Sexual Assault Nurse Examiner Essay

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A Sexual Assault Nurse Examiner (SANE) is a highly skilled, specially trained nurse, usually available on call to hospital emergency departments, medical facilities, and other specialized clinics to provide complete care to victims of sexual assault who come to the facility within a specified time period, usually 72 hours of the assault. Complete care includes five basic activities:

  1. Interview and examination to identify, evaluate, document, and provide care of genital and nongenital physical injuries sustained during the sexual assault.
  2. Evaluation of pregnancy risk, explaining options and offering emergency contraception to prevent pregnancy.
  3. Evaluation of risk of sexually transmitted infections, including HIV, and offering medications to prevent or lower the risk of contracting a sexually transmitted infection to those at high risk.
  4. Providing crisis intervention, support, and information about both medical and forensic options.
  5. Collection of forensic evidence using a sexual assault evidence collection kit and maintaining chain of custody of all evidence. If the SANE suspects a drug-facilitated sexual assault, additional blood and urine evidence will also be collected for forensic evaluation.

After the examination is completed, the SANE will explain what was done and recommend follow-up care options available for the sexual assault victim and victim’s family or friends.

The SANE evidence collection will typically include evidence that other members of the Sexual Assault Response Team (SART) will use to prove the elements of a sexual assault. These elements include evidence to identify the assailant, primarily through DNA analysis; evidence to demonstrate that there was recent sexual contact; evidence to show that this contact was the result of force, coercion, or lack of consent; and evidence to corroborate the victim’s history of the assault.

The SANE will typically provide services as a part of a SART. In addition to the SANE, this team includes a law enforcement officer, sexual assault advocate, prosecutor, and crime laboratory specialist. The team may also include a chaplain and other mental health specialists. If the victim has not reported the rape to law enforcement prior to the arrival of the SANE, the SANE or the advocate will explain to the survivor the options and implications of immediate and delayed reports or of not reporting so that the victim can make an informed decision. If the case goes to trial, the SANE will usually testify as a fact witness and/or an expert witness. To demonstrate their expertise and increase their credibility as an expert witness, many SANEs are certified as SANE-A (adult and adolescent) or SANE-P (pediatric) by the International Association of Forensic Nursing.

Although SANE programs have been in operation since the late 1970s, many medical facilities continue to operate without these trained specialists. When SANEs are available, the SANE-SART model results in an increase in reporting of sexual assault, shorter waits for care, better evidence collection, more guilty pleas by assailants, and increased prosecution of sexual assault cases. The SANE model has improved both clinical care of the victim and the forensic evidence collection.


  1. Ledray, L. E. (2006). Sexual assault. In V. Lynch (Ed.), Forensic nursing (pp. 279–291). Philadelphia: Elsevier Mosby.
  2. Ledray, L. E., & Schwartz, C. (2006). Sexual assault. In P. G. Zimmerman & R. D. Herr (Eds.), Triage nursing secrets: Your triage questions answered by experts you trust (pp. 511–520). Philadelphia: Elsevier Mosby.

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