Nurse examiner is ‘compassionate, skilled’ leader

IOWA CITY — Katy Rasmussen doesn’t like seeing “trauma and tragedy” every day, but her desire to help patients on the “worst day of their lives” is what drives her to provide physical and emotional care and support to those who have been sexually assaulted.

Rasmussen, 41, has been a registered nurse with the University of Iowa College of Nursing since 2008 and pursued additional training in 2017 to become a sexual assault nurse examiner, conducting medical forensic exams for patients who have experienced sexual violence. She became coordinator of the SANE program in 2020.

She saw it as a way she could “give back to the community and support survivors of sexual assault.”

“I started my training shortly after having my daughter and wanted to do something to help make the world a safer place for her to live in,” Rasmussen said. “And now, as the mom to two girls, it is even more important to me to fight against rape culture and violence against women.”

Rasmussen also is the coordinator of the Johnson County Sexual Assault Response Team, a coalition of sexual assault nurse examiners, emergency room staff, rape victim advocates, law enforcement and prosecutors that helps sexual assault survivors navigate the health care and legal processes.

In fiscal 2023, the team had 101 patients, Rasmussen said. It has averaged between 110 to 120 patients in the previous four years, except during the pandemic when the total dropped to 70 or 80. Women ages 18 to 24 are considered at high risk for sexual violence. The numbers typically go up in the first two months of the college academic year because new students are experiencing more freedoms — such as drinking alcohol — and don’t know how to deal with it.

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Care without revictimization

As a sexual assault nurse examiner, Rasmussen wants to provide a safe environment to anyone who has experienced sexual violence and ensure none of the patients are “revictimized” during the forensic exams.

During the exams, the sexual assault nurse provides “trauma-informed care,” which allows the patients to have control over the exam and determine how much they participate. The patients can withdraw consent, take a break or end it at any time.

The medical exam includes assessment of injuries and treatment, providing medications to treat and prevent sexually transmitted diseases and emergency contraception to prevent pregnancy, along with providing emotional support, education and plans for follow-up care.

Rasmussen takes a different approach with every patient, but she lets the patient take the lead — to have control, something most feel is taken away during a sexual assault.

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Some patients don’t want a head-to-toe exam because they aren’t comfortable being touched. If they agree to having evidence collected, some may choose to collect it themselves with some instructions from Rasmussen.

“A large portion of patients don’t want to report it (the rape) to the police,” Rasmussen said. “I never encourage them to report because that can be revictimizing them. But we can still preserve the evidence and collect the DNA up to 120 hours later,” as allowed by Iowa law.

As a sexual assault nurse examiner, Rasmussen said she is there to support, listen and provide whatever else is needed. Many survivors blame themselves for the sexual assault, and Rasmussen tries to help them understand it’s not their fault and the violence didn’t happen because of anything they did. Many times, she is the first person they tell of the trauma.

Nurse examiners also collaborate with the county response team on policies and procedures, education, community outreach and case reviews. And they may testify in court.

Rasmussen testified during the trial of Carlos Allen Hivento, 36, of Cedar Rapids, who was convicted in 2021 for repeatedly sexually assaulting an incapacitated 19-year-old woman in 2018 after meeting her in an Iowa City bar — and video recording the attack on his cellphone. Rasmussen conducted the forensic medical exam on the woman.

Hivento was sentenced to 34 years in prison. He also is charged with sexually assaulting three other women in 2017 and 2018. That trial is set for Oct. 17.

Compassionate, skilled nurse/leader

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Carrie Butler, Rasmussen’s cousin, said Rasmussen is “empathetic, “compassionate, thoughtful and fiercely loyal — someone who has your back.” She is always advocating for the nurse examiner program and bringing awareness of how these services help sexual assault survivors.

Johnson County Attorney Rachel Zimmermann Smith said Rasmussen wears “many hats,” but at her core is a “highly skilled nurse who is compassionate about caring for victims’ physical and mental health with zero judgment.”

Rasmussen also helps educate other providers, law enforcement and the community on how to approach survivors with respect and dignity.

“She is also very humble and always educating herself, learning more about specific issues that come up, such as strangulation, which is often very hard to diagnose,” Zimmermann Smith said.

Audrey Helt, a sexual assault nurse examiner and a UI nurse, said Rasmussen attended advanced and expert level training in strangulation to be able to testify at trials.

“Katy has faced quite a bit of adversity over the years while leading the program, including decreased funding (to county response team) and the state declining to cover the cost of emergency contraceptive medications for sexual assault survivors,” Helt said.

Rasmussen started working to secure funding for emergency contraceptives after Republican Iowa Attorney General Brenna Bird this year paused the funding as part of an audit of victim services, which is administered through her office.

After Polk County made the decision to provide funding for emergency contraceptives, Rasmussen, as part of the response team, gave a presentation and asked for funding from the Johnson County Board of Supervisors last month. The supervisors allocated $10,000 for the medications.

“Her willingness to continue to fight for survivors in the midst of political turmoil is incredibly admirable,” Helt said.

Stressful, draining job

Rasmussen admits her job is stressful and most days are “emotionally draining.” She and the 15 other nurse examiners she leads in the county work on call and are available 24/7. Most of them have other full-time nursing jobs.

But Rasmussen said the work is rewarding. The best part of her job, she said, is when former patients tells her how much they appreciated the exam and how it helped them process what happened so they could begin to move on.

As a nurse working with intensive care patients at the UI Hospitals and Clinics, she also gets to see those patients going from a significant injury to a recovery.

She copes with stress usually by leaning on family for support, but mostly talks with other nurse examiners and nursing friends to help her process her emotions.

“They have a better understanding of the stress you are feeling,” Rasmussen said. “I also have great support from the two previous (response team) coordinators who are a wealth of knowledge when I am dealing with a new situation or just need to talk through how to deal with something.”

Rasmussen also has another outlet — a roller derby team, which she just got back into recently. She started skating about 12 years ago, but had to have some hip surgeries, so she quit and then she got married and had two daughters.

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But “Holm Wrecker” — her derby skater name — is back with the Old Capitol City Roller Derby team, which allows her a way to deal with any “pent-up aggression or frustration” in a healthy, exhausting way.

“I’ve had some good falls but no big injuries, mostly bruises all over,” she said.

Comments: (319) 398-8318; trish.mehaffey@thegazette.com