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SANE: Sexual Assault Nurse Examiner

SANE, which stands for Sexual Assault Nurse Examiners are nurses who have taken specialized education courses to care for a patient who has experienced sexual assault or abuse.

Deanna Booker, RN discusses how nurses can receive this certified training and why it's important for the community.
SANE: Sexual Assault Nurse Examiner
Deanna Booker, RN
Deanna Booker, is an Registered Nurse (RN), Trauma Nurse Specialist (TNS) and Sexual Assault Nurse Examiner (SANE) in the Riverside Emergency Department. A SANE is specifically prepared to care for sexual assault survivors and to look for signs of trauma and abuse. Her specialized training includes providing trauma informed care, forensic evidence collection, forensic photography, as well as, training on how to be an expert witness in court. While all nurses in the ED are educated in the SANE process, Deanna is one of five nurses who have pursued additional specialty training. In addition to her specialized training, Deanna is an active member of International Association of Forensic Nurses (IAFN), Emergency Nurses Association (ENA), she serves as Riverside’s representative for the 21st Judicial Circuit Family Violence Coordinating Council (FVCC), Human Trafficking taskforce and Sexual Assault Response Team (SART) at KC-CASA.

Carl Maronich (Host):  Joining us on the podcast today is Deanna Booker. Deanna, welcome.

Deanna Booker, RN (Guest):  Hi, thank you.

Carl:  You are an RN at Riverside in the Emergency Department?

Deanna:  Correct.

Carl:  And also, the SANE Program coordinator.

Deanna:  That’s right.

Carl:  And that’s what we are going to talk about today. SANE. Tell us what SANE stands for and what it means.

Deanna:  SANE stands for sexual assault nurse examiner. That means that as an emergency room nurse, I took a 40-hour didactic training that is help by the Illinois Attorney General and after that training, I completed a rotation of clinical requirements, taking care of patients and survivors of sexual assaults.

Carl:  So, that’s really what it centers on, sexual assault and those patients that come into the ER at Riverside and how they are handled, how they are treated. I would guess from an emotional, physically, a lot of different levels. It is such a traumatic thing that there’s a lot that goes into that. So, let’s kind of talk a little bit about that. Somebody who, a sexual assault victim that comes in, there has to be a lot of things to think about, a lot of things to do, how do you handle all that?

Deanna:  Absolutely. It is a very traumatic experience and part of our SANE training is to lead with a trauma informed approach or trauma informed care. Which means putting yourself in the shoes of that patient and understanding that what they have been through is not always something that they can come out and tell you. It takes a lot of bravery, a lot of courage to come forward and say that that has happened to them. So, we always care for our patients with that empathy.

Carl:  Yeah, and yourself, you have been an RN for how long?

Deanna:  I’ve been an RN for six years.

Carl:  Okay and all of that ER-based or have you been in other settings?

Deanna:  All of it ER-based.

Carl:  Yeah, so that’s kind of your thing, your forte. And so, traumas come through al the time of different types. But this is a very unique one that with it there are a lot of different issues that arise aside from the emotional, I guess because there is going to be an investigation, a police case, if you will that things have to be done in a certain way. And that’s part of the training I would guess.

Deanna:  Yes, it is absolutely part of that formal training. Not only are you taking care of the patient that has just been through such a terrible traumatic experience; but also, you are taking care of their emotions. So, as a trauma nurse, we are trained to get those life threats and see the patient and their injuries and when you are trained as a sexual assault nurse you are trained to make sure that the number one thing is that you make sure that the patient can trust you and that you believe them and that you work on those emotional pieces first. And then you can then offer all of the medical care that the patient needs.

Carl:  Yeah and I would think a program like this and having this kind of training in an ER is important for the community, so people know that this is something that you have been specially trained in.

Deanna:  Yes, that is absolutely correct. Just a thought if something like this were to happen to me I would want someone there that has had that specialized training.

Carl:  And it’s – there are other in the ER, not just yourself who have been trained in some way in the program as well?

Deanna:  Yes. We actually have one other SANE nurse that currently works within our emergency department and there are four other nurses that have gone through the didactic training and are on their way to their clinical rotation.

Carl:  Now, with regard to sexual assault, is it – I’m going to guess it isn’t always a case of the victim comes right from the incident to the ER. There may be time in between and things like that. How is that handled and how are you trained to deal with that kind of situation?

Deanna:  Well as a sexual assault nurse examiner, I have been trained that this is often something that it takes them a little bit of time just to wrap their head around what has happened to them. Often whenever a patient has gone through that experience; they feel as if they might have been killed or they may not remember everything that happened, and it might take them a little bit of time. So, with my training, I have learned that I need to give them time and I need to give them the encouragement and give them the support that they might need to be able to tell me their story and to tell me what happened to them.

Carl:  Yeah. I am sure a victim has to retell the story unfortunately many times through the process which is not an easy thing to have to go through.

Deanna:  Yes, unfortunately, that in the past that has been something that has happened to survivors is, it’s something called secondary victimization where the survivor has to tell their story to multiple people and sometimes whenever that happens; it is revictimizing them. Something that as I say we really focus on trying to limit the number of times that they have to talk to the police, talk to the nurses, talk to the physicians, every person they talk to that could resurface that injury to them. So, we try to limit that.

Carl:  Yeah, well that makes sense. Are the other community organizations that are either involved in getting our team at Riverside SANE certified or that we work with as that certification or that process goes forward?

Deanna:  Oh yes, absolutely. There’s a numerous amount of resources in our community. One of them that the SANE program works closely with is KCCASA, the Kankakee County Center Against Sexual Assault. That’s a team of advocates and representatives throughout our community.

Carl:  And it that with KCCASA? Are they part of the same group, same organization?

Deanna:  KCCASA is the Kankakee County Center Against Sexual Assault. Advocates and counselors who, they respond 24/7 coverage, so they respond to the emergency any time that there is a sexual assault survivor in our ER and then they follow up with the patient. They give them medical legal services, and advice and we work very closely with them. Not only through our sexual assault response team that meets once a month but also our Kankakee Iroquois human trafficking task force. So, together we come together. We update each other on new things that are going on in our community, new laws that are coming into place and we all work together to take care of our survivors the best way that we can.

Carl:  Sure. I would guess there are people in the community that will hear the term human trafficking and think, oh that’s not here, that’s doesn’t happen around here in this kind of community. That’s something that sounds like it happens in far off lands and not in our world. But it does.

Deanna:  It is, it absolutely is happening here. And I agree with you there. There are a lot of people that might think well that probably isn’t happening here, we’re a small community and everyone knows everyone, but most definitely, it’s happening all over or country.

Carl:  And are you and other ER staff trained to look for signs of that when someone comes in to the ER, perhaps not as a sexual assault victim, but with something else? Are there signs that you look for that might indicate that could be happening?

Deanna:  Yes. All of the staff have been educated and informed on the red flag indicators that could possibly indicate that somebody is a human trafficking victim.

Carl:  Oh, and I would guess this is the same with sexual assault victims. If somebody comes in with some other kind of injury, there maybe indications or you see something that perhaps there is something else that went on and I don’t know if you are able to try to surface that or ask questions that might get to that. Again, a very delicate thing so, I am curious as to how that is handled.

Deanna:  Yes, it is delicate. It is sometimes hard for a patient to talk about as well, so the nurses take their time and screen the patients for safety, not only just for human trafficking and sexual assault but also domestic violence and neglect and abuse. So, the nurses are trained on things to look for and how to approach that if it were to arise. They also know their resources and what they can do if they need to reach out to someone.

Carl:  Talk if you would, a little bit about the training that you go through with SANE. Where does that take place and what kind of sections or classes and things are there as you are trained?

Deanna:  The Illinois Attorney General’s office, they host the didactic training. They have them all over the state truly. Their SANE coordinator, she travels all over to teach these courses. There is some online portion before you go to class, so you have a good foundation of what you are coming in to study for and you spend usually three days there in the classroom learning about the anatomy and physiology of the female and male genitalia and reproductive systems. You learn proper techniques on evidence collection. Most importantly

Carl:  I think that would be crucial.

Deanna:  That is crucial. It is yes, but the most important piece when I went to my training I found is truly how to use a trauma informed approach and how to think about what has happened to this patient and what they are going through. And that really was a very big piece of my training.

Carl:  Yeah. Different than the nursing training you received in school. Was that touched on at all or is this really something that you don’t get until you seek out that specialized training?

Deanna:  Of course, in nursing school they teach you empathy and putting yourself in that patient’s shoes, but really, they don’t touch base on something as deep emotionally deep as what sexual assault is. And so, everyone understands you may not have ever gone through that before, but SANE course teaches you how to take care of somebody who has even though you have not. So, it’s definitely a different form of learning for nurses and you are right, it does include that crucial piece of evidence collection, proper evidence collection that will help the patient in the long run, years down the road whenever they decide to go to court with this.

Carl:  Yeah, sure. If someone wants more information or they maybe want to refer somebody to this very helpful information, how can they go about doing that?

Deanna:  Yeah, if they are or someone has disclosed to you that they have been sexually assaulted; it is very important that they do get medical care. So, of course they could come to the emergency department. Also, they could call the hospital phone number or the Riverside emergency department phone number which is 815-935-7500. They could call and ask to speak to a nurse or to myself or one of the sexual assault nurses there.

Carl:  Well Deanna Booker, we appreciate all the information that you have provided today. Important, helpful information. And thanks for being on the podcast.

Deanna:  Thank you very much for having me.