Sexual Assault Nurse Examiners: The Critical Link for Victims
The medical and legal process that occurs after someone has been a victim of sexual violence can often be intimidating and frightening – sometimes causing victims to withdraw from the process completely, and often resulting in under-reporting and lower prosecution rates for these crimes.
For someone who has already been traumatized physically, mentally, and emotionally their first contact after the fact is critical. SANE (Sexual Assault Nurse Examiners) programs have emerged in the last few decades to provide patient-sensitive care and improve the medical-legal response to sexual assault victims. According to the International Association of Forensic Nurses, “Forensic nurses also conduct evidentiary exams in cases involving other types of interpersonal violence, public health and safety, emergencies or trauma, patient care facilities, and police and corrections custody abuse.” SANEs are currently available to rape victims when they enter a hospital in many jurisdictions.
SANEs take the patient’s medical history, history of the assault, make a physical assessment of the patient that record wounds, collect and preserve all evidence, provide a treatment plan and also create a discharge plan for the patient.
These nurse examiners also testify in court cases as an expert witness in sexual assault cases.
But the emotional level of care a SANE provides goes well beyond forensics and paperwork. To learn more about this crucial link in the sexual assault survivor’s experience, Moms Fight Back spoke with Kim Day (RN, FNE, SANE-A, SANE-P and SAFEta Project Director) about the SANE program, her experiences as a SANE and why Sexual Assault Nurse Examiners are so important to the sexual violence recovery process.
What kind of training does a SANE receive?
“The training to become a Sexual Assault Nurse Examiner (SANE) is one that occurs after the nurse is already a registered nurse (RN) or advanced practice nurse (NP – Nurse Practitioner or CNW – Certified Nurse Midwife). IAFN Education Guidelines and the US Department of Justice National SAFE (Sexual Assault Forensic Examiner) Training Standards recommend 40 classroom hours of training followed by some sort of clinical experience to go with that.
I took the initial SANE training when we did not have a program at our local community hospital, and I recognized the better care that could be given (to victims) by a trained examiner, rather than just reading directions from the (sexual assault evidence kit) box.”
A registered nurse can take training that includes victim interview skills, the rape crisis center process, crime scene investigation, the victim medical-legal examination, suspect interview process, laboratory analysis results, trial preparation, and mock trial. (Further information about this training program and process can be found here.)
SANEs are not, by profession, victim advocates however they do provide information to the victim about local sexual assault advocacy programs where the staff are trained and knowledgeable about a wide range of victim medical and legal needs.
Why are SANEs so important in sexual assault cases?
Recent studies have shown that prosecution rates in sexual assault cases have increased using SANEs as credible witnesses and due to the SANEs skilled forensic evidence collection.
Day concurs, “The research shows that the patient is more likely to feel better about the care they had in the healthcare system with a SANE- and they are more likely to participate in the criminal justice system if they do, also (and so, they individually heal better and as a community, the chance is that there will be a higher level of safety for all of us, when perpetrators are held accountable.”
During the course of our talk, Day shared a personal story where she saw her training and work as a SANE making a difference: “I had a case where a victim was assaulted by a stranger (which in itself is unusual, as most sexual assaults are by people that are known in some way to the victim) and it was not until almost 8 years later that they identified the perpetrator, who had been arrested for another crime – he was identified by a CODIS hit- and he had also spent time in prison for a crime that was eerily similar to the one that he had committed against my patient. Many of our patients do not get resolution in the courtroom, however. It is important for the SANE to recognize that the care they deliver and the information and resources and support given to the patient at the time of the exam is essential to begin the process of healing.
A SANEs role is to assure that the person/patient/victim has their healthcare needs met, and to provide access to resources that can be critical to begin the healing process.”
To learn more about this crucial link in the justice system for sexual violence victims the Sexual Assault Resource Service (SARS) site offers information to individuals and institutions interested in developing new SANE programs as well as improving existing ones.
SAFE TA Helpline – 877-819-SART. The SAFE TA helpline provides technical assistance to service providers for victims of sexual assault and to the agencies which serve them. These may include: medical professionals, law enforcement officers, attorneys, victim advocates, and first responders.