Why the U.S. Desperately Needs More Sexual Assault Nurse Examiners
- Sexual Assault Nurse Examiners (SANEs) provide necessary care to victims of sexual assault in the hospital, collecting necessary evidence for future legal proceedings and coordinating next steps.
- Unfortunately, fewer than 25% of U.S. hospitals offer a forensic nursing program with dedicated SANEs.
- The job of a SANE is extremely challenging, and burnout and trauma affect nurses in the role.
- The U.S. needs more SANEs and hospitals to coordinate efforts to continue and expand deserved care for survivors of sexual assault.
Every 74 seconds, someone in the United States experiences sexual assault. For survivors, the care provided immediately after an assault can profoundly impact both healing and justice.
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Sexual Assault Nurse Examiners (SANEs) stand at this critical intersection, yet a nationwide shortage of these specially trained professionals has created a crisis with far-reaching consequences.
Hospitals Do Not Track SANEs or Where They Offer Care
The work of a SANE is challenging, sometimes lonely, and mentally and physically grueling. Yet aside from the workload, part of the shortage begins at the hospital level.
Only about 25% of U.S. hospitals have any form of forensic nursing program, according to the International Association of Forensic Nurses. The coverage gaps are most severe in rural and tribal communities, with some regions in Alaska having no SANE providers at all. This shortage means many survivors must travel hours to receive specialized care, or worse, go without it entirely.
Even more challenging is that there's no formal database of SANEs or even the hospitals that offer them, so even if a survivor seeks care, there's no guarantee they can find a hospital to provide it.
"There's no mandatory database identifying who is a practicing Sexual Assault Nurse Examiner or forensic nurse and where they are located," Jennifer Pierce-Weeks, CEO of the International Association of Forensic Nurses, told Yahoo.
This lack of tracking makes it difficult to assess the full scope of the shortage or develop targeted solutions.
Why Is There a Shortage of SANEs?
Becoming a SANE isn’t as simple as signing up for a shift. Training is expensive, with certification costs that can be prohibitive.
Fewer than 24 colleges in the U.S. offer dedicated SANE programs, and the specialized nature of the work also takes a psychological toll. SANEs routinely witness trauma firsthand, leading to high rates of burnout and compassion fatigue.
"You have those added challenges of burnout and compassion fatigue and what we call vicarious trauma, where you're hearing and seeing trauma that other people have experienced," Samantha Mendez-Dominguez, a forensic nurse manager at HonorHealth in Scottsdale, Arizona, explained to Yahoo.
While SANEs can earn $80,000-$90,000 annually, the pay often doesn’t outweigh the emotional strain.
What a World Without SANEs Means
The consequences for survivors can be devastating. When SANEs are unavailable, crucial forensic evidence may not be collected properly—or at all—potentially undermining criminal cases.
For instance, after being assaulted by her partner in her home while her two-year-old son sat nearby in his crib, Lauren Easter underwent a SANE examination, only to later learn that her evidence had been lost.
"I remember getting the call from my advocate attorney where she told me that my evidence had been misplaced and that the prosecutor was no longer comfortable going to the trial," Easter recounted. "I remember just bawling... 'How? How does this happen?'"
What’s Being Done—and What Can We Do?
Addressing the SANE shortage requires action on multiple fronts: expanding training programs, improving support systems, and implementing retention strategies. Policymakers and healthcare systems must invest in solutions to ensure survivors receive the care they deserve while protecting nurses’ well-being.
Some hospitals are stepping up to retain SANEs. For instance, Scottsdale, Arizona, hospital system HonorHealth pairs new SANEs with mentors and encourages post-case debriefing sessions, recognizing the importance of emotional support.
Survivors deserve better. Nurses deserve the resources to provide that care without sacrificing their own health.
Interested in becoming part of the solution? You can learn more about becoming a SANE nurse to help address this critical shortage for future survivors.
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