SANE programs have benefits you can’t ignore
SANE programs have benefits you can’t ignore
When a rape victim came to an emergency department (ED) for treatment, she didn’t expect to spend seven hours waiting to be seen, but that’s exactly what happened. "Because the victim didn’t have severe physical injuries, she was left to wait while patients with more serious problems were seen and cared for," says Eileen M. Allen, RN, BSN, DABFN, sexual assault nurse examiner (SANE) program coordinator for Monmouth County, NJ.
The woman became increasingly upset during the long wait. "At the end of the ordeal, the victim was reluctant to go forward with the investigative process," adds Allen. "She said that she had had enough.’"
The above scenario is unfortunately all too common, but a SANE program can ensure that it doesn’t occur in your ED, says Allen. Without SANE programs, survivors of rape may be re-victimized when they come to the ED for help, says Allen. In addition to long waits, patients may perceive a lack of compassion from ED nurses and a lack of supportive response from law enforcement community, she says.
Diana Faugno, BSN, RN, CPN, FAAFS, district director of forensic health services for the sexual assault response team in Escondido, CA, urges you to determine if there are SANE programs in your area, and take steps to establish one if there are not. She suggests enlisting the help of local law enforcement to establish a referral system.
You may not have your own SANE, but you must have access to one, urges Linda E. Ledray, RN, PhD, FAAN, director of the sexual assault resource service in Minneapolis. "Training all your ED nurses does not work, and I do not recommend this model," she says. Ledray suggests working together with other hospitals within a three-hour radius to implement regional centers where SANEs are on call for many EDs, or developing a mobile SANE unit.
Small community EDs should send several staff members to be trained as SANEs, says Faugno. "You can establish relationships with others for peer review and to keep updated on current information," she says.
She suggests taking the following steps:
- photograph or videotape the examination so it can be reviewed by your peers in another county or group;
- review documentation of actual cases without names or identification;
- join a professional organization to keep abreast of national issues;
- ask an outside reviewer to give recommendations for specific cases.
Here are benefits of SANE programs:
1. Patients are treated faster. A recent study showed that rape victims were treated more quickly by SANEs than by ED physicians, and with fewer interruptions.1
2. It’s a current standard of care. SANE programs are the current standard of care for victims of sexual assault, according to Faugno.
3. The patient is treated by dedicated staff. Sexual assault examinations typically last two to five hours, notes Faugno. "With a SANE program, the patient is treated by staff who have a desire to do this work, and the ED staff is not asked to fit this in,’" she says.
4. There is better evidence collection. SANE programs have greatly improved the quality of evidence obtained during the forensic examination, says Allen. Ledray points to her own study, which showed that 48% of the time, non-SANE evidence collectors did not maintain chain of custody, while SANEs did so 100% of the time.2
There is more time for thorough evidence collection, adds Kathy Hendershot, RN, director of clinical operations for the ED at Methodist Hospital in Indianapolis.
5. Patients receive more consistent care. With the SANE program, everything is standardized, including documentation, training, collection, and method of treatment, says Hendershot.
6. There is a higher conviction rate. "We work very closely with the prosecutor’s office to improve our court presentation, and eventually, higher convictions," says Hendershot.
References
1. Stermac LE, Stirpe TS. Efficacy of a 2-year-old sexual assault nurse examiner program in a Canadian hospital. J Emerg Nurs 2002; 28:18-23.
2. Ledray LE, Simmelink K. Efficacy of SANE evidence collection; a Minnesota study. J Emerg Nurs 1997; 23:75-77.
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