Victim Benefits
ne advocate contended that the SANE program was "the best development in victim services" that she had seen "in the last 10 years."2 SANE
programs address several problems in the medical-legal response to sexual assault victims in hospital emergency departments, including the following:
- Emergency department staff frequently regard the needs of sexual assault victims as less urgent than other patients because the majority of these victims do not sustain severe physical injuries.3
- Sexual assault victims often endure long waits in busy public areas
(4- to 10-hour waits are not
uncommon).
- Sexual assault victims often are not allowed to eat, drink, or urinate while they wait for a physician or nurse to conduct the evidentiary exam, to avoid destroying evidence.
- Physicians or nurses who perform evidentiary exams often have not been trained in forensic evidence collection procedures or do not perform these procedures frequently enough to maintain proficiency.
- Some physicians are reluctant to perform evidentiary exams because they know that they might be called from the hospital to testify in court and that their qualifications to
conduct the exam might be questioned due to a lack of training and experience.
- Emergency department staff may not understand sexual assault victimization (e.g., they may blame victims for their assaults or may not believe a "real rape" occurred) and overlook the need to treat victims with sensitivity and respect.
- Emergency department staff may fail to gather and/or document all available forensic evidence, particularly in nonstranger cases.
With the advent of SANE programs, it became possible for sexual assault victims to consistently receive prompt and compassionate emergency care from medical professionals who understand victimization issues (e.g., SANEs recognize that the majority of victims are assaulted by intimate partners or acquaintances). A SANE can speed up the evidentiary examination process by reducing the time victims have to wait in a hospital's emergency department and the time it takes to complete the examination.4 The quality of the examination is usually improved because an experienced SANE is adept at identifying physical trauma and psychological needs, ensuring that victims receive appropriate medical care, knowing what evidence to look for and how to document injuries and other forensic evidence, and providing necessary referrals. Evidence collected by SANEs can help link the victim and suspect to the crime scene, indicate sexual penetration or activity, and establish lack of victim consent (e.g., bumps on the back of the head, abrasions on the back, and nongenital bruising). Establishing lack of consent is particularly important in the prosecution of nonstranger cases.
Recognizing the horror of sexual assault and the devastation it can cause victims and their significant others, SANEs ultimately strive to ensure that victims are not retraumatized by the evidentiary exam and to facilitate the healing process. SANE Program Director Jamie Ferrell, with the Sexual Assault Prevention and Crisis Services Division of the Texas Office of the Attorney General, remarked that "it's incredible to work with victims at possibly their lowest level of functioning and see them walk away with their heads held high.''5 SANE Coordinator Suzanne Brown, at Inova Fairfax Hospital in Fairfax, Virginia, noted that it was not uncommon for victims and their families to express gratitude to SANEs for the caring and efficient treatment they provided. On the few cases she has worked where victims of repeat assaults had evidentiary exams performed at different times by non-SANEs and SANEs, the victims commented that they wished they had been treated by a SANE the first time.6
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| Sexual Assault Nurse Examiner (SANE) Programs: Improving the Community Response to Sexual Assault Victims |
April 2001
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