Sexual Assault Nurse Examiners (SANE) are nurses who are specially trained in caring for victims of sexual assault. The main objective is to tend to the victims’ physical and emotional needs, as well as assist with evidence collection to help prosecute their assailant. The need for SANE nurses became evident with lack of support available to rape victims, and the lack of trained personnel capable of collecting forensic evidence properly in cases of sexual assault.
Sexual assault, or rape, is a crime in which is victims are often reluctant to seek help. Rape is any unwanted sexual contact, which can be from someone you know or a stranger. Shame, guilt, and embarrassment leave many victims feeling alone, and not wanting to seek treatment after a rape. When victims do present to the emergency room for help, they are often times treated as non-urgent patients. Emergency rooms do see a wide range of patients, and sexual assault victims can be a low priority if they are physically stable. When the victims do seek treatment, it is found that less than half of them get basic services, such as education on pregnancy and sexually transmitted diseases.
Emergency nurses realized the lack of resources available to rape victims. These resources range from immediate physical and emotional support, to long-term psychological support. There are also legal issues involved, since sexual assault is a crime. The sexual assault nurse examiner program started in response to this need. The first SANE programs started in the 1970s, and have evolved over the past 40 years to board certified nurses who have specialty training in the field of forensic nursing.
What is required to be a SANE nurse?
The International Association of Forensic Nurses maintains the structure of SANE programs across the country. To become a board certified SANE nurse, a nurse must have two to five years experience and completed at least 40 hours of clinical education. The clinical education includes pelvic exams and evidence collection. Extensive classroom training is completed in male and female anatomy, evidence collection, as well as the many legal aspects involved with sexual assault. SANE nurses are expected to be expert witnesses, and to testify at trial to support the evidence that they collect.
Forensic evidence collection and increased prosecution rates
Evidence that is needed for a sexual assault kit include blood, hair samples, and swabs from different areas of the body. Prior to SANE nurses, evidence was collected mainly by emergency room physicians with little or no training in forensic evidence collection. These kits are a chain of evidence that need to be completed thoroughly in order to catch and convict an assailant. SANE nurses are trained to be detail oriented, and to understand that an incomplete kit could be the difference in convicting a criminal or letting a rapist go free.
SANE nurses are having a major impact on prosecution rates of accused rapists. These nurses are often times called to testify at trials for evidence that they have collected, and are trained to be expert witnesses. The evidence collected by SANE nurses tend to be more thorough and detailed than when collected by non-SANE nurses or physicians. One study by Aiken and Speck shows that when evidence is collected by SANE nurses, assailants would rather plead guilty to a lesser charge than risk going to trial.
SANE nurses have also assisted with proving that some individuals are innocent when they have been accused of rape. These nurses testify to the facts, which is why their documentation and evidence collection is thorough. There have been situations in which there were lack of injuries, or no sperm present and the SANE nurses has been a beneficial witness for the defense. (Ledray, 1992)
Do all hospitals have SANE nurses?
SANE programs are set up in numerous hospitals across the country. There are not SANE nurses at every hospital or emergency room. The only way to know if your local hospital has a SANE program is to ask. If there in not a SANE nurse available there, then they should be able to direct you to the closest hospital with such a program. Local EMS and police also know where to take victims of sexual assault.
This information should also be provided online by the hospital.
SANE nurses should be available 24-hours a day. When a hospital implements a SANE program, there are generally several nurses trained in order to maintain the service at all times. The goal is to always have a SANE nurse on duty in order to meet the demands of the patient population. Some hospitals are unable to keep such nurses in the department at all times, so they may have a SANE nurse who is on-call.
What to expect from a SANE nurse
The SANE nurse performs the entire assessment and evidence collection, as well as remains with the patient for emotional support throughout the emergency room visit. She will also give the victim contact information for the hospital's SANE program. The door does not shut to victims when they leave the department, the SANE program is a continuous resource for sexual assault victims. Community resource options should also be given.
The SANE nurse will spend time teaching the victim about the risks associated with rape. Education is done on pregnancy options, as well as HIV and sexual transmitted diseases. An emergency room physician will see the patient, but will generally leave the assessment and education to the SANE nurse.
SANE nurses are available for victims immediately after the assault, as well as for long-term support. Sexual assault leaves its victims with life-long emotional and psychologic scars that do not go away when the physical pain has healed. The initial emergency room visit is only the beginning of the healing process. The main objective is to turn rape victims into rape survivors. SANE nurses can assist with this transition through their professional expertise, and the caring that all nurses do so well.
Sources:
Aiken, M.M., & Speck, P.M. (1995). "Sexual Assault and Multiple Trauma: A Sexual Assault Nurse Examiner (SANE) Challenge." Journal of Emergency Nursing, 2 , 466-468.
National Online Resource Center on Violence Against Women. "The Effectiveness of Sexual Assault Nurse Examiner Programs" (accessed October 6, 2010).
US Department of Justice. "Sexual Assault Nurse Examiner SANE" (accessed October 6, 2010).
Trustee. 24/7:The SANE Approach to Treating Rape Survivors.
Ledray, Linda E. (1992b) The Sexual Assault Examination: "Overview and Lessons Learned in One Program." Journal of Emergency Nursing. Volume 18, Number 3, pp. 223-232.
Diane Middleton - I have been a registered nurse in the Emergency Department for the past 15 years. I love to write about my ER experiences, and use this ...
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