turn. A lot of rape victims (gave up and) went away. The people that actually did do the exams hadn't been trained in evidence collection. So there were just a lot of frustrating situations for everybody involved--the victim, the advocacy program, law enforcement, and prosecutor's office.

So we developed a task force and started doing some problem identification and problem solving. In the course of that, we found out about some nurse examiner programs that were out there, in places like Memphis, Amarillo, and Minneapolis. We got information from them, and then took the things that made sense for this community. Then we got a group of nurses together--there were thirty that were originally trained--and then developed a training program. The task force had met for about a year, up to a year and a half. And then they started doing exams in July of 1991.

They started with about 15 or 16 nurses that had been trained. One of the main issues that came up early on was a site to do the exams. They had been being done in all of the hospitals. We originally decided that they weren't even going to do the exams in a hospital; they were going to do them outside the hospital at the College of Medicine. But about two weeks before we were going to start, the College of Medicine backed out as a site for the exams for security reasons. They're not a 24 hour facility, and I think they hadn't really thought through that the exams aren't all done Monday through Friday during business hours. It's evenings, nights and weekends, holidays--times when people aren't around. So they were trying to figure out something else because the ER is not an appropriate spot for rape victims. With that, the mayor got involved and pulled together all the powers that be within the different organizations : law enforcement, prosecutor's office, health department, all the hospitals, victims advocacy programs, etc. Various community leaders then just volunteered the things that the program needed to go. the CEO of Hillcrest Medical Center volunteered their building as a site for the exams. So then we got it set up, and they started doing exams on July 1, just like they had originally planned.

CTB: Wow. So it was this task force that you mentioned earlier that really started the ball rolling on getting all of these groups together?

Bell: Yes. And it primarily was led by the police department and the advocacy program. It was a joint push there to develop the task force and get everybody to sit down at the table.

CTB: So how do you keep all of these different pieces involved now that the program is going? What kind of things do you have to do to maintain those relationships ?

Bell: Just mainly open communication with them. You know, we're going to be working hand in hand with each one on a very regular basis. The nurses are in the exam room with law enforcement and with the advocacy program every time we do an exam. We interact with the health department each time that we refer someone to them for STD follow-up. Every time we do an exam we interact with law enforcement. And then the law enforcement, the prosecutor's office, and our examiners interact in the filing of the charges. Ongoing, constant communication is the key. We have regular meetings every other month. We've asked the defense attorneys to come participate in our training and they don't want to do that, but we don't see ourselves as a prosecutor's witness only. That's how the defense sees us. I also have a monthly newsletter that goes out to all of these people plus a lot of other people. There are 65 people on my mailing list that regularly get communication from me. Those are probably the main ways.

CTB: So, aside from the groups that are immediately involved, what other groups or persons do you look at as being really important to keep interested in supporting for the program?

Bell: I would say maybe not necessarily any group, per say, but maybe just the community as a whole. And they're going to do that with educational programs out in the community, whether Call Rape (the local victims' advocacy group) is presenting them, whether the police department is presenting them, whether the nurses are presenting them. We get some media attention with that.

CTB: It sounds like a very effective program, and a perfect example of bringing together people from a bunch of different segments of the community and putting together a really effective program.

Bell: Right. And what makes it work is the respect each group will have for the other groups. We each have our role, and even though the roles may overlap a little bit, we each have our own distinct piece of the pie. For example, I'm not going to step in and do the investigation because that's law enforcement's role. It's my role to provide medical treatment. I'm not going to try the case; the prosecutor's office is going to do that. And so we have to respect the other groups involved and know that they're going to take the ball when it gets to them and they're going to carry it until it moves to the next person.