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|  | General Guidelines about New Mexico Sexual Assault Nurse Examiner (SANE) Programs
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- SANEs are RNs who have embraced the challenge to be technically skilled evidence collectors who display compassion and acknowledge the patient’s dignity during every step of the examination.
- The SANE response may include a head-to-toe physical assessment (referrals will be made for serious injuries), test for pregnancy, medications for emergency contraception and sexually transmitted diseases (limited exam), documentation of injuries including photographs, and collection of forensic evidence (full exam).
- Emergency medical attention by Emergency staff always takes priority over the SANE exam.
- The SANE needs informed consent from the sexual assault patient. The patient must be able to understand, agree, and sign for each part of the exam. The only exceptions to this is in the case of child abuse, mentally challenged patients, or elder abuse.
- SANE nurses are on-call. They are not physically on-site. To dispatch a SANE nurse call the SANE cell phone 430-9485, the GCRMC Emergency Department 443-7901, or a member of the Sexual Assault Response Team (SART): Victim Advocate on call emergency line-430-4433, 24 Hour Rape Crisis Line-437-7404, Holloman SARC 24 hour line-572-6789.
- The SANE needs information about the patient’s medical stability, ability to give informed consent, special needs, and will schedule a time to meet the patient at the SANE exam room.
- A sexual assault exam should be done within 5 days of the assault for 13 years of age and older or 3 days of the assault for 12 years old and younger. Generally, the sooner the exam is done, the better.
- Encourage the patient to bring the clothes they were wearing when they were assaulted. If they are still wearing the clothes, ask them to bring a change of clothing.
- If the assault was recent, discourage the patient from eating, drinking, or bathing.
- SANE programs are equipped to do only one sexual assault exam at a time. Each exam can take 2 to 4 hours and some exams may take longer.
- A sexual assault adult patient does not need to file a police report to receive SANE services.
- There is no cost to the sexual assault patient for services provided by the SANE.
Forensic Nurse
Forensic Nurse is commonly defined as “the application of the forensic aspects of health care combined with the bio/psycho/social/spiritual education of the registered nurse in the scientific investigation and treatment of trauma and/or death of victims, perpetrators of violence, criminal activity, and traumatic accidents.” (Lynch, V. Forensic Nursing, Mosby, St. Louis, Missouri 2005 p.3)
- Obligated to Standards of Practice set forth by the American Nurses Association (ANA), International Association of Forensic Nurses (IAFN), and Qualifications/Guidelines of the New Mexico Coalition of Sexual Assault Programs
- Preserve victim’s dignity and reduce psychological trauma
- Head to toe physical assessment
- Injury-written, body map, and photo documentation
- Emotional/mental health assessment
- Pregnancy test, prevention medication, and education
- Sexually Transmitted Infection assessment/treatment/education
- Safety Plan
- Integral Part of a Multidisciplinary Coordinated Community Response Team
- Prompt, compassionate care and thorough comprehensive evidence collection-can corroborate victim’s account of an assault by establishing lack of consent
- Seamless delivery of specialized services
- Take part in the Safety/Justice/Health of Patient/Family/Community
- Increase funding opportunities
- Prevention Education
- Community Outreach
History of the SANE Program
GCRMC along with the 12th Judicial District Attorney’s Office and The Counseling Center collaborated to establish a Sexual Assault Nurse Examiner Program (SANE) in November of 2003 with GCRMC as grant fiscal agent/subcontractor and exam facility. In 2006, the New Mexico Coalition of Sexual Assault Programs asked the Otero County SANE Program to consider collaboration with Lincoln County. The Program became the SANE Program of Otero/Lincoln County shortly after.
SANE Program of Otero/Lincoln County
As of November 2007, the SANE Program has three active RNs and one Pediatric Nurse Practitioner with advanced education, training, and experience to conduct timely, compassionate, and culturally sensitive comprehensive medical/forensic examinations for victims of sexual assault. The Program Coordinator is Tina Godby-Ware, RN, BSN, SANE-A; the Clinical Coordiantor is Celeste Siebel, RN, SANE-A; and the Medical Advisor is Jeanne Monske, PNP, SANE-A. The Program is funded by two current grants: Since 2006, $24,672 is funded yearly by the New Mexico Coalition of Sexual Assault Programs from the Department of Health Injury Prevention Fund. $15,969 was awarded for fiscal year July 2008 to June 30 2009 by the Crime Victims Reparation Commission from the STOP Violence Against Women Formula Grant Program.
Coordinated Community Response
Successful SANE Programs do not operate in isolation. They must be integral in community coordination efforts to facilitate comprehensive and effective response (U.S. Department of Justice). The SANE Program of Otero and Lincoln County has taken a lead role in the coordination of sexual assault services. The Program Coordinator has served as Chairperson of the Otero County Sexual Assault Response Team (SART) from May of 2005 to July of 2008. SART meetings are held once a month in both Alamogordo and Ruidoso to facilitate team attendance. There are currently approximately 19 agencies from both counties that participate in the coordinated sexual assault response.
DATA: exam information from the Otero/Lincoln SANE Program. Collation of additional data began in 2006.
2003: 2 victim exams
2004: 9 victim exams
2005: 22 victim exams
2006: 40 victim exams-35 were reports to law enforcement
4 victims were under age 13 (In September 2006, two SANE nurses became qualified to perform pediatric (under age 13) exams. Before then pediatric exams were not done in Otero/Lincoln County.)
2007: 50 victim exams-42 were reports to law enforcement
15 victims were under age 13 (3 were male)
2008: 58 victim exams
(Note: most of these exams reflect the 17% of victims who report, we have not reached the 83% who do not)
Program Developments
January 2007, GCRMC Emergency Department underwent renovations. In these renovations, an exam room with private bath and shower, supply closet and new genealogical exam table were provided the SANE Program. This is in a more secluded area of the Emergency Department giving more confidentiality and privacy.
November 10, 2007, the New Mexico Coalition of Sexual Assault Programs awarded the SANE Program with a large travel case full of all the needed supplies to perform a SANE exam including a travel swab dryer and portable camera. The SANE Program began negotiations with the Mescalero Indian Services Hospital and Lincoln County Medical Center in Ruidoso to facilitate SANE services at those communities.
In November 2008, the ED Trauma Coordinator purchased a Colposcope and Alternative Light Source for the SANE Program.
Community Outreach
Part of community outreach (in an attempt to educate the public about the dynamics of sexual assault and to reach the 83% of victims who do not report or who do not come forward for medical or mental health services) is public presentations and sexual assault awareness events such as Take Back The Night. In 2008, NMSU-A professors and students partnered with the Otero County SART in Take Back The Night events that gathered approximately 300 marchers, four front page Alamogordo Daily News articles, and approximately $6,000 worth of donated radio time.
SANE and the Judicial System
SANEs enhance evidence collection for more effective investigations and better prosecutions. Particularly in non-stranger sexual assault cases, thorough documentation of evidence corroborating a victim’s account of an assault by establishing lack of consent has led to more successful prosecutions (Office of Victims of Crime Bulletin).
In 2005, SANE testimony led to successful prosecution of intimate partner rape.
SANE testified before Grand Jury twice in February 2007. Both times the suspects were indicted on all charges.
SANE testified before Grand Jury twice in July 2007. The suspects were indicted.
SANE testified in a Court Trial once in August 2007. The suspect was given a guilty verdict.
SANE testified at Bench Trial November 2007. The suspect was found guilty of 5 offenses.
SANE testified at Grand Jury February 2008. Suspect was indicted.
SANE testified at Grand Jury March 2008. Suspect was indicted.
SANE testified before Grand Jury twice in June 2008. The suspect was indicted in both cases.
SANE testified before Grand Jury once in September and also made a statement at a sentencing hearing.
SANE testified before Grand Jury once in November. The suspect was indicted on charges.
The above actual testimony does not reflect the number of subpoenas SANEs have received nor does it reflect the number of plea bargains whereby SANEs were dismissed from testimony.
Key points about New Mexico SANE Programs
- Is nurse, not physician driven
- Relies on community collaboration
- Science and Standards change constantly
Alliance with the New Mexico Coalition of Sexual Assault Programs (NMCSAP) provides:
- Reimbursement of sexual assault victim case fees through contracts with SANE-no cost to victim
- State SANE Coordinator
- Statewide Coordinator Task Force meetings
- Legal training, references, resources
- Materials, brochures, posters
- Legislative liaison
- Statewide basic SANE education and continuing advance SANE education
- Use of a New Mexico Sexual Assault Exam Kit (SAEK)
- State guidelines for SANE Protocols and response
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