In November 1996, three years of collaboration, research, relationship-building, and planning created the YWCA Nurse Examiner Program.

As Michigan's first free-standing program, the YWCA NEP was a pioneer. The approach addressed the sometimes competing priorities of victim advocacy, medical care, and criminal justice with a shared understanding that a victim's unique needs would be the first priority. Patients are cared for by YWCA victim advocates, who offer crisis counseling, and nurse examiners, who provide objective evidence collection and expert medical care. However, the YWCA NEP is not an arm of law enforcement or prosecution. Further, the program is located at the YWCA, not in a hospital.

The concept was initially introduced by the seasoned emergency department nurses who sat on the YWCA's Sexual Assault Advisory Committee. They witnessed first-hand how difficult it was to care for victims in the ER environment. YWCA advocates who were called to care for victims at local emergency departments echoed the nurses' concerns. Discussions with law enforcement and prosecutors made it all the more clear that when a victim is traumatized by a system that is supposed to help, holding perpetrators accountable can be an elusive goal.

A trauma-informed, victim-centered response requires many things, such as...

• Seamless, confidential access to services

• Attention that is focused exclusively on the patient

• Privacy and calm

• Expertise in medical care and forensic nursing

• Objective evidence collection alongside supportive victim advocacy

• The ability to maintain the chain of evidence

• A willingness to testify in court

• Access to counseling and crisis advocacy

Emergency departments simply are not designed to meet these needs. The YWCA Nurse Examiner Program is. And because of that, the experience victims have when they reach out for help has dramatically improved over the years since the Nurse Examiner Program started. The YWCA Nurse Examiner Program is not an additional option for victims. It is considered the best option.

Today, the YWCA NEP serves all ages and genders. Patients are not charged, and they are not required to report to law enforcement. All area hospitals and law enforcement jurisdictions, as well as many schools and universities, social service agencies, health clinics, and private medical practices, refer victims to the YWCA Nurse Examiner Program.

As a result, the criminal justice system has a deeper understanding of how best to engage survivors. The support a patient receives at the outset increases their willingness to consider pressing charges. The quality of evidence collection has increased plea bargains and reduced the necessity for victims to testify in court. And while that evidence can help hold perpetrators accountable, it can also help clear the innocent.

While the YWCA Nurse Examiner Program has had a positive impact on our community's response to sexual assault, from the beginning, it has been about much more than providing medical-forensic exams and collecting evidence. From the moment a victim arrives, their well-being is our sole priority. They find understanding, support, and hope. It is the YWCA's nurse examiners and victim advocates who ensure this. Victims are cared for by some of the most skilled nurse examiners in the state. They are supported by advocates who have been trained in trauma resolution by the top professionals in the field. The expertise of nurse examiners and victim advocates is only matched by their selfless, heartfelt commitment to their patients. Whether in the middle of the night or the middle of a snowstorm, nurse examiners and advocates are there to walk alongside a victim as they begin their healing journey.