Staying SANE: The Importance of Sexual Assault Nurse Examiners

What would you do if you went through the most traumatic experience of your life and you then had to go to a cold, sterile environment to be violated and re-traumatized? Would this make you more or less likely to be cooperative with law enforcement, prosecutors, etc.? Would you want to testify in front of a court room after being traumatized by the same person you trusted?

Before the SANE, or Sexual Assault Nurse Examiner, program was implemented in the United States, this was all too common for survivors of sexual abuse. Before SANEs, victims of sexual assault were often examined by normal emergency department nurses and physician’s assistants. In cases of abuse, the victim’s body is still a “crime scene” when they enter the emergency department; therefore, they need to be handled with even more care than an everyday patient. Nurses in generic emergency departments typically do not have specific training regarding handling evidence in cases of abuse. Without this proper training, the crucial evidence that should be carefully extracted from the victim’s body is often incorrect or incomplete. Emergency Department (ED) nurses are often reluctant to even preform sexual assault examinations due to their lack of training in forensic evidence collection. SANE programs are equipped with special tools and equipment for evidence collection which leads to their examinations being substantially more reliable, which gives them more credibility in court.

In addition to the issues surrounding the collection of evidence, the process of completing rape kits tend to be re-traumatizing for the survivor. SANEs are trained to meet both the physical needs of the case as well as the psychological needs of the survivor. These programs strive to minimize any additional physical and psychological trauma when victims are being evaluated and treated after an assault has occurred. Most SANE programs in the United States require nurse practitioners to complete a minimum of forty hours of classroom training and forty to ninety-six hours of clinical training(s) before being certified as a Sexual Assault Nurse Examiner.

It might not seem super obvious why we need SANEs in the first place. What might cause a person to need a medical forensic examination? What are examiners looking for when performing these examinations? Well, when someone is sexually assaulted, there are many ways the offender can leave behind physical evidence. This evidence can include bruising, marks, prints, bodily fluids, or DNA. This evidence can be the crucial difference between a survivor’s case being cold or solved. SANEs are trained to identify and collect these types of physical evidence; however, due to the crime, this process of evidence collecting is up close and personal. This closeness, after being sexually assaulted, can cause a trauma response for the survivor. SANE nurses are trained in the different types of trauma responses; therefore, allowing them to better communicate and work with the survivor.

Locally, PAVSA (the Program to Aid Victims of Sexual Assault) has collaborative efforts with St. Luke’s and Essentia Health to provide SANE exams to individuals thirteen years of age and older. On the other hand, here at First Witness we partner with our Medical Director, Dr. Jennifer Jones, through Essentia – Duluth and Dr. Jordan Blessing from St. Luke’s to provide pediatric forensic examinations to children ages twelve and younger. This way, we can cover and offer SANE examines to children of all ages who have experienced abuse.