SANE Nurses: How Nurses Help Victims of Sexual Assault

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A SANE nurse comforts a patient.Different nurses focus on different clinical practice areas. For example, some nurses are trained to provide medical care to postpartum mothers or newborn babies, while others may specialize in assisting cancer patients. Still other nurses have expertise in evaluating, diagnosing, treating and counseling the victims of assault or abuse—these nurses, working in a delicate and highly important field, are known as forensic nurses.

Those who’ve been victims of abusive or violent behavior can have significant physical health concerns and may also exhibit signs of disordered mental health, such as post-traumatic stress disorder (PTSD). A forensic nurse can help determine these patients’ care needs, while also providing them with the gentleness, compassion and warmth they need as they seek to move forward from a traumatic situation.

Nurses working in this field need to cultivate the right skill set and pursue the proper clinical certifications; for example, SANE nurse certification is an important distinction for forensic nurses to attain.

What Is a SANE Nurse?

Aspiring forensic nursing professionals need to understand what the SANE designation entails and which board administers the certification.

SANE Nurse Definition

SANE, an acronym for sexual assault nurse examiner, is a special designation that the International Association of Forensic Nurses (IAFN) awards to qualified nursing professionals.

The title is given to either registered nurses (RNs) or advanced practice nurses (APNs) who’ve proven their qualifications to provide treatment to those who are victims of abuse or sexual assault. The SANE nurse’s patients may include adults or adolescents who’ve been harmed in some way by abusive or violent behavior, as well as by neglect or abandonment.

In addition to directly providing patient care, SANE nurses and other forensic nursing professionals are often called upon to advocate for victims in the courtroom; for example, a SANE nurse may treat the victim of assault, and if that victim presses charges against the abuser, the nurse may be asked to give expert medical testimony court.

SANE nurses can also be powerful voices speaking out against violence and abuse and championing abuse victims’ rights.

About the International Association of Forensic Nurses

Those curious about becoming SANE nursing professionals may have some questions about the accrediting organization.

IAFN is an international membership organization that seeks to promote the forensic nursing professionals’ work and elevate the standards of practice in this important field. Additionally, IAFN advocates for those who need forensic nursing care to have easy access to it. According to its mission statement, IAFN ultimately hopes to see “a world without violence” and a “commitment to social justice.”

What Does a SANE Nurse Do?

Naturally, working with victims of violence and abuse can be emotionally challenging; at the same time, having the chance to help people during a time of intense need can be very satisfying, personally and professionally. Indeed, the forensic nurse job description can be broad and multifaceted. What does a SANE nurse do, precisely?

Clinical Work

Let’s consider the SANE nurse job description’s clinical side. What does a SANE nurse do to advance the physical health and well-being of victims of abuse?

  • A SANE nurse will meet with victims of abuse to provide basic triage. Through a brief medical evaluation, the SANE nurse will determine whether the patient needs an emergency intervention or more specialized medical care.
  • A SANE nurse will conduct a forensic examination of the patient, cataloging evidence of physical or sexual abuse that may be used in a court case or police proceedings. Additionally, the SANE nurse will conduct a forensic interview, asking the victim about the incident(s) of abuse.
  • During the forensic examination, the SANE nurse may be required to collect specimens and DNA samples, take photographs of bruises and other injuries, and conduct a detailed genital examination.
  • The SANE nurse’s primary goal is to ensure that the patient receives the necessary medical care and to provide guidance and support throughout any required treatments.

To summarize, the SANE nurse is responsible for fully understanding abuse’s physical manifestations and ensuring that patients receive whatever treatments and care are required for a full recovery.

Advocacy and Legal Work

In addition to providing clinical diagnosis, forensic examinations and medical treatment, SANE nurses may offer important legal support and general advocacy. For example, the SANE nurse job description may include the following:

  • Connecting patients with community resources, such as mental health providers or legal advocates
  • Serving as legal witnesses, providing expert testimony during relevant courtroom hearings
  • Maintaining the chain of custody for sexual assault examinations and adhering to all legal guidelines regarding evidence obtainment, documentation, and storage

Finally, because they can speak credibly and directly to abuse’s physical and mental health effects, SANE nurses may also be powerful public champions for victims’ rights.

How to Become a SANE Nurse

For those who are drawn to nursing and who feel passionate about advocating for victims of abuse, pursuing SANE nurse certification may be desirable. Crucially, those who wish to receive this designation must seek additional training and education, above and beyond what’s required to become an RN. Specifically, SANE nurses must develop the skill set required to diagnose abusive behavior’s physical and mental health effects and provide the level of compassionate care and medical advocacy that patients require.

Get a Nursing Degree

In terms of how to become a SANE nurse, the first step is to get a foundational nursing education. Specifically, aspiring SANE nursing professionals are encouraged to get a bachelor’s degree in nursing, and then, after passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN), to seek work as an RN. This is the minimum education level required to become a forensic nurse and an important foundation for those who desire SANE certification.

Work as an RN

SANE nurses must be skilled in providing direct clinical care to victims of abuse; often they must diagnose and treat patients who are experiencing great mental distress. As such, SANE nurses must have some basic clinical competencies, which they can only really acquire by working as an RN for a few years. (SANE requires two years of RN experience.)

Consider an Advanced Nursing Degree

While an advanced nursing degree isn’t required to be eligible for SANE certification, APNs will naturally bring more clinical experience and specialized training to the table; as such, they may sometimes be more competitive in the job market and command higher salaries. Those wondering how to become a SANE nurse should consider the advantages of a master’s degree or a post-master’s certificate program.

Get Certified

Nurses with the requisite RN experience may sign up for IAFN’s online didactic course. Next, they may sign up for a preceptorship in which they develop key clinical skills under a certified SANE professional.

Hone SANE Skills

Throughout the education, experience and certification process, those who aspire to be SANE nurses will have the opportunity to cultivate essential skills. The most important skills for practicing as a SANE professional include the following:

  • Analytical skills and basic evidence gathering
  • Compassion and empathy
  • Ability to stay levelheaded in emotional or high-stress situations
  • Basic clinical skills, including injury treatment
  • Communication skills, including courtroom presentation skills

SANE Nurse Certification and Credentials

Nursing professionals who are interested in working closely with victims of abuse may wish to know further details about SANE nurse certification and credentials.

Finding a Local Chapter

Each state has an IAFN chapter, and specific SANE certification clinical requirements may vary by state (a good rule of thumb is 300 hours). To learn more about how many hours of clinical experience are required under a certified SANE professional’s supervision, reach out to the IAFN chapter in your state.

Connecting with Nearby Programs

Another option is to contact a certified SANE program in your community. Throughout the country, SANE programs exist in local hospitals. Reaching out to a local program is a good way to find out more about the technical requirements and learn about potential job opportunities in the area. In some cases, local law enforcement departments may also have SANE connections.

Taking the Exam

Two SANE examinations are offered: Sexual Assault Nurse Examiner – Adult/Adolescent (SANE-A) and Sexual Assault Nurse Examiner – Pediatric (SANE-P). Both certification levels test to ensure the highest standards of compassionate clinical care; they differ in the age group that’s treated. The SANE-A focuses on grown-ups and teens who’ve been victims of abuse, while the SANE-P seeks to help children who’ve been abused or neglected.

Both examinations are held in different locations multiple times throughout the year. The accrediting organization provides study materials as well as up-to-date testing schedules online. As previously mentioned, connecting with a local chapter can be a good resource for nurses who wish to pursue SANE certification and ensure that they’re adequately prepared for the exam.

Renewing Your Certification

SANE nurse certification must be renewed after three years. To renew their SANE certification, nurses must earn 45 hours of continuing education credits. SANE professionals must also maintain their RN or ANP credentials. Finally, those who wish to maintain their SANE certification must have practiced in their specified field for at least 300 hours over the previous three years.

SANE Nurse Salary

A final area of consideration for those who wish to pursue a forensic nursing career is SANE nurse salary information.

Median Salary for Forensic Nurses

According to September 2020 data from PayScale, those who have forensic nursing certification can anticipate a median annual salary of about $70,000. Note: Those who are qualified in forensic nursing but choose to work in a private practice setting, such as in a nurse practitioner (NP) office, command an even higher salary, averaging about $85,000 annually.

Factors That Can Influence the SANE Nurse Salary

Numerous factors can influence the SANE nurse salary, including the following:

  1. Education Level: Advanced education may cause a forensic nurse to command a higher salary. While a masters-level nursing degree isn’t required, such advanced education can lead to more competitive salary offers.
  2. Experience Level: Forensic nurses will usually make higher salaries if they bring more years of clinical experience to the table, particularly clinical experience in a forensic nursing role.
  3. Certification: A SANE-certified nurse will likely draw a higher salary than a forensic nurse who doesn’t have this specialized certification.
  4. Geographic Location: Finally, the SANE nurse salary may vary by geography. Generally, nursing salaries are higher in more urban or metropolitan areas where demand for qualified nursing professionals is higher.

Earn a Forensic Nursing Post-Master’s Certificate

For those who wish to pursue certification and ultimately work as SANE professionals, a good place to begin is by seeking the right educational background. For example, consider Duquesne University’s online post-master’s certificate programs. The different certificate programs include the following:

  • Executive Nurse Leadership & Health Care Management
  • Family (Individual Across the Lifespan) Nurse Practitioner
  • Forensic Nursing
  • Nurse Education and Faculty Role

For those who are interested in SANE certification, the most relevant program on this list is Forensic Nursing. In this certificate program, nursing professionals can develop the skills required to provide empathic care to individuals who’ve gone through abuse and forensic examinations that assist in coordinating ongoing medical treatment and legal advocacy. In short, this certificate provides a foundation to achieve success and make a real difference through forensic nursing. Learn more about the program by connecting with Duquesne University today. 

Recommended Readings

Helping Patients Get the Medications They Need
Family Nurse Practitioners Identifying Autism Spectrum Disorders in Children
Forensic Nurses: Understanding PTSD


International Association of Forensic Nurses, SANE Certification Central
International Association of Forensic Nurses, Sexual Assault Nurse Examiners
International Association of Forensic Nurses, What Is Forensic Nursing?
Office for Victims of Crime, What Is a SANE?
PayScale, Salary for Skill: Forensic Nursing