Debra Higgins, RN SANE-A, SANE-P, is the SafeHouse Forensic Director and also performs most of the forensic exams for our sexual assault and strangulation victim-survivors. In recognition of Sexual Assault Awareness Month, we spoke with Deb about what it means to provide forensic examinations at SafeHouse. Read on for this interview with a Sexual Assault Nurse Examiner or SANE.
What is a Sexual Assault Nurse Examiner?
A Forensic Nurse is a registered or Advanced Practice Nurse who has received specific education and training. Forensic nurses provide specialized care for patients who are experiencing acute and long-term health consequences associated with victimization or violence, and/or have unmet evidentiary needs relative to having been victimized or accused of victimization. In other words, I am able to provide comprehensive care to victims of violence by conducting a medical forensic exam. This entails a head-to-toe assessment for the purpose of treating and diagnosing injury, evaluation for DNA evidence collection, and providing effective courtroom testimony. Most importantly, the exam is an opportunity show compassion and sensitivity towards survivors of violence. Forensic nursing care is not separate and distinctive from other forms of medical care, but rather integrated into the overall care needs of individual patients.
Why were you interested in becoming a SANE?
I was working the night shift on the OB/Peds unit at my local hospital. Walking through the ER, I said hello to the other nurses on my way to the cafeteria to get some caffeine. There I overheard a conversation about a patient there that had been sexually assaulted, and the staff was trying to figure out where to send them for care. The patient ended up having to drive two hours away for an exam. It hit me in my soul. What a disservice we were doing for this person. How might we be adding to their trauma? That morning, I couldn’t go home until I had a conversation with my nurse supervisor about what had occurred and how we needed to do better. I researched SANE training opportunities and haven’t looked back since. Although it’s a hard profession, I fell in love with it. I meet new people and each of their stories are different.
How does a nurse become a SANE?
The path to become a Forensic Nurse begins with becoming a registered nurse with at least two years of nursing experience. The Sexual Assault Examiner class is comprised of 40 hours of classroom training, followed by an average of 40 hours of clinical training focusing on adolescent and adult populations. If the SANE nurse wants to also see the pediatric population, they must complete additional 40 hours of classroom and clinical training focusing on pediatrics components. The International Association of Forensic Nurses has educational guidelines that recommend this training as a minimum starting point for SANEs. Although not required to practice, one can become certified as a forensic nurse in both adolescents and adults, as well as in pediatrics. This signifies that a sexual assault nurse examiner has demonstrated the highest standards of forensic nursing practice. I am very proud to be one of the 601 dual certified SANE nurses nationally. But the work doesn’t stop there. It’s vitally important to keep educating oneself on the best practices through various trainings, skill labs, and keeping up with the current laws and statutes. I learn something new every day in this field.
Why SafeHouse:
SafeHouse is an incredibly unique organization that provides individualized, comprehensive advocacy and support for those seeking services. We are able to see patients ages 14 and above that have been victims of sexual and domestic Violence. Our program provides 24/7 coverage for medical services. A medical exam is not just about collecting evidence. First and foremost, it about making sure the patient is ok. This mean we look for injuries that may have occurred during an assault and treat those injuries appropriately.
SafeHouse’s Exam Space
We have been very intentional to create a space that feels safe and comforting, confidential, and secure for the patient. It is a space that provides privacy—a space that, if the patient chooses to report the assault, they can talk to the nurse and law enforcement at the same time, minimizing the number of times they must recount the trauma. It is a space that gives power and control back to the patient that was taken away during the assault. Patients must give written and verbal consent for the exam, and they can stop the exam at any time. We will never force an exam if a patient is unready or unwilling.
When clients come to SafeHouse, they’re very anxious and nervous. But we explain our role and give them complete control over the medical exam. They have an advocate with them at all times. They can choose to have another supportive person with them. Often times after the exam, we have patients thank us and even share a hug of gratefulness for helping them.
Although encouraged, if above the age of 18, the patient has the option to not report to law enforcement. When patients choose this option, we can still conduct an exam and evidence collection if the assault has occurred within the last 120 hours in the state of Alabama. A report can be done at a later time if the patient so chooses.
Other Services
Other wrap around services provided by SafeHouse include counseling, legal advocacy, and emergency shelter placement. All services are free and confidential.
SafeHouse also provides critical domestic and sexual violence response, prevention, and intervention programs and trainings for the communities of Shelby, Coosa, Clay, and Chilton counties in Central Alabama.
My Why:
I see the need for services like these in this community. Sexual Assault and Domestic Violence happens here every single day. When I first learned about SafeHouse, I felt an immediate connection. I believe in the backbone and mission of SafeHouse so whole-heartily, my family and I moved to Alabama from Kansas because I felt God calling me to be part of the amazing work we do here. Our mission is, “To empower survivors by offering free confidential, trauma-informed services while promoting safer communities through violence prevention and education.” It’s huge for someone to feel believed, heard, and valued in a difficult time caused by a traumatic event. If I can be a light in someone’s darkness, it’s a true blessing and honor.
To read more about Deb’s story and her calling, check out this month’s Letter from the Executive Director.
Learn more about how to become a SANE at Nurse.org.
Learn more about obtaining a forensic exam from SafeHouse.
Please don’t hesitate to call our crisis line if you need help: (205) 669-7233 (SAFE)
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