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Sexual Assault Nurse Examiner (SANE) Program: Frequently Asked Questions

What is the Sexual Assault Prevention & Crisis Services Program doing to assist medical professionals who work with survivors of sexual assault?
The Program offers training for registered nurses (RNs) on how to complete sexual assault forensic examinations. Certification is also available for registered nurses who have completed the SANE Forensic Training Program.

What is a SANE?
A Sexual Assault Nurse Examiner is an RN who has been specifically trained to:

  1. provide comprehensive care to sexual assault survivors;
  2. demonstrate competency in conducting a forensic exam to include evaluation for evidence collection;
  3. have the expertise to provide effective courtroom testimony; and
  4. show compassion and sensitivity to survivors of sexual assault.

What is a sexual assault forensic exam?
It is a forensic examination performed by medical personnel for the purpose of collecting evidence following a sexual assault. It is not a medical treatment. The exam is ordered by the district attorney or county attorney of the county in which the assault occurred. The presence or absence of physical evidence does not prove whether a person has been sexually assaulted. Rather, it may provide supportive evidence to be used during legal proceedings.

Are sexual assault exams performed on adults and children?
Yes. Many of the evidence collection issues apply equally to adult and child survivors of sexual assault/abuse. However, there are particular issues regarding the interviewing and medical examination needs of children that differ from those of adults.

What happens during a sexual assault exam?
A history is taken by the SANE to determine injuries and treatment for the patient. The next step is a head-to-toe examination in order for the SANE to note any trauma, i.e., head, arms, back, neck, throat, etc. When a survivor has experienced trauma to the genital area (female and male sexual organs), an examination is conducted to identify injuries and document the results. Last, a collection of forensic evidence is done, and a rape kit is sometimes used.

What is a rape kit?
In addition to the sexual assault examination, a kit is used to collect physical evidence. Kits can be made from materials readily available at most medical facilities or purchased commercially. Kits are packaged in a crush-proof box to protect the contents during transportation to a forensic lab.

When would a kit not be used?
If it is determined that the assault took place more than 72 hours prior to the examination, the use of an evidence collection kit may not be necessary. It is unlikely that evidence would still be present on the survivor. However, evidence may still be gathered by documenting any findings obtained during the medical examination (such as bruises or lacerations), photographs and bitemark impressions (if appropriate), and securing statements made by the survivor about the assault.

Will a SANE know when to use a kit and when not to?
Yes.

Does a SANE treat injuries such as broken bones, internal bleeding, cuts requiring stitches, etc.?
No. A SANE will refer the sexual assault victim survivor to an emergency room.

What does an RN need to do to become a SANE?
An RN must complete classroom and clinical hours before performing sexual assault examinations independently. Classroom and clinical hour requirements will vary depending on where an RN receives training.

The Sexual Assault Prevention & Crisis Services Program requires an RN to complete fifty-six (56) classroom hours and suggests a completion of ninety-six (96) clinical hours.

The clinical hours include:

  • twenty-four (24) hours performing speculum examinations with preceptorship of a registered nurse, nurse practitioner or physician;
  • twenty-four (24) hours performing well-child exams with preceptorship of a registered nurse, nurse practitioner or pediatrician, with a focus on child development;
  • perform interdependently within the preceptorship of a credentialed SANE or physician with documentation of preceptor approval:
    • Six (6) sexual assault examinations using a collection kit
      (estimated time - 17 hours) on adults; and
    • Ten (10) sexual assault examinations
      (estimated time - 15 hours) on children
  • observing sixteen (16) hours of criminal trial proceedings.

How can an RN become certified, or re-certified as a SANE?
Certification and re-certification packets and instructions are available here.

Does the fifty-six (56) hours include information on all kinds of survivors?
Yes. Regardless of the client population (male, female, adult, adolescent, child or adult) a SANE program chooses to care for, the training must include information on all age groups and genders.

What information is included in the fifty-six (56) hour training?
Information is provided on Adult, Pediatric and Courtroom components and covers the following:

  • Advocacy
  • Survivor Symptomology
  • Documentation
  • History-taking Skills
  • Collection of Forensic Evidence
  • Use of a Rape Kit
  • Courtroom Testimony

Who pays for the exam?
State law requires the law enforcement agency requesting the exam to pay all expenses related to the gathering of forensic evidence from the victim. The victim's cooperation in pressing charges is not a factor; if the law enforcement agency requests that the exam be conducted, the law enforcement agency is responsible for paying the costs.

Other medical care for the victim, such as treatment of physical injuries, testing for AIDS/HIV and sexually transmitted diseases, or counseling may be paid for by the Crime Victims' Compensation Program. Applications for Crime Victims' Compensation and assistance completing the form are available from the hospital, sexual assault program or law enforcement agency.

How does a SANE program benefit a sexual assault survivor?
It is vital to a victim's recovery to be treated properly while the evidence is collected. It is also vital to the survivor's recovery and the prosecution of the offender that forensic evidence be properly collected.

It has been noted that survivors heal faster when treated properly by someone who is trained to be a sexual assault examiner. In addition, victims are more likely to follow through with the prosecution of criminal cases when they have received compassionate treatment from the same caregivers throughout the exam.

How does a SANE Program benefit a community?
With accurate evidence collections and more prosecutions, more sexual assault felons will be incarcerated rather than offending more victims, thus making for a healthier community. The message that a survivor receives when a SANE program is developed is: Sexual assault is a problem for the entire community, not just victims and local sexual assault programs.

The mental health and physical well being of sexual assault victims are important to the community. Support for professionals to receive special training to learn how to properly collect forensic evidence is important to community leaders to insure a higher conviction rate of sex offenders. In addition, support is provided to ensure a SANE Program continues.

Does every community in Texas have a SANE Program?
No. However, many communities are aware of the benefits and are actively pursuing the development of a program.

How can I find out whether my community has a SANE Program?
You can contact your local sexual assault program, medical facility or district attorney's office.

If my community does not have a SANE Program, is there anything I can do to start one?
You can call your local sexual assault program and inquire whether steps have been taken to establish a program. If nothing has been done to start a program and you'd like more information on how to begin the process, contact:


    Sexual Assault Prevention & Crisis Services Program
    Crime Victim Services Division, MC-011-1
    Office of the Attorney General
    PO Box 12548
    Austin, TX 78711-2548

    (512) 936-1270
    (512) 936-1650 FAX

 

 

 

 

 

 

 

Revised: 03/18/06
Revised: February 01 2008
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Contact Information:
Crime Victims' Compensation
P.O. Box 12198
Austin, Texas 78711-2198
1-800-983-9933 (state-wide) 1-512-936-1200 (in Austin)
1-512-936-1800 (FAX)
crimevictims@oag.state.tx.us Address Confidentiality Program, MC-069
P O Box 12199
Austin, Tx 78711-2199
512-936-1750
888-832-2322 TexasAttorneyGeneral.gov
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