Cases may differ, but domestic violence and sexual assault occur across cultures, and on every continent. And regardless of location, there is a great value in surrounding trauma patients with the resources they need, including health care, law enforcement and community advocates.

It is for those reasons that four Nebraska Medicine forensic nurses are sharing their skills and expertise with health care colleagues 5,800 miles away in Akita, Japan.

The registered nurses – Amy Mead, Emilee Wilkinson, Nicole Lenaghan and Kate Buehler – are Sexual Assault Nurse Examiners (SANE) in the Emergency Department. Each is specially trained to conduct sexual assault evidentiary exams and understand the medical, psychological and forensic examination of a sexual assault patient.

"Being a SANE nurse is about giving power back to someone who has had so much taken away," says Mead. "Our work in Japan was inspiring, and felt like the kind of spark that creates a movement."

In 2015, Japanese laws toward domestic violence and sexual assault changed, Buehler says, to allow for more prosecutions. That change led the International Association of Forensic Nursing to financially support teams in helping educate and train Japanese health care professionals in forensic nursing practices.

"There’s a culture change happening (in Japan)," says Buehler.

Our nurses are grateful to be part of the change.

"It’s cool to be that closely connected as a change agent," says Buehler. "We help our patients here, but, there, I felt the potential to have it be on an even greater scale."

Thanks to a grant from the United States Japan Foundation, the Nebraska team made three trips to Japan in 2019, which enabled them to make connections, educate and train at least 75 health care learners, and determine how best to leverage their available resources for success.

"Sexual assault is not as well reported in Japan," says Wilkinson. "Our learners expressed how domestic violence or child abuse in the home was just a way of life. They understand now that that’s not OK and want to transform that, but they need extra support and training."

The group will continue its work in 2020, and help their Japanese colleagues create a patient-centered, nursing curriculum that supports both Japanese law and health care.

Wilkinson says the experience has provided a greater appreciate of the progress that’s been made in Omaha.

"We’ve really grown our sexual assault team in the emergency department and actively trained more nurses to have coverage on calls day and night and work with community advocates and law enforcement," she says, noting that only five years ago, she and Mead were part of a three-person SANE team at Nebraska Medicine. Today, Buehler leads a team of 14 SANE nurses.

Regardless of culture, stories of sexual assault are often familiar, says Lenaghan.

"One learner talked about a patient they treated and it was like a patient I have had and a story we have all heard," she says. "It hit me that domestic violence and sexual assaults happen on every continent and across every culture and there’s so much more to do."