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MISSOULA, Mont. — Jacqueline Towarnicki got a text as she finished her day shift at a local clinic. She had a new case, a patient covered in bruises who couldn’t remember how the injuries got there. Towarnicki’s breath caught, a familiar feeling after four years of working night shifts as a sexual assault nurse examiner in this northwestern Montana city. “You almost want to curse,” Towarnicki, 38, said. “You’re like, ‘Oh, no, it’s happening.’” These nights on duty are Towarnicki’s second job. She’s on call once a week and a weekend a month. A survivor may need protection against sexually trans...

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