Practitioners: We Need More Sexual Assault Nurse Examiners

• A sexual assault occurs every 68 seconds in the United States, but only a limited number of sexual assault nurse examiners are available to treat survivors in the aftermath of their assault.
• SANE programs were first established in the 1970s in Memphis, Tennessee; Minneapolis, Minnesota; and Amarillo, Texas, according to the Office for Victims of Crime.
• A national SANE program database has yet to be established, despite a 2022 law requiring just that.

A sexual assault occurs every 68 seconds in the United States, but only a limited number of practitioners are specifically trained to help survivors in the aftermath of their assault.

Jacqueline Callari Robinson, a sexual assault nurse examiner (SANE) based in Milwaukee, Wisconsin, told PBS she provided a rape kit to a woman who traveled from the Chicago area to find a facility that would even see her.

“She said she felt humiliated to walk into the hospitals,” Callari Robinson said. “The trauma was pretty overwhelming. We actually just sat in the interview room with her for quite some time before she was really ready to be examined.”

But in cities where SANEs and SANE programs do exist, they have helped patients feel “supported, believed, heard, respected, safe, reassured, in control, informed, and well cared for post-assault,” according to the Office for Victims of Crime. 

History of SANE Programs

The International Association of Forensic Nurses (IAFN) has more than 5,500 members and 26 chapters, according to its 2022 annual report.

Stateside, SANE programs were first established in the 1970s in Memphis, Tennessee; Minneapolis, Minnesota; and Amarillo, Texas, where nurses “worked in isolation until the early 1990s,” according to the OVC.

Decades later, a Government Accountability Office report found “limited nationwide data” relating to the number of SANEs and the medical facilities that have SANE programs.

A national SANE program database has yet to be established, despite a 2022 law requiring just that.

And an NBC News analysis conducted in 2020 found “varying standards, patchwork regulations and a lack of funding and support for sexual assault forensic examiners.” The outlet also found that SANEs are less available in rural areas and some facilities “may only have one nurse with training on staff.” 

Sexual Assault Nurse Examiners Help Survivors

A study released in 2023 found that sexual assault survivors who were treated by SANEs “were more often offered recommended services and resources and more frequently accepted them.”

Eileen Poore, who survived a sexual assault in 2019, told Mirror Indy that the forensic nurse who conducted her assault examination saved her life.

“Having somebody that can put you at ease and believe you and get you through that first step of the process is so important,” Poore said.

A former sex crimes prosecutor in Indiana said conviction rates are higher “when a survivor gets an exam from a trained nurse.”

“If you do the exam right, it gives the power back to the survivor,” Angie Morris, who coordinates the University of Southern Indiana’s SANE training, told Indy Mirror. “It meets their needs, connects them to resources and allows them to decide what happens next.” 

Building the SANE Workforce

Jeana Friday, RN, told NBC Chicago that while the number of SANE nurses is increasing, there still aren’t enough. She herself works across six hospitals.

In hopes of spurring more interest in pursuing that path of the medical field, Friday spoke to nursing students about forensic nursing and the role SANEs play in supporting survivors.

“Victim blaming is huge, and it actually causes people not to disclose, or just fear of people not believing them,” Friday said. “They need us to know what to do. They need us to be there for them, they need us to start by believing.”

In its “SANEs in Level 1 and 2 Trauma Centers” position statement, released in April 2023, IAFN urges the passage of legislation to ensure 24/7 SANE access to assault survivors, regardless of age through:

• Onsite SANE services;  
• Contracts with community-based SANE programs; or  
• Formalized transfer agreements with area programs. 

One recent piece of legislation takes a step toward IAFN’s mission. H.R. 10000 directs the Secretary of Veterans Affairs to ensure SANEs are employed at “certain Department of Veterans Affairs medical facilities, and for other purposes.”

The Bottom Line

Sexual assault nurse examiners are in short supply, according to industry professionals. However, their unique training helps assault survivors not only with the post-assault exam but also with convictions. Industry associations have called on legislators and institutions to increase access to SANE programs and services. Some survivors have traveled miles from home just to find a facility with a nurse who will perform the exam. 

Editor’s Note:

If you, or someone you know, is a sexual assault survivor and needs assistance or support, contact the National Sexual Assault Hotline for confidential, 24/7 support.

If you’re interested in becoming a sexual assault nurse examiner, learn more about the process through IAFN.

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