Forensic Nursing: Sexual Assault Nurse Examiner – Part 1

SafetyNurse1968, BSN, MSN, PhD

I found Lacy through facebook. I sent a message to all my nurse buddies asking for an introduction to a Forensic nurse/Sexual Assault Nurse Examiner. I'd already done a lot of research on this occupation because it's one of those career options that has always appealed to me. I even applied to be a SANE nurse when I was working oncology, but I didn't make the cut (it's highly competitive in some places). Forensic nursing appeals to me because it contains so many elements: crime scene investigation, the legal system, law enforcement, advocacy and patient care. The idea of bringing perpetrators to justice appeals to me as well. Lacy first learned of the SANE nurse position in her regular duties as an ER nurse. She said the position interested her because of her involvement with supporting victims of human trafficking.

Forensic nurses serve victims of sexual assault, intimate partner violence, neglect, and intentional injury by collecting evidence and giving testimony. They also provide support and advocacy. Joseph Biden, President of the United States said, "Forensic Nurses play an integral role in bridging the gap between law and medicine. They should be in each and every emergency room.” Forensic nurses provide care for patients who have been victimized by violence. They often work in a hospital setting with emergency room personnel but may also work in a medical examiner's office doing death investigation, with community anti-violence programs, in corrections facilities and disaster settings.

Training

To be a forensic nurse, you need to be a registered or advanced practice nurse with two years or more of experience. It's especially helpful to have advanced physical assessment skills, experience with ER, critical care and maternal child health nursing. The first step is to find training that meets International Association of Forensic Nurses (IAFN) SANE education guidelines. The 40 hours of training will have a classroom and clinical component. You can't put SANE after your name, however unless you have completed the SANE-A (Adult) and/or SANE-P (Pediatric) certification. Lacy completed two, eight-hour days in the classroom and then found a volunteer opportunity that allowed her to perform 13 speculum exams as part of her clinical work. She has decided not to become SANE certified at this time, explaining that certification isn't required for her job and that she's heard the exam is insanely difficult. She said, "I heard they [the IAFN] are working on revising it to make it easier to achieve certification.”

Lacy has taken courses on sexual assault, documentation, and even strangulation, which is apparently very common in sexual assault cases. She told me that some are seated/in-person and some are online.

Law enforcement came to speak to the SANE trainees as well. Lacy told me about the training that police officers are now getting about how to interview victims of trauma. She sent me a link to a video that we should all watch about how trauma fragments our memories (I can identify with that). She said that often law enforcement will complain; "Police tend to assume the victim is partially to blame. They think the victims must be lying because they can't keep their story straight.” She went on to explain, "They don't understand how trauma affects memory. It's not that they are lying, they literally can't remember what happened. Trauma causes you to become scattered and to forget details or tell things in the wrong order. The video she sent me is called Post It Notes Analogy for Effects Of Trauma On Memory.

The Job

I went digging around for jobs and found one posted a week ago in Salinas CA at Natividad for a full time SANE coordinator. You'd need a valid CA RN license, BLS and two years of recent SANE experience. The duties of the job include assessing potential child abuse victims, counseling families, work with multidisciplinary team including law enforcement, social services, behavioral health and victim's assistance.

I was excited to find out that forensic nurses can be coroners or medical examiners in some states. In the US, death investigation lies with either a coroner or medical examiner. A coroner is an elected official who may have no specific educational requirements. A medical examiner is typically an appointed physician with training in forensics.

Critical components of any death investigation

Medical/social history
Examination of the body
Scene investigation

You can earn certification through the American Board of Medicolegal Death Investigators (ABMDI). I checked to see if nurses can be MEs in my state, North Carolina and I can! So cool to think I could be a coroner or medical investigator.

There are also degrees (MSN and PhD) in forensic nursing, though it doesn't seem like many of the jobs I found posted require a degree in forensic nursing. Any information you could possibly want can be found on the IAFN website, including a video about forensic nursing.

Salary (2020)

According to ZipRecruiter, the average annual pay for a Forensic Nurse in the U.S. is $65,047.

I'd love to hear your comments on this job. Are you a forensic nurse? Would you ever consider this job? Why or why not?

Thanks for reading!

Resources

Forensic Nursing (FN)

Forensic Nursing: Role of the Forensic Nurse – Part 2

Forensic Nursing (FN): Programs

Forensic Nursing: Sexual Assault Nurse Examiner – Part 1

Have you ever thought about being a forensic nurse?

Training

The Job

Critical components of any death investigation

Salary (2020)

About SafetyNurse1968, BSN, MSN, PhD

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