Sexual Assault Nurse Examiners

Sexual Assault Nurse Examiner (SANE) programs were created in response to the problem of survivors of sexual violence often feeling re-traumatized by their experiences in traditional hospital emergency departments. These programs provide specific education and training to nurses on medical forensic care and crisis intervention, for patients who have experienced sexual violence.

In Ontario, there are 35 such programs, called Sexual Assault/Domestic Violence Treatment Centres, where the most common services used by survivors include assessment and/or documentation of injury, and on-site follow-up care. One study of these Ontario Centres found that almost all clients or their guardians surveyed reported that they received the care they needed, rated their overall care as excellent or good, and stated that the care had been delivered in a sensitive manner.

A review of the literature on SANEs concluded that these programs are effective across five areas:

• supporting the psychological recovery of survivors
• providing comprehensive post-rape medical care, such as emergency contraception or sexually transmitted disease prophylaxis
• documenting the forensic evidence of the crime
• improving the prosecution of sexual assault cases
• creating community change by bringing multiple service providers together.

These conclusions, however, were tentative, as the authors warned that most of the studies were not controlled or rigorous enough to properly test the effectiveness of SANE programs.

One survey of emergency department nurses in the United States found that SANE-trained nurses held more positive attitudes toward sexually assaulted patients compared with non-SANE-trained nurses. This research suggests that in general nurses would benefit from SANE training, to improve patient outcomes and satisfaction.

Another qualitative study looking at rape survivors’ experiences with SANE-trained nurses found that the program provided survivors with care and compassion, clear explanations of the exam process and findings, and choices during the exam, and that these experiences were perceived by survivors as humanizing.

While no research currently exists on SANE programs within university or college campuses, one systematic review of the impacts of sexual violence on college student survivors suggests that nurses at on-campus health facilities are conveniently positioned to address sexual violence. The authors recommend that on-campus nurses aim to use consistent definitions of sexual violence when identifying survivors and to promote an atmosphere that encourages patient-provider discussion by minimizing barriers to disclosure. These recommendations may potentially be achievable through the use of SANE training for on-campus nurses.

Overall, evidence on SANE programs suggests that they are effective in providing adequate care for survivors, however, further investigation is still needed.