What is a SANE?
A SANE is a registered nurse (RN) who provides care and treatment to victims of sexual assault in collaboration with other healthcare providers. SANEs may also collaborate with law enforcement, prosecutors, advocacy groups, and other community partners as members of a SART team.
A SANE conducts a medical forensic exam to patients who have experienced sexual violence. Additionally, the SANE offers emotional support, crisis intervention, and resources available to them after the initial exam.
The exam itself is a combination of both medical and forensic. Although the forensic aspect of the exam is very important, the patient’s physical and mental health are always the first priority. The medical exam consists of a physical exam to assess for and treat injuries, medications to treat/prevent STIs, emergency contraception to prevent pregnancy, emotional support, and education regarding discharge and follow up care. The forensic part of the exam involves forensic photography and collection of evidence in the form of clothing, debris, fluids, specimens, and any other potential sources of DNA.
SANEs provide patients with a trauma informed approach allowing the patient to have full control of the exam and how much or how little they participate in. Patients are allowed to withdraw consent, take a break, or end the exam at any time.
In addition to the medical forensic exam, SANEs may also testify in court as a fact or expert witness. SANEs may also collaborate with the SART team on things such as policies and procedures, education, community outreach, and case reviews.
How to Become a SANE
To become a SANE you must have:
- A minimum of a registered nurse (RN) license. SANE practice is outside the scope of practice for a paramedic or LPN.
- Clinically practiced as an RN for 2 years. Clinical assessment skill is a critical component of being a successful SANE. SANEs practice independently and must rely on their skill and experience during exams.
- 40 hours didactic training
- 40 hours practicum
After you’ve completed your clinical training, it’s time for a clinical preceptorship/practicum. Each program will have different requirements for their practicum. These can include:
- Speculum Training
- Courtroom Observations
- Police Ride Alongs
- Clinical Skills Labs
- Exam Observations
- Trauma Informed Care
- Neurobiology of Trauma
- Mock Exams
- Orientation to Facilities
In addition to approved training, you should understand what state and local regulations and requirements are in place for the population you wish to serve. Contact your Board of Nursing for questions related to SANE practice in your state.
Types of SANE Programs
SANE programs function differently based on the needs and resources available In a community as well as based on the age of patients they serve. SANEs may work on staff in a hospital within a forensic nursing program, others work full-time as bedside nurses and are assigned to patients reporting sexual assault as needed, others still work as a SANE in an on-call capacity. In some areas, SANEs may see patients via telehealth and not directly in person.
SANEs may be trained to see adult/adolescent patients, pediatric patients, or both.
In Johnson County, SANEs work strictly on-call and most have another primary role within one of the local hospitals. JCSART has an adult/adolescent program and sees patients who are aged 13 and older. Pediatric patients (12 and under) are sent to the Child Protection Center for evaluation and treatment.
Certification
There are two certifications for SANEs:
- SANE-A (adult/adolescent)
- SANE-P (pediatric/adolescent)
After proper training and practice, you may be eligible to sit for board certification. Requirements to sit for the SANE certification exam:
- Current, unrestricted licensure as a registered nurse (RN) or advanced practice nurse (APRN)
- At least 2 years’ practice as an RN (for SANE-A exam) / 3 years’ practice (for SANE-P exam)
- Completion of a minimum 40-hr SANE didactic course by an accredited provider
- Completion of a SANE clinical preceptorship
- Accrual of 300 hours of SANE-related practice within the past 3 years (at least 200 with the intended exam population)