How to Become a Sexual Assault Nurse Examiner (SANE)

The Rape, Abuse & Incest National Network (RAINN) reports that every 68 seconds, there is a sexual assault in the United States. Sexual assault nurse examiners, often called SANEs or SANE nurses, are specially trained medical professionals who treat SA victims and collect evidence to bring their attackers to justice.

If you're considering becoming a nurse and feel called to SANE nursing, you're in the right place. This guide will explain what a SANE nurse does, how to become one, salary expectations, and more. Read on to learn whether SANE nursing is right for you.

A sexual assault nurse examiner (SANE) nurse is a type of forensic nurse with specialized training and education to work with patients who have experienced sexual assault, abuse, or incest. SANE nurses must hold specific certifications for performing medical, psychological, and forensic examinations on adult and pediatric sexual assault victims. 

SANE nurses meet with sexual assault and abuse victims to conduct forensic exams. They may also provide expert testimony in court cases when necessary. 

SANE nurses have several responsibilities, from triaging and treating sexual assault victims to performing forensic evaluations and testifying in court. Here's a breakdown of what SANE nurses do:

Evaluation & Referrals

A SANE exam includes medical treatment, forensic interviews, and exams. SANE nurses also assess whether the patient needs further treatment or support. Specific tasks include the following:

• Perform emergent medical triage on patients
• Perform and document sexual assault medical forensic interviews and exams
• Provide emotional support
• Assess the patient’s emotional state & determine if further evaluation or treatment is necessary
• Coordinating referrals for proper follow-up care as needed
• Provide referrals to legal aid and advocacy groups
• Offer to counsel or provide reference to a recommended counselor

Specimen Collection & Documentation

Specimen collection is another vital SANE nurse duty. They'll obtain forensic specimen collection and complete supportive documentation during the exam. These tasks include:

• Collecting urine & blood samples
• Noting any areas of injury, including bruising, bite marks, and scratches
• Obtaining photo documentation of bodily and genital-anal injuries with competent documentation
• Obtaining swabs of the victim’s cervix, rectum, vaginal or penile areas
• Removing head hairs from the victim from various areas of the scalp for comparison
• Removing pubic hairs from the victim for comparison
• Swabbing the victim’s oral cavity
• Taking a DNA sample from the victim for comparison

Medical Treatment & Forensic Testimony

In addition to forensic evaluations, SANE nurses also provide bedside nursing care. But their responsibilities don't end at the bedside - they may also provide court testimony regarding their findings. Some tasks they perform to meet these needs include:

• Administering prophylactic medications and emergency contraception
• Assessing for mandatory reporting status and reporting when appropriate
• Ensuring patient/medical record confidentiality at all times (HIPPA)
• Performing trauma assessment with genital/anal examination
• Testifying as a fact witness to any/all cases performed while contracted as a SANE

According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a registered nurse in 2023 is $86,070 per year or $41.38 per hour. However, pay varies depending on where you live and other factors.

Glassdoor found that SANE nurses earn $88,000 annually. A SANE brings home more money than non-specialized forensic nurses, with the average forensic nurse salary at just $72,659 per year.

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You must graduate from an accredited nursing school, earn bedside experience, and earn a certification to become a SANE nurse. The following is a breakdown of the four steps you can take to start your SANE nursing career.

Step 1: Become a Registered Nurse (RN)

The first step to becoming a SANE nurse is earning your RN license. You can become an RN through an accredited Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program. Then, you'll take the NCLEX-RN exam to become a registered nurse.

Step 2: Gain Bedside Experience

You must have at least two years of bedside experience to become a SANE nurse candidate. You can earn this experience in several workplaces, like hospitals, residential care facilities, and home health care.

Step 4: Take a Sexual Assault Examiner Class

The International Association of Forensic Nurses (IAFN) states that the minimum requirement to practice as a SANE is completing a Sexual Assault Examiner Class. The class includes 40 hours of classroom training and 40 hours of clinical work.  

Step 5: Earn Your Certification

The IAFN offers certification for SANE nurses. The SANE-A (adult) and SANE-P (pediatric) certifications are available to those who meet eligibility requirements. Note that the conditions are the same for both credentials.

SANE-A and SANE-P Certification Eligibility Requirements:

• Hold an active, unrestricted license as an RN in the United States or a US territory
• Have a minimum of 2 years of experience as an RN
• Have completed an adult/adolescent sexual assault nurse examiner education program that:
  • Grants a minimum of 40 hours of continuing nursing education contact hours from an accredited provider, or
  • Comprises a minimum of 40 hours of academic coursework or the national equivalent from an accredited educational institution, or
  • Grants a minimum of 64 hours of continuing nursing education contact hours from an accredited provider, or
  • Comprises a minimum of 64 hours of academic coursework or the national equivalent from an accredited educational institution
• Have completed a sexual assault nurse examiner clinical preceptorship 
• Have practiced as a sexual assault nurse examiner for a minimum of 300 hours within the past three years. At least 200 of those 300 hours must comprise SANE-related practice focused on the adult and adolescent patient populations

SANE nurses generally work in emergency rooms and urgent care departments that assist with trauma and rape cases. Some hospitals have SANE nurses available 24/7, but most are on call.

SANEs may also work in non-traditional settings like academia, local government, and non-profit organizations.

SANE nurses, like all nurses, are in high demand. According to the BLS, in 2022, there were 3,172,500 registered nurses in the United States. By 2032, there will be a need for an additional 177,400 nurses, which is an expected growth of 6%. 

In addition to the ever-growing need for nurses throughout the country, the statistics regarding rape, abuse, and incest are astounding. Additional nurses are needed every year to manage patient care. SANE nurses work with each patient to gather evidence and perform the necessary tests. 

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Each state has different RN license renewal standards. If you hold a compact nursing license, the CEU requirement will be for your state of permanent residence. Keep in mind that some states require CEUs specific to child abuse, narcotics, and pain management. 

RN licensure renewal generally requires a completed application, 15-30 continuing education hours, and a nominal fee. You should check with your state's board of nursing to find out what CEUs you need before applying for renewal.

Check out our guide to learn more about nursing CEUs by state.

SANE Certification Renewal

The IAFN requires 45 continuing education hours every three years for SANE certification renewal. These requirements include at least 30 hours of attendance at one of the following:

1. Conferences
2. Conventions
3. Workshops
4. Seminars
5. Webinars

Additionally, SANE nurses must complete 15 hours of one or more of the following tasks:

1. Completion or instruction of SANE-related academic courses
2. Publication of a SANE-related article or chapter in a book, journal, or newsletter 
3. Presentation of SANE nursing content to professional or community groups
4. Poster Presentations of SANE-related topics
5. Precepting other SANE nurses

Alternatively, you may renew your SANE certification by re-examination.

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Check out these additional resources for more information on SANE nursing:

1. Academy of Forensic Nursing
2. American Academy of Forensic Sciences
3. American Nurses Association (ANA)
4. Canadian Forensic Nurses Association
5. International Association of Forensic Nurses
6. Journal of Forensic Nursing
7. RAINN (Rape, Abuse & Incest National Network)
8. The Ultimate Source for Sexual Assault Forensic Examiner

$70,000 - $90,000 Associate Bachelors Forensics RN Bedside SANE