ONSA/DVTC 30th Anniversary: Interview with Sheila Macdonald

June 28, 2023

1. Can you tell us a bit about yourself and your work with the ONSA/DVTC?

I am a registered nurse and have been at WCH since 1990.  I joined the SA/DVCC in 1990 as an on-call nurse and provided front line care for about 10 years.  During these years I have held the role of Team Leader, Manager of SA/DVCC and Manager of the Bay Centre for Birth Control.  I became the Provincial Coordinator for the ONSA/DVTC in 1993 and am now in a director role since 2018. The Network of SA/DVTCs was established in 1993 to enhance collaboration, education, research and standardization of services among the 37 SA/DVTC’s across Ontario.

2. What is some of the important work done by the ONSA/DVTC?

The collective contributions of frontline clinicians, educators, program leaders across the province and the Network team have enabled us to achieve numerous accomplishments. These include a standardized Sexual Assault Nurse Examiner training program, the development of Standards of Care for our programs and ongoing education and support for our teams, and the development of a province wide database (currently being implemented). In partnership with WCRI – Dr. Janice Du Mont, Dr. Robin Mason and Dr. Sarah Kosa, we have engaged in numerous research initiatives which have resulted in clinical practice changes. Some examples are the HIV PEP study (2003-2005), led by Dr. Mona Loutfy which ensures HIV PEP prophylactic medication free of charge for all clients who are at risk of HIV exposure from the assault, and the Drug-Facilitated Sexual Assault Study (2007), resulting in enhanced clinical care (screening and testing) if needed. Numerous online educational trainings have also been development through this collaboration including elder abuse care, sexual assault care for trans persons, training for Emergency Department clinicians and most recently SA/DVTC care for Persons who may be Sex Trafficked (almost completed).  

We have also developed online training modules specific to northern nurses’ stations so that care can be provided locally by the nurse instead of the survivor needing to travel (far distance) to a SA/DVTC. We have adapted these training modules for community emergency department clinicians and working collaboratively to enhance community ED support so that care can be provided at the community ED when travel distances are too far to the SA/DVTC.

In May 2020 (pandemic) we launched the provincial navigation line to assist survivors in accessing services at the nearest SA/DVTC as well as provide information to health care providers and police services. Our plan is to continue the line and expand its purpose to enhance support for clinicians across the province.

3. What are some of the challenges faced by sexual assault and domestic violence survivors?

Survivors continue to face numerous challenges even though there has been increasing awareness about issues of sexual and intimate partner violence. These are very under-reported crimes, not just to police but to anyone due to fear, shame, self-blame and lack of sufficient resources to help someone seeking services.  Insufficient resources include difficultly accessing counselling services (not just crisis support) due to long wait lists and difficulty in finding safe and affordable housing for survivors of intimate partner violence who want to leave but have no place to go.

Perpetrators of violence are often not held accountable by the legal system and the myths prevail that blame the victim for the assault/abuse. The legal process can be lengthy and taxing on victims/survivors who often question whether reporting to police was worth it.

4. What improvements or continued work would you like to see in the next five years?

In the next five years, I would like us to continue to enhance access to care to our services through increased partnerships with community emergency departments and community health agencies that provide services to survivors. Survivors need to be able to access care locally without needing to travel long distances.  Training and supporting clinicians virtually is one option we are exploring.

We are currently challenged with insufficient nurse staffing for some of our programs and I will continue to work with our programs and the Ministry of Health to find creative ways to address this challenge across the province.

We also will continue to increase public awareness about our services through social media strategies and community partnerships.