SANEs: How many of you DID NOT start in the ER

**All Heart RN** · Jun 24, 2008

Okay,

Since I can't get any posters to respond (although several have viewed this thread), I'll try this:

Siri-

What's your opinion on my initial post? I'm not sure if I'll ever have a real interest in working in the ER but through my previous experience as a Rape Crisis Advocate, I really believe in the work that SANEs provide and would love to pursue this path.

Thanks in advance!

Editorial Team / Admin · Jun 24, 2008

Hello all-
I'm still in nursing school but during my first degree (Psychology), I volunteered at a Rape Crisis Center as an advocate. I loved it! My work as an advocate challenged me in ways that I had never experienced before.
I love the work and the challenges that becoming a SANE would offer but I don't really desire, at this time, to work in the ER. I would rather work in a cardiac unit or the ICU and be on call as a SANE.
I've read other posts that strongly suggest working in the ER to gain experience with assessing wounds, bruises, and conducting pelvic exams. However, we all know that one destination can have several paths. This argument is like whether a new nurse should start off in Med-Surg to gain certain skills vs. starting off in a speciality unit of one's own interest.
So, I'm really wanting to hear from SANEs who work in units other than the ER and are also SANEs.
Thanks for your insight!

Hello, wsuchic1, and welcome to the Forensic Nursing forum

I am not a SANE-educated nurse; I am a Forensic nurse, but I do advise those seeking this career path to gain experience in an ED.

There, you have more options to be at the portal of entry regarding sexual assault issues. ICU is after-the-fact. That is my rationale for seeking experience there.

Hopefully other SANE trained nurses will come along and give input.

Good luck with your plans.

lsvalliant · Jun 29, 2008

hi, I was wondering the same thing as I posted a similar question. I'm a new nurse going into psych nursing(part-time) and contemplating sticking with psych as my specialty. However, finding an ED new grad program may be the way to go. good luck. If you find out, PM me.

**All Heart RN** · Jun 30, 2008

Hi Isvalliant,

Thanks for responding! Have you made any decisions about getting some experience in the ER?

Good luck on your path as a new Nurse ; )

lsvalliant · Jun 30, 2008

I'm torn. it is really important for me to be working days cuz I am going to try to pull down 2 jobs. I doubt I'll find an ER day shift, especially as a new grad. I might stick with psych and get my NP. Forensics does sound facinating though, and I would love to testify and help get some justice for the victims of crime.

Journey_On, BSN, RN · Jul 1, 2008

wsuchic1,

Thank you for posting this question! I have been a little interested in how to become a SANE nurse....but I am not interested in working in the ER right now, either. I was a volunteer in the ER during high school, and it was alright for me. I saw many things, I'm sure, but it didn't peak my interest in that field.

I like how you mentioned the new nurse & Med-Surg issue because that's how this is, too. And to add another one, it's like should a nurse who wants to become a nurse-midwife work in L&D to get experience, or would she pick up "bad habits?"

I too have my first degree in Psych, and I loved it. It's really good that you got to volunteer at a rape crisis center.

dsczephyr · Jul 1, 2008

Hello wsuchic1,

As SirI noted, the main portal for victims of sexual assault who are seeking medical care and evidence collection is the ED. It is the natural and logical place to go if you are an assault victim looking for assistance. I do believe, however, that there are a few free-standing clinics out there specifically for sexual assault victims who don't want to go to an ED. But there are not that many of them and they are typically found in big cities.

That said, working as a nurse in an ED does not guarantee that you will see many sexual assault victims. I worked in a community hospital ED for a year and a half before I ever saw my first sexual assault, and I had done SANE training prior to that. There are hospitals that see many and those that see few, depending on factors such as urban or rural location, etc.

In ED, we see many of the patients that end up on med-surg units, but on a more urgent basis.

You stated you have a degree in Psychology and loved being an advocate. A SANE nurses' role is different than that of an advocate, (the SANE role is strictly objective and biased for justice and the advocate's role is inherently biased for the victim). That said, the advocate is an invaluable member of the Sexual Assault Response Team (SART). You could work as a nurse where you want to work and are comfortable, but be that advocate in a SART when not working as a nurse. It would be tough and dependent on your work schedule, but I did both (in two separate counties) for a time.

One thing I don't recommend is going to work in an ED solely because you want to be a SANE nurse. Sexual assault victims are a very minor percentage of the patient population you will see in a typical ED.

I hope this has been of some use.

dsczephyr

MSN - Forensic Nurse Clinical Specialist, SANE

Editorial Team / Admin · Jul 1, 2008

you stated you have a degree in psychology and loved being an advocate. a sane nurses' role is different than that of an advocate, (the sane role is strictly objective and biased for justice and the advocate's role is inherently biased for the victim). that said, the advocate is an invaluable member of the sexual assault response team (sart). you could work as a nurse where you want to work and are comfortable, but be that advocate in a sart when not working as a nurse. it would be tough and dependent on your work schedule, but i did both (in two separate counties) for a time.
dsczephyr
msn - forensic nurse clinical specialist, sane

very well stated, dsczephyr, and thank you for pointing that out. the sane nurse is definitely one of support, not advocacy.

**All Heart RN** · Jul 1, 2008

Hello wsuchic1,
As SirI noted, the main portal for victims of sexual assault who are seeking medical care and evidence collection is the ED. It is the natural and logical place to go if you are an assault victim looking for assistance. I do believe, however, that there are a few free-standing clinics out there specifically for sexual assault victims who don't want to go to an ED. But there are not that many of them and they are typically found in big cities.
That said, working as a nurse in an ED does not guarantee that you will see many sexual assault victims. I worked in a community hospital ED for a year and a half before I ever saw my first sexual assault, and I had done SANE training prior to that. There are hospitals that see many and those that see few, depending on factors such as urban or rural location, etc.
In ED, we see many of the patients that end up on med-surg units, but on a more urgent basis.
You stated you have a degree in Psychology and loved being an advocate. A SANE nurses' role is different than that of an advocate, (the SANE role is strictly objective and biased for justice and the advocate's role is inherently biased for the victim). That said, the advocate is an invaluable member of the Sexual Assault Response Team (SART). You could work as a nurse where you want to work and are comfortable, but be that advocate in a SART when not working as a nurse. It would be tough and dependent on your work schedule, but I did both (in two separate counties) for a time.
One thing I don't recommend is going to work in an ED solely because you want to be a SANE nurse. Sexual assault victims are a very minor percentage of the patient population you will see in a typical ED.
I hope this has been of some use.
dsczephyr
MSN - Forensic Nurse Clinical Specialist, SANE

Dsczephyr-

Thanks for your response!

Because I volunteered as an advocate for a few years and had the opportunity to observe the SANE closely, I am definitely aware that the role of the advocate and the role of the SANE are different. I also would not work in the ED solely to become a SANE. That is why I am so eager to hear from SANEs that have chosen a path other than working in the ED.

I am actually surprised that I do not have a burning desire to work in the ED because I've worked in roles that were geared towards extreme crisis intervention in the past--positions that really got the adrenaline pumping (although I know those experiences vary greatly from the role of the ER nurse). I've worked on Suicide hotlines for teens and adults and have also worked in different capacities, in addition to being an advocate, for the Rape Crisis program.

Oh well, that's what I absolutely adore about Nursing--there's so much to choose from and so many paths to one destination.

I guess I (along with other creative souls) will just have to blaze a new path for SANEs!

**All Heart RN** · Jul 1, 2008

wsuchic1,
Thank you for posting this question! I have been a little interested in how to become a SANE nurse....but I am not interested in working in the ER right now, either. I was a volunteer in the ER during high school, and it was alright for me. I saw many things, I'm sure, but it didn't peak my interest in that field.
I like how you mentioned the new nurse & Med-Surg issue because that's how this is, too. And to add another one, it's like should a nurse who wants to become a nurse-midwife work in L&D to get experience, or would she pick up "bad habits?"
I too have my first degree in Psych, and I loved it. It's really good that you got to volunteer at a rape crisis center.

Hi Sehsun,

It's always nice to meet fellow Psychology grads! Yes, I definitely see it as a 'Med-Surg kind of issue". While we are aware of the value of starting our careers in Med-Surg, it's also refreshing to see new nurses who have challenged the traditional viewpoints by going into specialty units first and still gaining those valuable skills.

I have next quarter off and have actually thought about contacting the local Rape Crisis Program to begin volunteering again. I loved being able to be such a great resource to survivors of sexual assault and also being able to observe SANEs in all that they do!

BunkyRN · Jul 2, 2008

Hey there !

I was a SANE nurse for 4 years and DID NOT start out in the ER...... but I eventually wound up there and loved it ! I started out as a med/surg nurse when I started my job as a sane. So ..... no you dont HAVE to be an ER nurse. I would say that you should be a nurse for at least a year so you do have the assessment skills needed to be a sane. Keep doing the advocate work, that will expose you to more cases and keep you in the loop with the sexual assault working world. I did the on-call thing, even as an ER nurse.... I was just able to work in the ER and do my on call time while working, as someone would come in a take over my ER load when I had a case that would come in.... therefore I didnt have to give up so much of my free time to be on call. Because..... after a while you cherish your free time and dont want to spend it all on call ! Just a word of the wise. The assessment skills are critical to have (and not the ones you learn in school...) because it takes time and experience to learn these.... you learn them by working in any unit. You generally work alone when doing cases (I have never had another nurse work a case with me) and you need to have this time and skill before you can tackle such an important job. Good Luck with your schooling..... if you have the desire..... you can make it happen.