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Penn Highlands Healthcare’s Emergency Departments' SANE Nurses

April 28, 2019 | Emergency Department - Brookville , Emergency Department - Clearfield , Emergency Department - DuBois , Emergency Department- Elk


Sexual assault is a terrifying experience that affects people emotionally and physically. Coming forward to get the help needed takes strength, and it also takes someone equally as strong on the other end to lend the helping hand.

That is why in Penn Highlands Healthcare’s Emergency Departments we have SANE nurses trained to help. SANE stands for Sexual Assault Nurse Examiners. They are registered nurses who have completed specialized education and clinical preparation in the medical forensic care of the patient who has experienced sexual assault or abuse.

Though it is the end of April, Sexual Assault Awareness Month, the SANE nurses are available 365 days a year.

What is sexual assault? 

It is:
• Attempted rape, however slight;
• Fondling or unwanted sexual touching;
• Forcing a victim to perform sexual acts, such as oral sex or penetrating the perpetrator’s body;
• Penetration of the victim’s body, also known as rape.

Statistics from the National Sexual Violence Research Center show that in the U.S., one in five women and one in 67 men will be raped at some point in their lives.  In eight out of 10 rape cases, the victim knew the person who sexually assaulted them.

Statistics also show that nearly one in two women and one in five men have experienced sexual violence other than rape in their lifetime, and by the time people were 17 years old, 57 percent of women and 42 percent of men had experienced some form of sexual abuse. 

At the Emergency Department, SANE nurses care for the patients while also collecting physical evidence. Nurses follow a check list for a sexual assault forensic exam. The term “rape kit” is used often on TV shows, but refers to the kit itself that contains envelopes and containers to package any specimens collected during the exam. The contents of the kit vary by state and jurisdiction, and may include forms, a comb, swabs and other items.

It is the hope that what is needed can be collected before a person bathes/showers, uses the restroom or changes clothes, but even if those things happen, an exam can still be done. In most cases, DNA evidence needs to be collected within 120 hours in order to be analyzed by a crime lab.

“As a SANE nurse, you care for some of the most vulnerable patients in your career,” Holly Hertlein, RN, SANE, said. “Your care must be done in a delicate, yet methodical, manner. You not only have to be a bedside nurse, you have to have an investigative mind and be a forensic examiner, a therapist, a protector and an active listener. You are this patient’s advocate and must do everything in your power to collect the best evidence possible and provide compassionate bedside care.”

“I have learned about forensic nursing, and collecting and preserving evidence during my SANE training,” Hertlein said. “We also learned how to testify in a court of law. The SANE nurse is considered an expert witness and frequently gets called to court to testify for the patient.”

“To me, a SANE nurse is an integral part of the healing process when an assault occurs,” Kirsten Adams, RN, SANE, said. “We can provide support to the survivor throughout the exam, offer them services through Passages (or CAPSEA, local non-profit organizations that help sexual assault survivors) for follow up care and just be there for them to confide, possibly for the first time. I've learned that no patients’ experiences are the same, but there may be some similarities. We can often pull on previous experience to let the patient know what is to be expected.”

“It is a very emotional time for everyone involved, including the SANE nurse,” Adams said. “Sometimes, we need to debrief with each other and that is an important aspect as well. A SANE nurse is not just having the knowledge of how to conduct an exam and collect the evidence, but also the expertise of how to navigate the emotions and varied responses of the patient.”

At Penn Highlands Healthcare, we are here to help. Those who suffer sexual assaults “we see as trauma patients,” Kim Cicon, MS RN CEN, Emergency Department Service Line Director/Trauma Program Manager for Penn Highlands Healthcare, said. “They are traumatized. And we are elevating them to where they need to be.”

Cicon made this powerful comment in August of last year when Penn Highlands DuBois’ Emergency Department was named a partner with Penn State College of Nursing’s Sexual Assault Forensic Examination Telehealth Center, or SAFE-T. PH DuBois Emergency Department was chosen as one of four rural hospitals in Pennsylvania to participate in SAFE-T through a $4.1 million dollar U.S. Department of Justice, Office for Victims of Crime (OVC) Grant Funding grant given to Penn State.

SAFE-T uses technology to allow for a SANE nurse who is highly-experienced to serve as a second expert during an exam. With permission of the patient, this nurse – located elsewhere in the state - is connected remotely through extremely-secure video-conferencing equipment in the room.

Called a TeleSANE because she using telemedicine, she can provide support to the staff and the survivors. She can give the patient extra attention during the exam process. She also ensures best practices are done –all for the common goal of providing high-quality, compassionate care for all survivors.

This support is well-received by staff who don’t do exams every day. At Penn Highlands DuBois, 16 cases have been recorded since October 2018.  “That doesn’t mean more assaults aren’t occurring in our region,” Cicon said. “That number just reflects those who came for exams.”

“If you or someone you know is the victim of sexual assault, get help immediately,” Hertlein pleaded. “Evidence dissipates over a short amount of time. The sooner you are seen after an assault, the more evidence there will be to collect and preserve.”

If you or someone you know is a survivor of sexual assault or interested in more about ending sexual violence, Penn Highlands encourages you to talk to Passages at 814-371-9677 in Clearfield County, 814-849-8628 in Jefferson County, or 814-226-7273 in Clarion County or to CAPSEA, Citizens Against Physical, Sexual and Emotional Abuse at 814-772-1227 in Elk County and 814-486-0952 in Cameron County.