How to Become a Sexual Assault Nurse Examiner (SANE)


    GUIDE
    June 7, 2021
    How to Become a Sexual Assault Nurse Examiner (SANE)
    Kathleen Gaines
    By: Kathleen Gaines MSN, RN, BA, CBC

    By: Kathleen Gaines MSN, RN, CBC

    According to the Rape, Abuse & Incest National Network (RAINN), every 68 seconds, there is a sexual assault in the United States. Sexual Assault Nurse Examiners (SANEs) are the ones called to emergency rooms and urgent care centers to interview, collect evidence, and document the findings of these assaults. 

    If you're feeling called to the nursing profession and think becoming a SANE nurse might be the right path for you, this guide will explain what a SANE nurse does, how to become one, how much they make, and give you a complete overview of what this career entails.

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    Part One What Is a SANE Nurse? 

    A Sexual assualt nurse examiner (SANE) nurse is a highly qualified RN with specialized training and education to work with patients who have experienced sexual assault, abuse, or incest. They are considered a type of forensic nurse.

    SANE nurses meet with victims of sexual assault and abuse to conduct a thorough forensic exam, as well as provide expert testimony in court when needed. 

    This nursing specialty requires that you hold specific certifications for examining adults and pediatrics in the medical, psychological, and forensic examination of sexual assault victims. 

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    Part Two What Does a SANE Nurse Do? 

    SANE nurses perform a variety of specific tasks, including:

    • 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 to determine if further evaluation or treatment is necessary
    • Provide referrals to legal aid and advocacy groups
    • Offer to counsel or provide reference to a recommended counselor
    • Perform a complete medical forensic evaluation that includes: 
      • Administering prophylactic medications and emergency contraception
      • Assessing for mandatory reporting status and report when appropriate
      • Coordinating referrals for proper follow-up care as needed
      • Ensuring patient/medical record confidentiality at all times (HIPPA)
      • Performing trauma assessment with genital/anal examination
      • Obtaining photo documentation of bodily and genital-anal injuries with competent documentation
      • Testifying as a fact witness to any/all cases performed while contracted as a SANE
    • Obtain forensic specimen collection and supportive documentation, which includes:
      • Collecting urine samples
      • Noting any areas of injury, including bruising, bite marks, and scratches.
      • 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 
      • Collecting blood samples
      • Taking a DNA sample from the victim for comparison

    Part Three SANE Nurse Salary

    According to the U.S. Bureau of Labor Statistics (BLS), the median salary for a registered nurse in 2020 is $75,330 per year or $36.22 per hour. However, pay varies depending on where you live as well as other factors.

    The BLS does not differentiate between different specialties of nursing, but according to Glassdoor.com SANE nurses can earn an average annual salary of $69,196 per year. 

    Payscale.com does not identify SANE nurses specifically but rather groups SANE nurses with Forensic Nurses. They state that this nursing specialty can earn an average hourly salary of $30.61

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    Part Four How to Become a SANE Nurse

    To become a SANE nurse, you’ll need to complete the following steps:

    Step 1: Attend Nursing School

    You’ll need to earn either an ADN or a BSN from an accredited nursing program to take the first steps to become a registered nurse. ADN-prepared nurses can complete an additional step of completing their BSN degree if they wish. 

    Step 2: Pass the NCLEX-RN

    Become licensed as a registered nurse by passing the NCLEX examination in the state where you wish to practice.

    Step 3: Gain Experience at the Bedside

    To be considered for employment as a SANE nurse, you must have at least two years of bedside experience.  

    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, along with 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 that meet eligibility requirements. Note, the requirements are the same for both certifications.

    SANE-A and SANE-P Certification Eligibility Information:

    • 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

    Part Five Where Do SANE Nurses Work? 

    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; however, most SANE nurses are on call. 

    Non-traditional settings that employ SANE nurses include:

    1. Academia
    2. Local government agencies
    3. Non-profit organizations 

    Part Six What is the Career Outlook for a SANE Nurse? 

    SANE nurses, like all nurses, are in high demand. According to the BLS, in 2019, there were 3,096,700 registered nurses in the United States. By 2029, there will be a need for additional 3,318,700 nurses, which is an expected growth of 7%. 

    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 of these patients to gather evidence and perform the necessary tests. 

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    Part Seven What are the Continuing Education Requirements for a SANE Nurse? 

    Generally, for an individual to renew their RN license, they will need to fill out an application, complete their state's requirement for continuing education (usually between 15-30 hours), and pay a nominal fee. Each state has specific requirements, and it is essential to check with the board of nursing before applying for license renewal.

    If the RN license is part of a compact nursing license, the CEU requirement will be for the state of permanent residence. Some states require CEUs related to child abuse, narcotics, and pain management. 

    According to IAFN, certification as a SANE requires a minimum of 45 continuing education hours every three years to maintain certification, including 30 hours of attendance at one of the following: 

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

    In addition, 15 hours of involvement in one of the following is mandatory:

    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

    A detailed look at Continuing Nurse Education hours can be found here:

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    Part Eight Resources for SANE Nurses

    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

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    Part Nine SANE Nurse FAQs

    • How long does it take to become a SANE Nurse?

      • It takes at least four to six years to become a SANE nurse. Individuals must graduate from an ADN or BSN program (which take 2 or 4 years respectively) and pass the NCLEX-RN exam for licensure. After two years of nursing experience at the bedside, nurses can take the IAFN Sexual Assault Examiner Class.
    • Is SANE nursing a good career?

      • SANE nursing is a good career and will continually be needed as the number of sexual assaults increases across the country. SANE nurses are needed for ongoing education, testifying in criminal cases, and providing support to victims of sexual assault.  
    • What skills do you need to be a SANE nurse?

      • Analytical skills and basic evidence gathering
      • Compassion and empathy
      • Ability to stay level headed in emotional or high-stress situations
      • Basic clinical skills
      • Communication skills

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