The Role of Forensic Nurses in Sexual Assault Cases

Sexual assaults are traumatic. They change lives forever. Victims of rape and sexual assault suffer severe psychological harm that lasts a lifetime. Victims may never feel safe again. The victims of sexual assault will need help from their loved ones, psychologists, psychiatrists, and other healthcare providers. While most healthcare providers treat the physical and mental health of sexual abuse victims, forensic nurses serve a special purpose. Forensic nurses also help victims obtain and secure the physical evidence that can show that a rape or sexual assault did occur, the severity of the attack, and that the assault was definitely not consensual.

According to the National Sexual Violence Resource Center (NSVRC), when a sexual assault victim goes to a hospital, the victim will have a rape kit examination done. This procedure is performed by a forensic nurse.

In a discussion with the NSVRC, a forensic nurse, Tammy Bimber, explained the daily responsibilities of a forensic nurse, why she became a forensic nurse, and how the rape kit evidence collection process works. Nurse Timber explained that in addition to being a teacher, she works for a university and for a telehealth service. She explained that she often works with an on-site nurse at a rural location by using Zoom. She also conducts hands-on at a medical center.

Her formal title is Sexual Assault Nurse Examiner (SANE). She became a SANE forensic nurse because she understood how difficult and upsetting it was for a sexual assault victim to use the rape kit without personal guidance, and because of a personal experience helping a young girl who said the sex she had was consensual but Ms. Timber became convinced the sex was coerced.

What are the duties of a forensic nurse?

Ms. Timber explained that SANEs answer victim’s questions and help them begin to breathe again and cope with their trauma. Ideally, advocates are called in immediately when a patient/victim arrives. The advocates provide support “during the set-up of the kit, during the exam, and basically the entire process, including giving a statement to law enforcement.” She goes on to say:

Utilizing trauma-informed care, where you have training and talk to patients, it gives them empowerment and control that they’ve lost — it is so important. The victim advocates are a huge part of helping the victims, and they are always there to help give them emotional support, and also support me as well. I lean on them heavily.

SANEs need at least two years of clinical experience working as an RN or at a higher nursing profession level. Three-hundred hours of SANE clinical training are required. SANEs must pass a certification examination. SANEs need different types of certification. Different states have different certifications. The International Association of Forensic Nurses (IAFN), has a SANE-P certification for pre-pubescent children and a SANE-A certification for adolescents and adults.

According to the Georgetown School of Nursing, a SANE healthcare provider is the first point of care. The forensic exam can be given even if the patient chooses not to notify law enforcement. The exam may also include toxicology tests and the use of a body map. A body map is a diagram of the location of the abrasions, bruises, scratches, and other injuries.

Forensic nurses also provide holistic care. This care may include testing for pregnancy and prophylactic antibiotics to prevent the contraction of diseases. A SANE may refer the sexual assault victim to specialists, such as psychologists or psychiatrists.

A key duty of a SANE is that SANEs are qualified to testify in court in a criminal or civil sexual abuse trial – though Georgetown’s School of Nursing emphasizes that the nurse should prioritize the physical and mental health of the patient.

What is a rape kit examination?

A rape kit is a “sexual assault evidence collection kit.” Each state has its own variation of a rape kit. The rape kit exam takes about three to four hours. The kits include the tools used to collect forensic evidence to confirm if sexual contact occurred. These tools include DNA swabs, smears, clothing, and evidence collection bags.

The exam included photographs, information about emergency contraception, and sexually transmitted diseases. Forensic nurses advise patients that they can pick and choose the parts of the exam they want to complete.

What are the duties of a forensic nurse in addition to the rape kit examination?

The biggest priority is keeping the patient safe.

Other forensic nurse duties for sexual assault victims include:

• Taking a complete medical history
• Documenting the patient’s description of the sexual assault
• Conducting a full body assessment
• Being supportive and non-judgmental

Forensic nurses need to keep evidence intact if the sexual assault victim has a medical condition that needs to be addressed immediately.

After the exam, victims are given information to speak with law enforcement, victim advocacy, housing information, and information about the legal system. Forensic nurses also discuss where the victim will stay/live after they leave the healthcare facility. The nurses make sure the victim gets home safely and securely.

SANEs are trained, according to Georgetown’s School of Nursing to “minimize the harm of invasive exams that may trigger a patient. In doing so, they can also equip their patients with forensic evidence that can be used if they decide to report their assault.” Not every hospital has a SANE program.

What are some of the challenges of being a SANE forensic examiner?

It’s difficult to conduct a physical exam without traumatizing the victim. It’s standard procedure for SANEs to ask for consent while they perform each test. For example, a SANE may ask for consent to examine a victims’ neck – and may then ask for a second consent, if necessary, for a sample collection for DNA or other purposes.

At Taylor & Ring, our California lawyers fight for sexual assault victims whose confidence has been shaken and whose soul has been broken. We work with forensic nurses, counselors, psychologists, and other healthcare providers who can verify the horror of a sexual assault and the full range of medical help victims will need. We represent clients throughout the Los Angeles area and Southern California. To assert your right to compensation and civil justice, call us or fill out our contact form to schedule a free initial consultation today.

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