Creating a relationship based on trust with both individual patients and communities is a critical part of SANE program development. Before a program can begin to develop trust, there must be recognition that health care systems in the United States have not always provided equal access or care to some specific individuals or specific communities. It is important for nurses to understand why patients or communities may not have automatic trust in a health care program. For example, when nurses label patients as “drug seekers” because they have a history of using narcotic pain medication, patients may feel that they cannot seek care for problems unrelated to their chronic pain for fear of having their problems ignored or dismissed. Native American women may have a historical distrust of health care systems because sterilizations were performed on some native women without their consent as late as 1976. Trust begins by listening to members of your community. There are several ways to begin the conversations to involve specific communities.
One approach is to identify and reach out to the leaders of a specific community, recognizing that there may be several leaders and several different perspectives coming from one group. Trust is not automatic and will only develop with time.
A common saying in the disability community is "nothing about us without us." This is a good saying to remember across the spectrum of community members who will be served by your SANE program, a reminder to acknowledge the expertise those in the community can provide. SANE programs need that expertise to provide appropriate care to all individuals who may have unique cultural, physical, or emotional needs for sexual assault care.