The Army is changing the way it handles sexual harassment and assault cases. Under a congressional mandate, military hospitals providing emergency care are now required to have a trained, full-time sexual assault nurse examiner. MAJ Douglas J. Erdley, the clinical nurse officer in charge of the emergency department at Keller Army Community Hospital in West Point, N.Y., said the new policies result in more careful treatment of victims of sexual harassment and assault. Erdley has already begun to observe the changes as he treats his patients.“I’ve seen some changes in the dedicated sexual assault clinical providers,” he said. “We also know who our sexual assault response coordinator [SARC] is, and patients have a dedicated SARC assigned to their individual case. Now, with the SHARP’s [Army Sexual Harassment/Assault Response and Prevention program’s] specialized, individual training, it’s a really great advantage to the patient. The patient is the center of everything we do.”Erdley said the training—the Army Sexual Assault Medical Forensic Examiners course—is “a weeklong, 40-hour program, followed up with another week of clinical training. You work with actors and actresses who play the role of a victim. You go through the whole process, stopping and explaining every part of the process, every step of the way. If the patient says, ‘I don’t want you to take pictures of that’ or ‘I don’t want an exam,’ we move on. It’s excellent training and you don’t feel like you’re standing out there with only book knowledge during your first encounter with a sexual assault patient. You have background when you first go in, and it’s excellent.”When asked about his role in the treatment process, Erdley said he places the victims’ wants and needs above everything else. Once he ensures that they are physically and emotionally stable, the next step is to reinforce the idea that, in spite of the trauma they just faced, somebody cares.“I’m here to listen to their story and provide them with all needed resources and requests for information they need before we ever start the exam,” he said. “In the exam itself, I’ve taken their history for the purposes of the forensic examination, and then proceed with my exam in a step-by-step procedure to make sure that we’re looking at how the victim says they’ve been harassed or assaulted. … We make sure that we cover all those bases, and then we collect samples that contain only the victim’s or alleged attacker’s DNA.”Erdley stressed that it is important that patients feel both safe and in control every step of the way. Victims come in to seek treatment at a time when they have already had control removed from their lives. He and his team “don’t need to bring them in here and bring them through a cookie-cutter, assembly-line type of process. The most important thing I do in the emergency room is to make it all about the patient,” he said.The average sexual assault case can take up to one year before being resolved. In the event that a serial rapist is suspected—or, for that matter, a suspect has another case file currently open—the U.S. Army Criminal Investigation Division can fast-track the investigation. One of the changes in the 2014 National Defense Authorization Act is the elimination of a five-year statute of limitations on sexually based offenses, which can prove invaluable in stopping repeat offenders before they do any more damage.Regarding punitive measures for the suspect, victims have two options: Their case can be marked as restricted, which does not involve a criminal investigation, or unrestricted, in which case an investigation will occur. Erdley emphasized that all cases are handled the same way, regardless of their status. Patients are afforded some flexibility here, as well: They always have the option to change the status from restricted to unrestricted. The evidence will be stored for up to five years, and before disposing of the forensic material gathered when the victims came into the hospital, the SARC will contact them to ask if they’ve changed their mind about changing the status of their case.“Unrestricted reporting enables the Army to reach out to soldiers until they’re ready to make that next step, if they choose to come forward and go through the process of prosecuting the offender. … We need to prevent revictimization of patients as much as possible. Having the option to go unrestricted is allowing them to be ready for that. It helps give them control,” Erdley said.Last year, when Chief of Staff of the Army GEN Raymond T. Odierno spoke before the Senate Armed Services Committee about sexual assault in the military, he called it “a cancer within the force.” Fighting this cancer begins with reporting these horrific instances of sexual harassment and assault, and Erdley said he hopes that these recent changes to the process encourage more soldiers to speak up and report incidents when they occur.“We are going to treat those soldiers and get them in the pipeline to getting as well as they can, no matter what their trauma or situation,” Erdley said. “I think the recent changes, above all else, are showing that command at higher and local levels cares. [Victims] want to know that the Army is definitely looking toward making soldiers better, keeping them in the Army and preventing this violation of their person.“There’s a great desire for the Army to make all medical care even more patient-centric than it was before. We’re trying to change the culture, and we’re going to make it happen. I’m 100 percent sure that the Army is committed to this, and I feel good about what I’m hearing from command at senior levels. People want it out of the Army. I want it out of my Army.”