Become a Sexual Assault Nurse Examiner (SANE) in 3 Steps

Nurse Types / Sexual Assault Nurse Examiner

A Sexual Assault Nurse Examiner (SANE) provides expert nursing care to victims of sexual assault and abuse.

This type of nursing requires advanced knowledge and experience. SANEs must also have additional certification and several years of prior experience in the emergency room, maternal health, or critical care.

There is a desperate need for more qualified SANEs. According to RAINN (Rape, Abuse & Incest National Network), someone is sexually assaulted every 68 seconds. However, many of these victims are unable to receive a proper forensic exam (or “rape kit”) due to a lack of qualified staff.

There are currently 2,331 SANEs in the United States. In practical terms, there are only 66 registered SANEs (out of 93,902 Registered Nurses) in the entire state of Virginia. This means there are only 66 SANEs to serve more than 8.5 million people living in Virginia. Similar disparities exist around the nation.

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This article will describe the steps to become a SANE, including:

• What is a SANE?
• What do SANEs do?
• Where do SANEs work?
• What are closely related fields?
• How do you become a SANE in 3 steps?
• What are additional requirements of SANEs?
• What are the salary and career outlooks for SANEs?

What is a SANE?

A SANE supports and treats victims of sexual abuse and assault in collaboration with other healthcare providers, law enforcement, social work, and mental health providers.

While a large part of the job includes conducting forensic exams that may be used in prosecution, a SANE is first and foremost a nurse who prioritizes their patient’s physical and mental health needs.

Qualities of a successful SANE 

It can be emotionally challenging to work with victims of sexual assault or abuse. In order to succeed as a SANE, you must:

• Establish a good self-care practice to handle the emotional challenges of this work
• Obtain advanced certification and training
• Understand how to support victims of sexual abuse and help them access recovery resources
• Advocate for your patient’s well-being through communications with law enforcement, social workers, and other healthcare providers
• Have excellent assessment skills, usually based on years of experience as a Registered Nurse

What do SANEs do?

A SANE conducts physical exams after sexual abuse or assault, provides emotional support, and coordinates care with other members of the healthcare and law enforcement teams.

The forensic exam is used to document trauma and collect evidence that may be used as part of a criminal trial. The SANE collects the patient’s medical history, takes photos of injuries, and documents any visible scratches, bruises, abrasions, or other injuries. They also collect DNA swabs and toxicology samples as needed.

Most importantly, the SANE supports their patient in the immediate aftermath of a traumatic event. This may include prophylactic contraception and antibiotics as well as testing for sexually transmitted diseases. A SANE also provides referrals to mental health providers to support patients in their recovery. 

SANE exams can be difficult for patients as they often require access to personal areas of the body. SANE nurses are trained to ask for consent throughout the exam, which can help the patient regain a sense of control over their body after a traumatic event.

A SANE is part of a Sexual Assault Response Team (SART). These teams include survivor advocates, law enforcement personnel, and mental health providers.

A day in the life a SANE

A SANE plays an instrumental role in supporting patients at the start of their recovery from sexual assault.

Some SANEs work on staff in a hospital. Others work full-time as bedside nurses, perhaps in the ER, and are assigned to patients reporting sexual assault as needed.

Many SANE work on-call shifts. When they receive a call about a new patient, they may drive to the hospital to conduct an exam in person, or they may work with the patient via telehealth. In these cases, a Registered Nurse or other healthcare provider conducts the physical exam under the guidance of the SANE.

Throughout the patient interaction, the SANE provides support, information, and validation for the patient. They also ensure that physical evidence is collected in accordance with law enforcement guidelines. 

A SANE may also be called to testify in criminal trials. However only 20% of sexual assaults are reported to law enforcement. RAINN reports that only 25% of perpetrators will be convicted.  

As long as the patient consents, SANEs may conduct physical exams even if the patient does not wish to report their assault to law enforcement. In most states, evidence is held for several months in case the victim chooses to pursue prosecution at a later date.

Where do SANEs work?

SANEs typically work in emergency rooms, although some SANEs operate out of separate offices or mobile clinics.

What are closely related fields?

SANEs are a type of forensic nurse. Related fields include:

• Correctional nursing
• Legal nurse consultant
• ER nursing
• Psychiatric nursing

How do you become a SANE in 3 steps?

Step 1 – Become a registered nurse

SANEs are Registered Nurses who have several years of bedside experience. To become a Registered Nurse, you must complete between 2-4 years of education and pass the NCLEX exam.

Earn a BSN degree

The first step to becoming a SANE is to obtain your Bachelor of Science in Nursing (BSN). 

Most employers prefer nurses with a BSN rather than an Associate Degree in Nursing (ADN).  BSN-prepared nurses usually qualify for higher salaries and greater responsibilities. If you have already completed an ADN program, there are RN-to-BSN programs that can help streamline the BSN process.

Individuals who already have a bachelor’s degree in a different field may qualify for an accelerated BSN program. These can be completed in as little as 16 months depending on your prior degree and coursework. 

Pass the NCLEX exam

After completing your BSN degree, it’s time to take the NCLEX exam and apply for a nursing license in the state where you want to work. The NCLEX is a national exam that certifies you have the minimum knowledge to practice safely as a nurse. All prospective nurses must pass this exam in order to apply for a nursing license.

Step 2 – Accumulate experience

Helpful skills and experience

In order to qualify as a SANE, you must have prior bedside experience as a Registered Nurse. Experience in the emergency room, maternal or women’s health, or forensic nursing can be particularly helpful.

Changing specialty to SANE 

If you wish to change your specialty to become a SANE, it helps to take continuing education units in related topics. CEUs may also be used to renew your nursing license depending on the state where you hold your nursing license.

When applying to a SANE position for the first time, be sure to highlight your assessment skills, any experience you have working with victims of abuse or trauma, or any advocacy work you’ve performed in the past.

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Step 3 – Obtain certifications

SANEs must undergo a rigorous certification process that includes clinical experience, a preceptorship, coursework, and a national exam.

There are two main certifications: the SANE-A is for nurses who specialize in adult patients and the SANE-P is for pediatrics.

In order to sit for the SANE exam, you must:

• Have at least two years of bedside experience to obtain SANE-A certification
• Have at least three years of bedside experience to obtain the SANE-P certification
• Complete a 40-hour course
• Participate in a clinical preceptorship
• Demonstrate 300 hours of SANE-related practice within the past 3 years, with at least 200 of those hours spent working with the intended exam population.

The certification is good for three years. You can renew your SANE certification through a combination of relevant CEUs and practical hours.

Curious about nurse certifications? This guide explains everything you need to know.

What are additional requirements of SANEs? 

The SANE’s most important role is to provide exceptional nursing care that supports a patient’s both mental and physical recovery. 

Outside of providing direct patient care, the SANE:

• Connects patients with resources like mental health providers or legal advocates
• Provides expert testimony during criminal court proceedings
• Maintains the chain of custody for evidence obtained from sexual assault examinations
• Closely adheres to legal guidelines regarding the collection of specimens and other evidence, as well as documentation and storage of these materials
• Serve as an advocate for victim’s rights within the community

What are the salary and career outlooks for SANEs?

Overall, the field of nursing continues to grow by 6% between 2021 and 2031. The demand for SANE nurses is high. 

The U.S. Bureau of Labor Statistics states that the average pay for all nurses is $82,750 per year. Actual pay varies based on location, work setting, additional certifications, and years of experience.

SANE nurses can expect to earn an average salary of around $78,000 per year with a typical range of $46,000 to $93,500. Actual salary depends on where you live, years of experience, and additional certifications. 

According to ZipRecruiter, the highest salaries for this career are currently found in cities in California, New York, Massachusetts, and Virginia.

Job satisfaction

SANE work provides essential nursing support for patients during a very difficult time. SANEs have the opportunity to make a deep impact on sexual assault survivors. Many SANEs report high levels of job satisfaction despite the emotional challenges of this work.

Outside of pay, this type of nursing may be a good fit for nurses who want a job that is less physically demanding than bedside nursing or who prefer to work closely with just one patient at a time.

Next steps

Sexual assault nursing is a rewarding career that provides vital nursing care to patients experiencing a crisis.

SANE nurses who wish to advance their careers may consider:

• Obtaining an advanced degree or post-graduate certificate
• Participating in victim advocacy groups
• Conducting research or working in academia
• Preparing training or courses for other nurses who may encounter victims of sexual assault or abuse
• Working as a legal consultant or expert witness for sexual assault cases

Do you have what it takes to become a SANE? Connect with other SANE and forensic nurses on the Incredible Health forum. 

Explore more career resources to help you prepare for your next nursing position as a SANE. Once you create a free profile with Incredible Health, we can provide you with additional materials and resources to help you reach your professional goals.

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