Before deciding whether or not you should go to the Emergency Department, it is important to understand the different reasons someone would use these services after experiencing a sexual assault.
First, you should know where you can go:

Carilion Roanoke Memorial Hospital (24 hours a day)
     Directions and Parking Information

Forensic Nurse Examiners (FNEs) are trained to specifically help with survivors of crimes such as:
Sexual assault
Drug-facilitated sexual assault
Child abuse and neglect, including physical and sexual abuse
Elder neglect and abuse
Intimate partner violence
Injuries resulting from weapon use
Sharp or blunt-force trauma

Why go to the ED and work with an FNE after experiencing a sexual assault?

• To ensure your body is healthy and safe

and/or

• To collect evidence (must be completed within 120 hours of the assault)

FNEs provide medical services to patients of all ages and genders who have experienced physical violence or sexual assault. These specifically trained and educated nurses assess trauma, identify immediate physical or psychological needs, document injuries, collect evidence, and provide professional referrals needed for follow-up care. Your well-being is of the most importance to the FNEs. They help make sure your body and mind are safe following a sexual assault.

Getting a PERK (Physical Evidence Recovery Kit) is a very personal decision to make. The PERK will collect evidence that could be later used for legal procedures. Many survivors are not sure whether they are interested in pressing charges this soon after a sexual assault. You always have the option to:

1. Collect evidence but not press charges
2. Collect evidence and press charges
3. Collect evidence and decide to press charges later. Your PERK will be kept on file for two years after being collected. This is often called a “blind” PERK, identifiable only by a number given to the patient.

The PERK is a long and intense process but the FNEs are understanding throughout the process. Nothing is done without your consent. For example, you may want photos taken of your injuries but you are not comfortable having swabs taken. You have the choice over what evidence is collected and can always change your mind during the process. The FNEs know that this may be difficult and do their best to put control back into your hands.

What happens if I decide to go?

Some things to keep in mind (again none of this is required, but could be helpful for evidence collection):

• Do not bathe, shower, or wipe as important evidence may be lost.
• Do not eat, drink, smoke, or brush your teeth.
• Do not change your clothes. If you must change, place your clothes in a paper bag and bring them to the hospital with you. If possible, bring an extra set of clothes to wear home from the hospital.
• If you do not know your attacker, write down personal identifiers such as hair color, facial hair, tattoos, etc.
• Ask a friend to come with you, or remember that a SARA Companion can support you throughout the process too.

What happens when I get to the ED?

• You will check in at the check-in desk.
  • When you check in you’ll provide your name, address, insurance information (if you have it), and emergency contact information.
  • They will also take your vital signs including: blood pressure, heart rate, weight, and height.
  • At this time they will also want to know why you are there. It can be very uncomfortable to tell them when you are in a lobby that may be busy or crowded. What you might say:
    • “I’m here to see a Forensic Nurse.” (you may be asked why)
    • “I think I was sexually assaulted or raped.”
    • “I’m having pain because someone had sex with me and I didn’t want to.”
  • At check-in, you can also ask them to call SARA and ask for a SARA Crisis Advocate to join you at the ED. You can do this whether or not you have already spoken to us on the hotline. The staff knows who we are and how to get in touch with us. (*COVID-19 UPDATE: SARA Crisis Advocates are not currently able to provide in-person response at the hospital; however, a Crisis Advocate can support you by phone during your medical exam).
• At this time, they will notify an FNE that you are there. You may have to wait depending on whether an FNE is currently at the ED or if they are with another patient.
• You will be taken to an ED room or the FNE room and have your medical and incident history documented. You can be as detailed as you are comfortable. This may be done by a physician if the FNE is helping someone else.
• Once you are working with the FNE they will walk you through the whole process and discuss your options. The medical exam is essentially a physical and gynecological exam (for biological females). This includes: blood tests, STI treatment, pregnancy prevention, swabs, photographs, and information about local resources. This process can take approximately 4-8 hours (from check-in to discharge).

Reporting

Although reporting is not required, hospital staff are mandatory reporters. The FNEs will be required to file a report if:

• A deadly weapon was used, such as a gun, knife, throwing star, etc.
• Child abuse/neglect is suspected.
• Elder abuse/neglect is suspected.

If you would like to file a police report, please see “File a Police Report”

The decision to report to law enforcement is entirely yours. Some survivors say that reporting and seeking justice helped them recover and regain a sense of control over their lives. Understanding how to report and learning more about the experience can take away some of the unknowns and help you feel more prepared.

You have several options for reporting sexual assault and a SARA Companion can be with you every step of the way.

• Call 911: If you are in immediate danger, dial 911.
• Contact the local police department: Again, 911 is a good place to start by stating that you would like to file a police report. Don’t worry about “clogging” up the 911 call center if you are not in immediate danger. The call center is trained to prioritize emergencies AND answer your questions. Crimes get reported WHERE the offense took place. For example, you may be a resident of Roanoke County, but the assault happened in the City of Roanoke. To file a police report, you’ll need to contact the City of Roanoke Police Department.
• Visit a hospital: If you are being treated for injuries resulting from sexual assault, tell a medical professional that you wish to report the crime. You can also choose to have a sexual assault forensic exam. (See “Go to the ER” for more information).
• Call our hotline: Remember, we can walk you through all of these processes. We can talk with you about what filing the police report will look like and mentally prepare you for the difficulty of talking about your experience. We have close relationships with local law enforcement.

Filing the police report can occur in a few different ways including: over the phone, at the police department, at the SARA office, at the emergency department, and other locations. We have often met with clients and called to have an officer meet us at SARA in order to take the report.

Common Concerns about Reporting

Time Limits
There is NO TIME LIMIT (also known as statute of limitations) on felonies in the Commonwealth of Virginia. Most sex crimes are considered felonies. For a full list of crimes, their definitions, and the statute of limitations, see this list.

I know the person who hurt me
The vast majority of sexual assaults are perpetrated by someone the survivor knows. Regardless of who the perpetrator is, sexual assault is against the law. It is common, however, for survivors of sexual violence to worry about the ramifications for the perpetrator. Police do not always make an immediate arrest of the perpetrator. You can ask questions about how the police will handle this situation when you file the police report.

I’m worried the police won’t believe me
There has been a great investment in police training on this topic. While there are occasional exceptions, most law enforcement officers are understanding and on your side. If you do encounter someone who isn’t taking your case seriously, ask for their supervisor and/or contact SARA to help advocate for you.

I don’t want to get in trouble
Sometimes people are afraid of being disciplined, either by the law or by their parents, because they were doing something illegal or breaking rules at the time of the abuse. For example, a teen might have been consuming alcohol. It’s important to remember that sexual assault is a crime—no matter the circumstances. Nothing you did caused this to happen.