An interview with Carol A. Walters, DNP MHA RN NE-BC
Operations Manager, Geisinger Bloomsburg Hospital Emergency Department
Nurse Leader, Geisinger Sexual Assault Nurse Examiner Program
Within a few days of Carol Walters starting as the Operations Manager of Geisinger Bloomsburg Hospital (GBH) Emergency Department (ED) in September 2016, GBH ED nurses and an administrative fellow gave a public presentation on how GBH could enhance community services by initiating its first Sexual Assault Nurse Examiner (SANE) program. GBH was able to purchase all necessary equipment through donations and the Geisinger Health Foundation. Despite being the smallest Geisinger campus at that time, GBH ED nurses harnessed their passion and staffed the program to the best of their ability. GBH started with just four nurses, who were trained through a grant funded program at Mount Nittany Medical Center. Carol noted, “They were like the little engine that could,” and by 2018 the GBH team had more than doubled in size.
During that same year, Geisinger embraced a regionalized model for the SANE program. Funding was provided for internal education for additional nurses to become SANE trained and for Cortexflo forensic cameras for each of the eight Geisinger E.D’s. Since 2019, Geisinger has contracted annually with a SANE educator to provide a six-day combined adult/adolescent/pediatric course. The regional structure has grown to include nine hospitals supporting the western, central, and northeastern regions of the Commonwealth.
Carol tells us that, “As the nurse leader for the program, I fully support Geisinger’s SANE nurses and the survivors for whom we provide care. I’m also involved in a variety of multidisciplinary teams including Luzerne County’s MDIT and Northumberland, Snyder, and Union Counties’ STOP-grant efforts. I view my work with the SANE program as a blessing and a calling. I fully believe that God placed me in my position to be able to make a difference in the lives of some of the most vulnerable people experiencing some of the worst circumstances they may ever face. The SANE program gives me purpose and positions me to make a difference in the lives of those individuals who need a voice and an advocate. There are days where I can’t seem to accomplish anything on my to-do list. However, I always make time for the SANEs and for victims requesting a SANE when one might not be readily available”.
Carol’s words were echoed by one of the SANEs working under her. “Carol demonstrates exceptional dedication to the program and provides a great deal of support to the SANEs and the patients they care for. In part, the program’s success can be attributed to Carol coordinating a SANE review course for experienced nurses and organizing clinical skills labs that foster professional development. Through her commitment and initiative, Carol ensures nurses receive vital support and patients benefit from high-quality care. Her leadership positively influences the entire team and strengthens the program as a whole.”
Natalie Giordano is the Associate Vice President for Emergency Medicine and serves as the operations leader for Geisinger’s SANE program. Together, Carol and Natalie host a virtual meeting for SANEs every other month. Carol shared that all SANEs hold full time positions outside of their SANE role which presents time and scheduling constraints. Therefore, to enhance communication, Geisinger utilizes the Tiger Connect secure texting platform. When a victim of sexual assault presents at one of the EDs, staff connect with SANEs via Tiger Connect. SANEs also use this platform to communicate with one another. Carol has developed an email group for all Geisinger SANEs as well as region-specific groups since there are nuances to each campus and region as well as varying community partners, including rape crisis centers, children’s advocacy centers, and law enforcement with whom the groups regularly collaborate. Carol is in the process of developing checklists for SANEs, providers, and non-SANEs to utilize when they are called upon to complete an exam. The checklists highlight important policies and outline many of the steps that could easily be overlooked during this complex process. At the present time, Geisinger does not have designated SANE coordinators, so with Carol’s assistance, the hospital system has applied for grant funding through the Department of Justice that, if awarded, will support a program priority of hiring one or more coordinators.
When asked what other hospital administrators can learn from Geisinger’s experiences, Carol stated, “There is a quote often used from the movie, Field of Dreams, ‘If you build it, they will come.’” As Natalie and Carol continue to fortify their approach to sexual assault and domestic violence, they have garnered a great deal of interest from nurses across Geisigner’s footprint who are interested in becoming a SANE. As a result, they’re hoping to offer two six-day SANE training courses, adding an additional 50 to 60 nurses to their team. They’d also like to offer a review course for the approximately 60 current SANEs to expand and/or reinforce their skills. They offered a review course for the first time in September 2025, and it was very well received. Their long-term goal is to offer a course developed and facilitated by Geisinger and approved by the International Association of Forensic Nurses.
Carol shared that “Geisinger’s SANE program serves the needs of victims of sexual assault by adapting to their stated needs as well as embracing technological advances and regulatory directives. Many hospitals that have multiple campuses share the same concern – that it’s not ideal to have a nurse without SANE training provide a medical-forensic exam when a neighboring hospital has a SANE-trained nurse available. Geisinger is working on enhancing mobile SANE coverage. For example, we don't always have consistent on-call coverage, so we are now trying to mobilize float staff to cover on-duty SANEs who can be relieved of their assignment to tend to the needs of the sexual assault victim. Additionally, we look forward to the opportunity to comment on changes to the Pennsylvania Department of Health Sexual Assault Victim Emergency Services (SAVES) regulations that address the highly debated issue of hospital transfers”.
Carol very eloquently shared with us her personal commitment to the Geisinger SANE program. It is evident that her unique approach to the patients and the program is what has made her a leader that SANEs respect and appreciate working with. “The most rewarding part of my job has been helping both victims and SANEs. I have several memories that will never fade regarding actions I took that might seem trivial to some, but made a positive, lasting impact on the victim. Moreover, I find it rewarding to be the person on the other end of the phone helping a SANE problem-solve during her first case or talking through a situation that an experienced SANE hadn’t seen before. It’s my calling to help them help others. I am here to remove barriers so that others can do their life’s work which, in turn, has become my life’s work.”