Kristina Kenyon, RN
The role of the sexual assault nurse examiner
Kristina Kenyon, RN, is certified as a sexual assault nurse examiner (SANE). She is also employed in a community hospital as a telemetry nurse. A SANE is a registered nurse who has received specialized training and certification in the forensic examination of victims of sexual assault. They work closely with both medical and legal professionals involved in a given case to ensure that the collection of evidence and information is handled in the most competent manner. They also provide an invaluable source of support to the client by mitigating the chance of re-traumatization in the traditional emergency room setting where treatment delays and lack of training can compound the emotional impact and compromise the integrity of physical evidence. In the following interview, Kenyon talks with Kim Jordan about her initial experience as a SANE.
Q. How did you hear about the SANE (Sexual Assault Nurse Examiner) program and why did you get involved?
A. When I was doing my graduate studies in criminalistics, I would be on the receiving end of the MSAECK [rape kit]. I would do the processing but was very interested in the process of evidence collection. Last year, I was participating in a competency fair where I work and there was a station for SANE nurses to complete. The SANE cart was there and I felt drawn to explore it, although it was not a requirement for me. I spoke with the SANE nurse who was in charge of that station and she gave me a business card for the Southeast region coordinator. Shortly thereafter, I enrolled in the training program.
Q. Can you describe the training process?
A. It is a seven day training which consists of more than forty hours of didactic content and skills stations. Candidates are also required to complete a pelvic/sexual assault exam preceptorship. Participants must attend the entire seven day training in order to sit for the exam and receive contact hours and certification.
The trainers were a diverse group representing law enforcement, rape crisis counselors, forensic chemists, as well as the SANE regional coordinators. The training process reinforced how crucial it is for medical and legal professionals to collaborate in order to provide the optimal outcome for victims of sexual assault.
Q. What was your first call like?
A. On my first call, I was accompanied by an experienced SANE. This is a requirement of the training program and can also be repeated if necessary. I was on call on a Sunday and my pager went off around 2 P.M. I had mixed feelings about being called. On one hand, I was excited to use my skills. But I was anxious and also sad for the victim. It was unsettling to have no idea what the circumstances of the case would be or even the age of the victim.
SANEs can be involved in cases where the victims are at least twelve years old. For younger children, pediatric SANEs are utilized. I immediately responded to the call and contacted the SANE who would accompany me. Once we verified that the patient met the SANE criteria, we went to the emergency room where the teenage victim was receiving initial medical treatment.
Upon arrival, we introduced ourselves and explained our role. We also described the process of evidence collection so that she would know what to expect. The patient consented to our treatment plan. We began the process of obtaining pertinent health history and also the circumstances of the assault.
In this particular case, it seemed as though the assault may have been drug facilitated. This means that the victim was given a substance which made her vulnerable to the attack. We established that the patient was oriented to person, time, and place. Next, we performed a thorough physical examination and collected samples for evidence. Throughout the entire process, we provided emotional support and were careful to maintain the dignity of the client. Finally, we provided a list of referrals for medical follow-up and psychological support.
Q. Working as a SANE would seem to be emotionally taxing. Is there support available for these professionals?
A. Absolutely. What has really been reassuring to me is how the SANE program recognizes and addresses the psychological strain on the caregiver. Support is given all along the way. Beginning with the training process, we receive ongoing support. After a call, the regional coordinator reviews the case with the SANE as a sort of debriefing session. We also meet monthly in order to vent and support each other.
Q. How do you feel your involvement made a difference?
A. I know in my heart that the victim was treated with dignity and compassion and received the specialized care that she deserved. I also know the examination and evidence collection was done according to protocol. She was never left alone and this reduced her anxiety. I am certain that I made a difference and that also gives me a sense of accomplishment.
Q. How can other RNs become involved?
A. Interested nurses can contact Ginhee Sohn, Program Coordinator, MA Sexual Assault Nurse Examiner Program.
Kim Jordan, RN, is a freelance writer and regular contributor to On Call.
