Sexual assault has always been a complex topic that requires respect and attention to those who have experienced it. With or without the aid of health care providers, recovering from rape is a long process that significantly influences victims’ lives due to a high likelihood of the development of such mental health conditions as posttraumatic stress disorder, depression, anxiety, irrational fear, and many more.
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While there are patients who are capable of dealing with the consequences of rape on their own, it is still recommended for everyone to seek the assistance of health specialists for evaluating the impact of rape on the individual for producing better patient outcomes. In this paper, the focus will be placed on the role of sexual assault nurse examiners (SANE) who provide comprehensive evaluations (forensic, medical, and psychological) of patients who have been sexually assaulted.
Involving SANEs into treating rape victims is imperative due to their role in performing evaluations of patients’ conditions as well as in the collection of forensic evidence that can be later used in a lawsuit against the offender. Also, SANEs can contribute to resolving the problem of inadequate care for rape victims who often get blamed for what happened to them.
Placing importance on the role of SANEs is of significance for nursing due to the array of benefits for victims since regular RNs or physicians are rarely qualified enough to perform complex forensic evaluations and collection of evidence, which may lead to errors and thus the decreased quality of care to patients. In addition, because SANEs are also trained in assessing victims’ psychological conditions, they can assist in referring patients to mental health specialists as well as be more understanding of what victims go through; emergency department workers may not provide the same level of emotional care since they often overlook the need of caring for patients not only physically.
Therefore, the role sexual assault nurse examiners play is multi-faceted and has extreme value for nursing as a profession. Due to the complexity of emotional and physical issues that rape victims are forced to undergo during and post-assault, it is imperative to provide them with the assistance of medical professionals who were specifically educated to deal with cases of rape. Also, SANEs are also important for communities since the correct collection of forensic evidence can lead to the improvement of conviction rates of sex offenders. Overall, both patients and communities, in which they live, can benefit from the expertise that SANEs provide.
In this analysis, several research articles will be evaluated for underlining the important role that sexual assault nurse examiners play in caring for rape victims. According to the research conducted by Darnell et al. (2015), who studied factors that contribute to attendance and follow-ups among rape victims, stated that SANEs were usually “well received by victims” (p. 89).
Involving SANEs into reinforcing the quality of care provided to rape victims is essential not only for initial evaluations but also for scheduling follow-ups that involve medical check-ups and assessments of future treatment needs. The researchers indicated that there were some difficulties in engaging rape victims in the recommended appointments for follow-ups, which resulted in many of them not receiving adequate care.
The expected outcomes of the integration of SANE’s expertise via programs or individually include patient education on the importance of follow-ups as well as providing initial forensic evaluations for assessing victims’ psychological and physical needs. For the nursing practice, SANEs can reinforce patient-centered care with the help of special skills and expertise catered to the specific emotional and physical needs of rape victims.
Pearsall (2013) proposed a toolkit for interventions associated with procedures targeted at improving patient outcomes and encouraging sexual assault victims to engage in follow-ups and ongoing evaluations. Importantly, the researcher proposed a framework of six steps of evaluation that include the following:
- Understanding design evaluation;
- Identifying questions for evaluation;
- Establishing cooperative agreements;
- Collecting data and using sample cases;
- Analyzing the collected data;
- Interpreting the results of the analysis (Pearsall, 2013).
The expected outcomes of this evaluation not only include getting the results of a rape victim’s condition but also developing a change plan that will positively influence patients’ health and contribute to improved legal case outcomes. Utilization of collected evidence is the key point that SANEs look for when conducting patient evaluations to assist in planning new initiatives or improving the already existing plans of care.
For the nursing practice, the proposed evaluation framework is expected to create positive change due to the improvement of nurses’ knowledge and contribute to the development of action plans to benefit patient outcomes.
Campbell, Greeson, and Fehler-Cabral (2013) evaluated the role of sexual assault nurse examiners in providing care to adolescent victims of rape. Based on the interviews conducted with survivors of sexual assault, the researchers identified three aspects of SANE services that were very beneficial for adolescent patients. The first beneficial aspect of SANE care was that the nurses showed compassion and understanding of patient’s mental and physical needs of patients when conducting initial and follow-up examinations.
The second aspect was that patients reported their SANEs being extremely caring and sensitive, which made them feel more comfortable during examinations. The third aspect was that SANEs believed the accounts of the assault and did not blame victims for what they had gone through (Campbell et al., 2013). Therefore, the expected outcomes of interventions associated with SANE practice imply the provision of patient-centered care to victims of sexual assault and making them feel comfortable during emotional or physical evaluations.
In the context of Campbell’s et al. (2013) research, the implications of SANE care for nursing practice include the increased awareness of healthcare providers of patients’ psychological needs, especially when it comes to dealing with adolescents. Since the interviews with adolescent victims of sexual assault showed that SANEs provided valuable care to them and were attentive to their emotional and physical needs, it is important to note that the general nursing practice should learn from SANE competencies in providing high-quality and patient-centered care to sexual assault victims.
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Exploring the role of SANEs in providing quality care to a patient is also important in the context of elder abuse. Sexual assault nurse examiners are required to conduct assessments of sexual abuse victims, complete the required medico-legal documentation, and contribute to the development of patient-centered action plans. However, Du Mont, Kosa, Macdonald, Elliot, and Yaffe (2016) found that SANEs needed to have extensive knowledge of forensic assessments of older adults due to the specifics of this patient group. In contrast to adolescents, elder patients are less likely to adhere to recommended treatments or follow-ups. The three key objectives of effective SANE care for elder patients include the following:
- Evaluating the importance of recommended practices targeted specifically at the delivery of care to the elderly;
- Determining the “components of care would fall within the scope of practice of an Elder Abuse Nurse Examiner, a forensic nurse examiner with additional training to respond to elder abuse” (Du Mont et al., 2016, p. 3);
- Reviewing and refining skills and competencies that SANEs exercise for providing quality care to the elderly.
The expected outcomes of the practices mentioned above include the provision of quality SANE care to elderly patients who have been subjected to sexual abuse. For the nursing practice, the framework is extremely valuable since working with elder victims of sexual abuse is more complicated due to the issues of treatment adherence and the lack of desire to follow-up on initial assessments.
To conclude, sexual assault nurse examiners play an essential role in providing patient-centered care to the victims of sexual abuse regardless of their age, gender, sexuality, culture, or other demographic variables. Research findings suggested that successful evaluations of rape victims’ physical and mental conditions are only possible when health professionals are trained to work with patients that have experienced sexual abuse specifically.
In contrast to emergency care nurses or physicians, SANEs are attentive to the emotional needs of sexual assault victims and can provide comfort when conducting preliminary and follow-up assessments. Due to the sensitive nature of rape and the psychological struggles that victims undergo, nurse practitioners who have received additional training on dealing with such victims are more likely to provide quality care and improve patient outcomes.
Campbell, R., Greeson, M., & Fehler-Cabral, G. (2013). With care and compassion: Adolescent sexual assault victims’ experiences in sexual assault nurse examiner programs. Journal of Forensic Nursing, 9(2), 68-75.
Darnell, D., Peterson, R., Berliner, L., Stewart, T., Russo, J., Whiteside, L., & Zatzick, D. (2015). Factors associated with follow-up attendance among rape victims seen in acute medical care. Psychiatry, 78(1), 89-101.
Du Mont, J., Kosa, D., Macdonald, S., Elliot, S., & Yaffe, M. (2016). Development of skills-based competencies for forensic nurse examiners providing elder abuse care. BMJ Open, 6(2), 1-8.
Pearsall, B. (2013). Evaluating sexual assault nurse examiner programs. National Institute of Justice Journal, 272, 41-44.