Last year, "Michelle" made a trip to Santa Barbara, perhaps the most difficult she/s ever taken.

Michelle, who asked that her real name not be used, is a survivor of rape. Her journey to Santa Barbara made her one of those affected by a shortage of nurses in the county.

Michelle had gone on a date with a friend last Oct. 2. Her companion was quiet during the date, a stark contrast, Michelle said, to what lay ahead when they returned to his home.

"He called me in the back (of the house)," she recalled. "He said, /I have something to show you./ When I got back there, he didn/t have any clothes on."

He grabbed her, pinning her with his body, then lifted her dress and raped her.

"I told him, stop, stop, stop," she said. "I just felt helpless."

It wasn/t until the next day that Michelle mustered up the courage to report the assault to police. And that/s when she ran into a problem.

Michelle ended up having to wait an extra day, and travel to Santa Barbara for a forensic medical examination. It wasn/t until three days after the attack 77 and more than 24 hours after she reported the rape 77 that her body was examined for fragile DNA and other evidence.

Such evidence typically must be collected within 72 hours after a rape occurs, because it degrades over time.

In California, specially trained Sexual Assault Nurse Examiners, or SANE nurses, perform evidence-gathering exams on rape victims. Currently, there are none in North County.

As a result, a rape victim who reports her assault and consents to the invasive forensic exam must be transported to Santa Barbara to have it done. Rape victims assaulted in the evening may have to wait until the following morning to be examined, adding to the trauma.

Rape victims cannot shower, brush their teeth or change clothes between when the rape occurs and when evidence is collected. Doing any of those things can destroy forensic evidence.

"It/s always preferable to have as much done as quickly as possible," said Shannon Chavez, executive director of the North County Rape Crisis & Child Protection Center. "(Delays) just draw it out for the survivor."

Lompoc Police Chief William Brown echoed Chavez/s sentiment. "I know there are cases where victims have really been inconvenienced," he said. "We run into … big impediments when we don/t have staff available."

Complicating the issue further is the fact that SANE nurses in Santa Barbara County generally have full-time jobs. While they/re paid by the Department of Public Health to be on call and to perform exams, SANE nurses essentially volunteer for on-call shifts.

Dr. Fran Malinoff, who supervises Santa Barbara County/s SANE nursing program, denied that the delays present a serious problem.

"The exam is arranged at the soonest possible time that accommodates the need for evidence collection and the comfort of the survivor," she said. "We have a limited number of examiners, and I think we do a good job of deploying that limited resource the best we can."

Some in the community, such as Shannon Yeterian, of Lompoc, who applied to work as a SANE nurse, disagree with Malinoff/s contention. Yeterian, a registered nurse with a full-time job, said she feels passionate about helping victims of rape. It is that passion that made her apply for the position, and it is that passion that makes the current situation so untenable to her.

"If you come in in the evening, it could be up to the next morning before you/re examined. And you/re left there, in that aftermath of rape, so you can go see a SANE nurse 60 miles away," she said. "It makes me want to cry."

Yeterian said she believes the county, and SANE Coordinator Judy Malmgren, aren/t doing all they can to resolve the shortage. "I think if Judy wanted to fill the position, it would be filled," she said.

Malinoff flatly denied any suggestion that the county is not motivated to fill the open positions. "Judy (Malmgren) spends a huge number of hours recruiting and training people," she said. "It/s not realistic for one person to do this job, and she/s more than delighted to get help."

Malmgren, who works in South County, is on call for North County rape cases, but does not travel to Santa Maria or Lompoc to help victims.

When Yeterian applied for the position, she said, she hit roadblock after roadblock. One challenge was the cost of the state-mandated training for SANE nurses, which the county expected the applicants to pay for, she said. "I estimated that it was going to run about ,750," she said. "That/s substantial for me."

And, she said, her attempts to find funding to cover her training were unsuccessful. "Nobody could agree about who had money to pay for it," she said. "Ultimately, nothing ever transpired."

Malinoff said the county cannot afford to pay to train SANE nurses. If the county paid for the course, nurses could simply take the class to earn Continuing Medical Education (CME) credit, she said. "There/s a lot of people who say, /Wow, that was interesting, thanks for the CME, this isn/t interesting to me,/" she said.

Yeterian called that idea "ridiculous." "I can go online and for ,27 I can sign up for unlimited continuing education for any area (of nursing) under the sun," she said. "When someone comes forward and says, /This is something I really want to do,/ a comment like that is absurd."

Yeterian tried several times over a period of more than six weeks to find a solution. "I beat my head against the wall, is how I felt," she said. "I just kept calling and calling."

In spite of that work, the issue was never resolved, and Yeterian/s application stalled.

The shortage of SANE nurses has repercussions beyond just the psychological well-being of the victim. Transporting rape victims to Santa Barbara means that the agencies that support the victims 77 law enforcement and rape crisis, for instance 77 have to send staff to Santa Barbara as well. And that means added travel time, overtime pay, and increased expenses.

"I have to have an investigator here to investigate the case, and an officer to accompany the victim," said Lompoc Police Sergeant Joe Bailey. "It can sometimes (be) an all-day or all-night affair."

Lt. Larry Ralston, of the Santa Maria Police Department, agreed. "It/s a frustration from our side, trying to get cases investigated," he said. "We/ve been struggling with (this) problem for four years."

Chavez, of the North County Rape Crisis & Child Protection Center, said she struggles, too, with the added costs, at a time when budgets are already tight.

"For our staff, we have to pay for overtime and mileage," she said, adding that the additional costs are secondary to the comfort of the victim.

For some, the shortage of SANE nurses means that another community resource is going under-used. Lompoc has a Sexual Assault Response Team (SART) house, where forensic exams and interviews can be conducted. But because North County lacks SANE nurses, the house is being used only for videotaped interviews with victims.

Loni Johnston, a rape survivor from Lompoc, has written letters to the editor to raise awareness of the shortage. "I think it/s wonderful that the community banded together to create that resource," she said. "We need to use it." Police Chief Brown and others echoed her sentiment.

The shortage of SANE nurses, as all parties acknowledge, is without an easy solution.

"We just have a limited population of nurses to draw on," said Malinoff.

The state requirements for SANE nurses impose another challenge. Prior to being certified, nurses must observe and assist in about six forensic examinations. Since relatively few rapes are being reported to law enforcement, it can take a nurse three to six months to accumulate the necessary hands-on experience.

Michelle said she wasn/t unduly traumatized by having to travel for her exam. But, she acknowledged, not everyone would feel the way she does. "It really depends on the person where they feel comfortable," she said.

The county is considering offering incentives to retain nurses once they/ve completed their SANE training. But it/s unclear if, or when, the county will attempt such a program.

According to several sources, the county is now attempting to hire and train new nurses.

Lt. Ralston, in Santa Maria, said, "There is light at the end of the tunnel, I think."

Whether the county will succeed in attracting and training new SANE nurses remains to be seen. Yeterian said she/s still willing to apply for the position, if the cost of training can be worked out. "If they want a damned good SART nurse, I/m still here," she said.

If you/ve been the victim of rape or sexual assault, the North County Rape Crisis & Child Protection Center operates a 24-hour hotline. Their hotline can be reached in Lompoc at 736-7273, and in Santa Maria at 928-3554.

* Contributing Writer Tammy Cravit can be contacted at tammy@wordsofwonder.net.

Jan. 27, 2005