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NOTE: The author of this post has chosen to remain anonymous.

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It’s late in the evening. I’m laying in bed and I receive a call on my cellphone. Someone recently reports a sexual assault to the police and they’re waiting in the emergency room for a sexual assault examination. I immediately get in my car and drive to the hospital, my survivor’s advocacy team bag in tow, mentally preparing myself for the situation I may encounter.

When I get to the ER, I explain to the receptionist that I’m with the survivor’s advocacy team and I’m let into the back to meet the patient.

When I arrive at the patient’s room, I introduce myself. I let them know I’m a survivor’s advocate and ask if they’ve been told that I’d be coming. Sometimes police or medical staff will explain to the patient that an advocate is on their way to meet them at the hospital, but this doesn’t always happen. I explain that I’m there to make sure they have everything they need during their stay, that I have clothing and underwear to give them after their exam, that I have information to give them about free counseling and legal services, and that I’m there to answer any questions they have or talk about anything they need.

I then pull two teddy bears out of my bag and ask them to pick one. Of all the women, men, and children I’ve visited in hospitals, not one has ever turned down a bear. “It can be nice to have something soft to hold while you’re here,” I tell them. The bears usually get them to crack a smile, and give them a source of comfort during their hospital stay.

I am a survivor’s advocate. I meet survivors of sexual assault at different hospital locations and sit with them during their time in the ER. In my survivor’s advocacy team (SAT) bag, I carry clothing, underwear, flip flops, crayons, coloring books, tissues, teddy bears, booklets about sexual assault and survivor rights, and pamphlets about the organization I volunteer for.

When a sexual assault nurse examiner (SANE) arrives, patients are taken to a separate examination room for their sexual assault exam. As part of the exam, their clothes are collected as evidence. I provide clothing so they aren’t made to go home in only a hospital gown after they’ve been discharged. If the patient requests it, I may go back to the examination room with them or be present during police questioning.

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I’m a college student, and I learned about survivor’s advocacy while sitting in a psychology class. An employee with a local domestic violence and rape crisis center gave a presentation about survivor’s advocacy and what advocates do. It was all volunteer-based, and a professional counseling degree was not required to offer services. I knew right away that it was something I wanted to be a part of. As soon as I had the time, I signed up for training.

Every organization employs different training methods. Directly from the Sexual Assault Training Manual,

“The sexual assault field originated as a “grassroots” movement with the philosophy that a professional license or academic degree was not necessary to provide basic emotional support to survivors. Volunteers who were well trained and sensitive to the issues could provide excellent service to clients.”

I received 40 hours of training that included presentations from the organization’s legal team, the local police, a SANE, counselors, and children’s protective services employees. We toured the hospital’s emergency room and examination room. I shadowed two other SAT calls before I went on a call alone, and I felt more than prepared for what I was walking into.

These calls can last anywhere from one and a half hours to nine hours. I am there until the survivor is discharged or until they let me know they want me to leave, which they are free to do at any time.

I can receive calls any time during the hours I volunteered to be on the front line, so I make sure not to drink or travel long distances during those times. This is important work, and although I am only a volunteer, I am wholly dedicated to what I do.

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The situations I walk into are different each time. Sometimes I walk into rooms filled with a patient’s supported family members and friends. Other times I walk into a room where the patient is alone, unwilling to tell their family, friends, or partner what happened to them. There may be children, confused or bored, unsure how to react to the situation that is unfolding around them. I keep coloring books in my bag for child victims and children of the survivors who may be present when I visit. Calls involving children are particularly difficult.

I see parents, students, children, and elders. The moods and reactions of each patient are varied and sometimes surprising. Patients may laugh and joke, even in the face of distressed family members, trying to elevate everyone’s mood despite the present situation. Other patients may be severely distraught and need to talk through what happened. Some patients are quiet and don’t feel like talking at all. Sometimes parents and friends need support too, as they are often distressed and angry about what happened to their loved one. Active listening is a key component to what I do, and despite what I may be feeling, the people in front of me are my priority.

The most common phrases I hear from survivors in hospital rooms are variations of I shouldn’t have been there, I shouldn’t have trusted them, I shouldn’t have been vulnerable, or I should have done xyz differently. Survivors have heard these statements throughout their lives, that assault is caused by a series of mistakes or by someone not being careful, and many deeply internalize these messages and blame themselves. An important part of my job is to let survivors know that absolutely nothing that happened is their fault, that what happened to them happened because someone decided to violate them. Nothing the survivor did prior to the assault or after excuses the perpetrator’s actions. Nothing. In every case, I try to emphasize this as much as I can. An assault happened because someone chose to assault them, and they are not to blame.

Do I ever get angry or upset during calls while listening to survivors’ stories? Of course. Is doing this work emotionally exhausting? Sometimes it is. Calls go up during holidays and at the beginning and end of each new school semester. There have been stretches of time where I’ve received a call almost every day of the week. My heart grows heavy remembering all the faces I’ve seen and stories I’ve heard, but I try to shift the direction of these feelings so they fuel my compassion, not my sadness.

The importance of self-care is repeated emphasized during advocacy training. If I feel like I’m starting to get burnt out and that this work is having a negative effect on my day-to-day life, I take my name off the call schedule for a week or two. I know if I’m not at my best, I won’t be able to help clients at my best. I make sure to pay attention to my needs in order to be 100% present and supportive in the way the clients I meet need and deserve.

Knowing how much these services are needed is what motivates me to continue this work. Having an advocate present after sexual assault decreases the likelihood of survivors developing PTSD or resorting to unhealthy coping methods later on. Knowing that without advocate intervention, survivors may remain unaware of the free counseling services, legal services, and financial assistance they are absolutely entitled to continues to drive me forward.

Sexual assault is a widespread and pervasive human rights issue, and the numbers paint a disturbing picture. According to the Rape, Abuse, and Incest National Network (RAINN), 1 out of every 6 women and 1 out of every 33 men in the United States experience rape or attempted rape in their lifetime. For students in college, the numbers are even greater. About 2/3rds of assaults are committed by someone the survivor knows. Nation-wide, 68% of sexual assaults are not reported to police. Out of the assaults that are reported, only 2% of rapists will ever spend a day in prison (for information on sexual assault numbers, visit rainn.org).

When survivors ask what the future looks like, it’s sometimes hard to answer. I can tell them about future police questioning, about the court process, about trials and statistics, but despite these survivors reporting these crimes and allowing themselves to be examined and questioned again and again by doctors, police, detectives, and attorneys, justice isn’t always guaranteed.

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Nurses and medical staff in emergency rooms are busy and don’t have the time or energy to sit with survivors and provide them with the comfort and answers they need. Law enforcement and investigators are often not properly trained to handle these cases with the sensitivity they require. Reporting assault can often be a whole different kind of trauma, as survivors are made to repeat their stories again and again, often to unsympathetic police officers and detectives.

A large part of survivor’s advocacy is putting in the emotional work others are unable to do. Advocate services are invaluable and are often tremendously needed in every region of the United States.

Many rape crisis centers offer survivor advocacy services and provide training throughout the year. If survivor’s advocacy sounds like something you are interested in doing, or if you want to learn more about survivor’s advocacy, check out what volunteer services are offered in your area.

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