Sexual Assault Nurse Examiners
The Sexual Assault Nurse Examiners Program was developed at the University of Virginia to provide quality care and evidence collection to victims and families of sexual assault and abuse. Patients, who are victims of sexual assault, arrive in the emergency department usually with a friend, law enforcement officer, or by themselves. If the patient is interested in reporting the sexual assault, information on how to call law enforcement, how evidence is collected, and what medical treatments are available is given. Once a report is filed, the examinations authorized by a law enforcement officer or the Commonwealth Attorney will be paid for by funds administered by the Virginia Supreme Court.
If the assault had occurred within 72 hours, a Forensic Nurse is available and on call 24-hours-a-day. To reach a Sexual Assault Nurse Examiner, call the page operator at the University of Virginia Health System at 434-924-0211 and ask for the Sexual Assault Nurse Examiner on call.
The program's staff consists of Sexual Assault Nurse Examiners who are registered nurses that have received extensive classroom training as well as precepted clinical experiences.
The purpose of the sexual assault examination is to:
- Deliver immediate crisis intervention to the victims and their families.
- Complete a thorough, objective medical-legal exam to include both a physical and sexual assault evaluation.
- Maintain chain of custody and preserve evidence for law enforcement and judicial systems.
- Provide appropriate referrals.
- Testify as an expert witness.
- Educate the community and professional colleagues regarding issues of assault and abuse.
Background on Sexual Assault and Nursing
Rape is primarily a crime of aggression and violence, not passion or sex. The assailant is motivated by anger and a desire to dominate and control rather than sexual desire (Ramin et al, 1992). The medical term, rape, and the legal term, sexual assault, can be defined by the following three criteria - the use of force, penetration, and lack of consent in an attempt to accomplish sexual intercourse while the laws regarding sexual assault vary from state to state, all are based on the above criteria. Intimate partner rape (IPR) is defined as the use of physical force or threat by a current or former sex partner to compel a person to engage in a sexual act against her will. (CDC, 2001).
It is estimated that 1 in 4 to 1 in 6 women is raped during her lifetime, and even more if intimate partner rape is included (Tjaden & Thoennes, 1998). Yet as many as 50 to 83% neither report this to the police nor seek medical attention (Bowyer and Dalton, 1997), with even lower proportions reporting if the partner is an intimate partner or acquaintance than if it is a stranger (Mahoney, 1999). Of the sexually assaulted women who do report to the Emergency Department, medical care and evidence collection is provided either by the Emergency Room physicians or by specially trained forensic nurses.
Sexual assault nurse examiners have been providing this care and service since the early seventies, testifying for both prosecution and defense regarding sexual assault cases. The SANE (Sexual Assault Nurse Examiners) subspecialty of forensic nursing emerged in the 1990s as health providers and the legal community recognized a need for compassionate care and better evidence collection (IAFN web site, 2001). National interdisciplinary policy making bodies of advocates and professionals from the health and criminal justice systems have continued to recognize the need for more SANE nurses to provide these services in the health care system (Violence Against Women Agenda for the Nation, DOJ web site, 2000).
Forensic nursing, an American Nursing Association (ANA) recognized specialty, continues to experience growth with the subspecialty of sexual assault nurse examiners (SANEs) remaining the largest group within the specialty (Ledray, 1999). Sexual assault nurse examiners (SANEs) are registered nurses specially trained in all aspects of the care of sexually assaulted patients; medical evaluation, forensic evidence collection, and emotional support of victims and family members. Most often SANEs work collaboratively through a hospital or emergency room with other members of a sexual assault response team (SART) such as physicians, law enforcement, social workers, child/adult protective service workers and therapists.