A new report from federal auditors on forensic exams for sexual assault cases gives insights into why nurses with the right training may not be available when a victim asks for help.

Conducting the grueling exam required to collect evidence from a victim's body takes special training. But the Government Accountability Office report says there are so few of them that in all likelihood, one won't be available when a crime takes place. Funding to train these examiners and fund their services are scarce. Burnout for these workers, who are typically nurses, makes the shortage worse.

While the report only mentions Georgia in passing, a top expert says a shortage of examiners also hurts victim care in this state.

"It is probably one of our single greatest challenges in sexual assault services," said Ann Burdges, CEO and executive director of the Gwinnett Sexual Assault Center & Children's Advocacy Center. "We simply do not have enough trained skilled sexual assault nurse examiners in place. And that includes us in Gwinnett."

Even though Burdges' center provides some of the most comprehensive services available for sexual assault victims in the state, it too is struggling to provide specialized examiners. She is trying to hire a new, full-time sexual assault forensic nurse examiner after she lost her nurse of eight years to a job with better pay, hours and benefits.

A nurse shortage has driven up wages, making it hard for nonprofits like hers to compete. In fact, most jurisdictions in Georgia have been unable to come up with funds to hire a forensic examiner full-time, she said.

Most specialized sexual assault nurses have other full-time jobs. When they moonlight to help rape victims, they are paid as little as $3 or $4 an hour to be on call, Burdges said. They don't receive additional pay unless they are called out to perform an exam, which is generally compensated by the state at $150 to $300 per case, she said. They aren't paid for testifying in court.

Nurses can easily make twice as much money by picking up an extra shift, she said.

If a jurisdiction's primary provider of forensic exams is a local trauma center, qualified nurses may be too busy treating patients with life-threatening injuries to devote as many as six hours to examine a rape victim. Individual hospital policies can make the process of finding qualified examiners more complicated.

"If I’m nurse working in an ER handling a gunshot wound or car accident and a rape case comes in, are you going to pull me off my trauma patient?" Burdges asked.

Rural areas are hardest hit, she said, which according to the GAO report makes Georgia no different than much of the nation.

"It’s a huge, huge commitment by nurses do this work. Sadly, most programs are still functioning on the criteria of 20 or 25 years ago," she said.