Afte Court Case
On a gloomy Saturday morning, a badly bruised and distraught Sally Richards stumbled into the doors of UC’s medical hospital, seeking assistance for the terrible incident that she experienced the night before. Standing in front of the triage desk, Sally explained to the hospital secretary how she was sexually assaulted and possibly raped by her ex-boyfriend the night before. Quickly, the hospital secretary called an expedient nurse from the back room and in a flash, Sally was suddenly brought to a private room. With Sally being instructed into the room, she noticed an individual standing across the medical room, who she later learned would be her advocate throughout her examination and during her court case. Throughout the duration of her stay, though distraught, Sally cooperated with the SANE nurses, especially with the physical evidence collection.
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After being fed, clothed and receiving pain medications, Sally was instructed on the aftercare of her wounds including the bite marks, repetition of pregnancy tests in 2 weeks and to soak her genital region for soreness.
Waiting for her aunt to pick her up, Sally knew that she would go through much stress with her case. But, she hoped that she would receive the justice that she deserved. Sally’s ordeal, just like over 293,066 rape and sexual assault victims age 12 or older , is what usually occurs when visiting a SANE nurse or a SART team. With over 68% of sexual assault cases being left unreported (2), SANEs and SARTs are an important component of court cases when dealing with collecting physical evidence in rape kits. Even though the task of being a SANE seems like a tedious occupation, the collecting of evidence to bring justice to victims is nothing less than satisfying. With this type of humane appeal, what is a SANE/SART, how does an individual become a SANE, what are their tasks and how do they assist the legal
system? According to the anti-sexual assault organization RAINN, a SANE (Sexual Assault Nursing Examiner) is a registered nurse who has “…received special training so that s/he can provide comprehensive care to sexual assault victims” (3) Also they are able to conduct a forensic exam and could aid in adept testimony if the case goes to trial. Even though SANEs are more accustomed to being expert in forensic nursing, a conglomerate are leveraging beyond sexual assault victims, expanding “…their clinical practices to accommodate victims of other forms of interpersonal violence.” (4) These specially-educated nurses can be a valuable expedient to prosecutors, especially when the victim is unable or unwilling to testify. For SARTs (Sexual Assault Response Teams), they are a communal based team that systemizes the retort of sexual assault victims. These teams can comprised of “…SANE's, hospital personnel, sexual assault victim advocates, law enforcement, prosecutors, judges, and any other professionals with a specific interest in assisting victims of sexual assault.” (5) Dealing with a disproportionate issue of domestic violence, many communities have executed coordinated response through the creation of “…community response protocols, formalized collaborative networks, and most recently, domestic violence fatality review teams” (6). The goal of these communities is to increase the consistency of services to domestic violence victims while heightening communications between affiliated organizations. With SARTs, this system can create a foundation that increases (7):
- Communal education and public awareness
- Assessment of coordinated response
- Interdisciplinary education and professional role development maturation
- Standardized state level response
- Planning for sustainability
- Collaborations with military or tribal communities
By combining these components, with cooperation of forensic nurses and prosecutors’ efforts to better enhance communal resources, domestic violence, rape and sexual assault victims can have the aid needed to make a healthy recovery through their ordeal. With the much importance of being a part of SART or being a SANE, there is very intricate process that one must experience to become specialized forensic nurse including the didactic and clinical education. When defining a SANE, the purpose of this specialized nurse is to become trained in taking care of “…adult/adolescent and/or pediatric/adolescent patients following sexual assault.” (8) Whether the individual is being trained as an adult/adolescent SANE, a pediatric/adolescent SANE, the nurse should have a comprehensible understanding of components that influence the nursing process and the contingency of care to persons following sexual violence, including: “1. Age 2. Gender 3. Language skills 4. Physiological development 5. Sexual maturation 6. Psychosocial skills 7. Cognitive skills 8. Sexual orientation 9. Moral, ethical, and legal considerations 10. Spiritual beliefs and practices 11. Cultural influences 12. Health priorities 13. Confounding life and/or family issues” (9)
These guidelines aids in the competencies with both the adult/adolescent didactic and clinical guidelines regarding post pubertal patients (onset of menses for females and secondary sex characteristics in males) and postmenopausal, with older adult patients. The coursework requirements for a SANE trainee to become eligible to sit for the Commission for Forensic Nursing Certification examinations includes a 40-hour course for adult/adolescent or pediatric programs. These programs are designed as a basic course new to the forensic nursing field and the specific area for the aid of sexual assault victims. The addition of clinical preceptorships, experience and continual training will solidify a strong foundation for practice in this field. With adults/ adolescents and pediatric/adolescents, a minimum of 40 hours of coursework that generates 40 nursing education contact hours or academic credit or national counterpart from an accredited institution. Clinical segments, including stimulated clinical experiences are completed with addition to the coursework and is not part of the calculated 40 hours. If one would like to pursue into the specialization of both segments, a minimum of 64 hours for coursework that consists of 64 nursing education contact hours, with the additional clinical experiences. During the didactic period, the SANE-in-training will learn of key competencies to successfully provide integrated care to adult/adolescent sexual assault patients. The target components follow the steps of the nursing process including “…assessment, diagnosis, outcomes/planning, implementation, and evaluation.” These consists of: “I. Overview of Forensic Nursing and Sexual Violence II. Victim Responses and Crisis Intervention III. Collaborating with Community Agencies IV. Medicolegal History Taking V. Observing and Assessing Physical Examination Findings VI. Medicolegal Specimen Collection VII. Medicolegal Photography VIII. Sexually Transmitted Infection Testing and Prophylaxis IX. Pregnancy Testing and Prophylaxis X. Medicolegal Documentation XI. Discharge and Followup Planning XII. Courtroom Testimony and Legal Considerations” (10) Subsequently, the clinical component consist of mentorship, designed to didactic experience and to oblige the SANE to be applicable with their learned knowledge. The required clinical experience is an addition to the 40 hours of coursework and nursing education contact hours with the guidance of a physician, advanced practice nurse or a forensically experienced nurse. In most cases, a newly trained SANE will begin his/her practice at the novice or advanced beginner’s stages of skill accretion due to both the patient population and role being new tot the nurse. For this reason it is recommended that a minimum of two years in clinical routine as a registered nurse occurs before practicing as an SANE. Accustomed to the diversity of a multitude of communities and challenges (urban vs. rural), numerous options for clinical skill attainment must be identified. Clinical skills acquisition can be obtained with any of the following methods: Approach 1- Clinical practice with a non-sexual assault patient or with patients following sexual assault, precepted by a physician, advanced practice nurse, etc. ; Approach 2-Simulated patient experiences using models, being monitored by a physician until competency is reached; and Approach 3-Simulated patient action using medical simulation models, monitored by physician, advanced practice nurse until competency is reached at a local program level. With this copious amount of training and hands on experience, a certified SANE nurse is qualified to professionally practice on real patients and assisting with legal cases.
After being fed, clothed and receiving pain medications, Sally was instructed on the aftercare of her wounds including the bite marks, repetition of pregnancy tests in 2 weeks and to soak her genital region for soreness.
Waiting for her aunt to pick her up, Sally knew that she would go through much stress with her case. But, she hoped that she would receive the justice that she deserved. Sally’s ordeal, just like over 293,066 rape and sexual assault victims age 12 or older , is what usually occurs when visiting a SANE nurse or a SART team. With over 68% of sexual assault cases being left unreported (2), SANEs and SARTs are an important component of court cases when dealing with collecting physical evidence in rape kits. Even though the task of being a SANE seems like a tedious occupation, the collecting of evidence to bring justice to victims is nothing less than satisfying. With this type of humane appeal, what is a SANE/SART, how does an individual become a SANE, what are their tasks and how do they assist the legal
system? According to the anti-sexual assault organization RAINN, a SANE (Sexual Assault Nursing Examiner) is a registered nurse who has “…received special training so that s/he can provide comprehensive care to sexual assault victims” (3) Also they are able to conduct a forensic exam and could aid in adept testimony if the case goes to trial. Even though SANEs are more accustomed to being expert in forensic nursing, a conglomerate are leveraging beyond sexual assault victims, expanding “…their clinical practices to accommodate victims of other forms of interpersonal violence.” (4) These specially-educated nurses can be a valuable expedient to prosecutors, especially when the victim is unable or unwilling to testify. For SARTs (Sexual Assault Response Teams), they are a communal based team that systemizes the retort of sexual assault victims. These teams can comprised of “…SANE's, hospital personnel, sexual assault victim advocates, law enforcement, prosecutors, judges, and any other professionals with a specific interest in assisting victims of sexual assault.” (5) Dealing with a disproportionate issue of domestic violence, many communities have executed coordinated response through the creation of “…community response protocols, formalized collaborative networks, and most recently, domestic violence fatality review teams” (6). The goal of these communities is to increase the consistency of services to domestic violence victims while heightening communications between affiliated organizations. With SARTs, this system can create a foundation that increases (7):
- Communal education and public awareness
- Assessment of coordinated response
- Interdisciplinary education and professional role development maturation
- Standardized state level response
- Planning for sustainability
- Collaborations with military or tribal communities
By combining these components, with cooperation of forensic nurses and prosecutors’ efforts to better enhance communal resources, domestic violence, rape and sexual assault victims can have the aid needed to make a healthy recovery through their ordeal. With the much importance of being a part of SART or being a SANE, there is very intricate process that one must experience to become specialized forensic nurse including the didactic and clinical education. When defining a SANE, the purpose of this specialized nurse is to become trained in taking care of “…adult/adolescent and/or pediatric/adolescent patients following sexual assault.” (8) Whether the individual is being trained as an adult/adolescent SANE, a pediatric/adolescent SANE, the nurse should have a comprehensible understanding of components that influence the nursing process and the contingency of care to persons following sexual violence, including: “1. Age 2. Gender 3. Language skills 4. Physiological development 5. Sexual maturation 6. Psychosocial skills 7. Cognitive skills 8. Sexual orientation 9. Moral, ethical, and legal considerations 10. Spiritual beliefs and practices 11. Cultural influences 12. Health priorities 13. Confounding life and/or family issues” (9)
These guidelines aids in the competencies with both the adult/adolescent didactic and clinical guidelines regarding post pubertal patients (onset of menses for females and secondary sex characteristics in males) and postmenopausal, with older adult patients. The coursework requirements for a SANE trainee to become eligible to sit for the Commission for Forensic Nursing Certification examinations includes a 40-hour course for adult/adolescent or pediatric programs. These programs are designed as a basic course new to the forensic nursing field and the specific area for the aid of sexual assault victims. The addition of clinical preceptorships, experience and continual training will solidify a strong foundation for practice in this field. With adults/ adolescents and pediatric/adolescents, a minimum of 40 hours of coursework that generates 40 nursing education contact hours or academic credit or national counterpart from an accredited institution. Clinical segments, including stimulated clinical experiences are completed with addition to the coursework and is not part of the calculated 40 hours. If one would like to pursue into the specialization of both segments, a minimum of 64 hours for coursework that consists of 64 nursing education contact hours, with the additional clinical experiences. During the didactic period, the SANE-in-training will learn of key competencies to successfully provide integrated care to adult/adolescent sexual assault patients. The target components follow the steps of the nursing process including “…assessment, diagnosis, outcomes/planning, implementation, and evaluation.” These consists of: “I. Overview of Forensic Nursing and Sexual Violence II. Victim Responses and Crisis Intervention III. Collaborating with Community Agencies IV. Medicolegal History Taking V. Observing and Assessing Physical Examination Findings VI. Medicolegal Specimen Collection VII. Medicolegal Photography VIII. Sexually Transmitted Infection Testing and Prophylaxis IX. Pregnancy Testing and Prophylaxis X. Medicolegal Documentation XI. Discharge and Followup Planning XII. Courtroom Testimony and Legal Considerations” (10) Subsequently, the clinical component consist of mentorship, designed to didactic experience and to oblige the SANE to be applicable with their learned knowledge. The required clinical experience is an addition to the 40 hours of coursework and nursing education contact hours with the guidance of a physician, advanced practice nurse or a forensically experienced nurse. In most cases, a newly trained SANE will begin his/her practice at the novice or advanced beginner’s stages of skill accretion due to both the patient population and role being new tot the nurse. For this reason it is recommended that a minimum of two years in clinical routine as a registered nurse occurs before practicing as an SANE. Accustomed to the diversity of a multitude of communities and challenges (urban vs. rural), numerous options for clinical skill attainment must be identified. Clinical skills acquisition can be obtained with any of the following methods: Approach 1- Clinical practice with a non-sexual assault patient or with patients following sexual assault, precepted by a physician, advanced practice nurse, etc. ; Approach 2-Simulated patient experiences using models, being monitored by a physician until competency is reached; and Approach 3-Simulated patient action using medical simulation models, monitored by physician, advanced practice nurse until competency is reached at a local program level. With this copious amount of training and hands on experience, a certified SANE nurse is qualified to professionally practice on real patients and assisting with legal cases.