Role of a Sexual Assault Nurse Examiner

Forensic Nursing – Role of a SANE

 Forensic Nursing is a specialty that combines nursing practice with the legal system.  They often perform as a liaison between medicine and the law.  There are many subspecialties of Forensic Nursing, one of which is a SANE (Sexual Assault Nurse Examiner).  A SANE is a Registered Nurse who has received special training in order to provide comprehensive care and forensic examination for sexual assault victims or perpetrators (Nies & McEwen, 2019).  Most hospital systems in urban communities, including where I live, employ a SANE in their Emergency Departments.  This paper will discuss the role of a SANE nurse and their impact on the patients they serve as well as the legal system.

Community Setting

 I live in a rural community just outside of Cleveland, Ohio.  All of the large hospital systems around here (there are 4) have a SANE nurse as part of their ED (Emergency Department) staff.  Sexual assault victims who seek treatment in the ED will be seen by a SANE.  The SANE will perform and document detailed physical exams, collect forensic evidence, and may be called upon in the future to testify in court.  Evidence collected would include documenting the history of the event, taking photographs of injuries, collecting clothing, and/or evidence obtained from pubic combings and fingernail swabbing (Nies & McEwen, 2019).

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 The SANE’s first priority is the care of the patient, which includes collecting evidence.  Although it is the SANE’s responsibility to report the crime to the police, it is the patient’s decision whether or not they wish to pursue legal action.  If the patient refuses, the SANE has to respect and support their decision.  However, the evidence obtained is still collected in case the patient later changes their mind.  The SANE always provides their patient with information on how to report the sexual assault if they wish.  Information is also provided for counseling services and support groups so the patient knows they are not alone in this journey.  For some, just knowing they have support through the process may be enough for the victim to pursue prosecution (Campbell, Greeson, & Patterson, 2011). 

Health Promotion Nursing Intervention

“Although SANEs are taking a neutral position (most of the time) with their patients regarding legal reporting and prosecution, their direct practice with patients may still influence prosecution outcomes” (Campbell, Greeson, & Patterson, 2011).  This may indirectly affect a victim’s willingness to participate in the legal system.  Common practice is to always address a survivor’s emotions and their possible feelings of blame and guilt.  The SANE not only provides assurance that the assault is absolutely not the victim’s fault, but also reminds the victim of their strength for coming in at all.  Providing the victim with information on reporting the assault and supportive services available to them may help the victim start to feel in control of their lives again (Campbell, Greeson, & Patterson, 2011).  This may aid the victim to pursue prosecution which if successful, would not only make the victim feel safer, it would also make the community safer if their attacker is behind bars.

With the rise of sexual assaults occurring on college campuses across America, utilization of a SANE for purposes of education would be invaluable to college communities.  I think if a SANE teamed up with law enforcement and presented information on what a sexual assault is and how to report it, victims might have the strength to come forward.  It would be important to stress that if the assault is not reported, the attacker is free to do it again.

Professional Nursing Organization

A Professional Nursing Organization that supports Forensic Nursing is the International Association of Forensic Nurses.  This organization supports all subspecialties that fall under Forensic Nursing.  Some of the offerings included with Association are Certification Programs, continuing education, professional networking, and education guidelines.  The Association was started in 1992.  Because Forensic Nursing is still considered a new specialty, roles, definitions and educational programs are being identified and created on a continuous basis.  The Association provides a framework of Scope and Standards of Practice along with Education Guidelines for the various roles included in Forensic Nursing.  (International Association of Forensic Nurses, 2019).

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One goal of the Association is to incorporate forensic nursing science at the basic and graduate levels of nursing programs around the world.  Their scope of practice includes fidelity to patients and clients, responsibility to the public, obligation to science and dedication to colleagues.  The website is a wealth of knowledge and provides an ethical framework to help make ethical decisions while following the identified scope of practice (International Association of Forensic Nurses, 2019).

Summary

 The SANE is a very integral part of our community.  He/she provides care and support for the sexual assault victim and collects the evidence needed for our legal system.  With the International Association of Forensic Nurses providing the education, framework, and scope of practice for this role; future nurses will be aware of its importance.  Teaming up with law enforcement to provide education on the importance of reporting these assaults would improve public awareness and hopefully willingness to report these crimes.  The SANE provides the victim with the care and tools needed to participate in prosecution.  With that participation the victim regains control.  When the legal system is effective, the victim feels safe and it makes our community a safer place. 

References

• Campbell, R., Greeson, M., & Patterson, D. (2011). Defining the boundaries: How sexual assault nurse examiners (sanes) balance patient care and law enforcement collaboration. Journal of Forensic Nursing, 7(1), 17-26. doi:10.1111/j.1939-3938.2010.01091.x
• International Association of Forensic Nurses. (2019). International Organization of Forensic Nurses. Retrieved from https://www.forensicnurses.org
• Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.