Collaborations with other professionals and with community organizations are an essential part of SANE program development. This topic is covered in Chapter 8.
|Factors that Impact Initial SANE Selection
|A psych nurse has applied for a SANE position. Should this nurse be hired?
|Many programs require emergency or trauma experience before hiring someone to work as a SANE. This may be important in a setting where patients frequently need additional types of trauma care. At the same time, a nurse with a psychiatric or maternal child health background may be able to provide specialized knowledge to the SANE program that can improve care to all patients. If you are in a community setting, the nurse needs to be able to identify which patients might require a higher level of care. Triage and transfer need to occur before there is a critical need. Nurses in these settings need good assessment skills and enough experience to know when a patient might need to be transferred to a hospital setting. It is equally important to have policies that outline when physician intervention or transfer are necessary. In addition, the job description should identify what skill sets are essential (e.g., phlebotomy or microscopic examination).
|Will nurses be allowed to work another job while working as a SANE?
|Like all other nursing jobs, the SANE needs clear guidelines about call and shift expectations, preferably prior to hiring. Many programs expect a nurse to be able to work 3–4 hours after their shift ends in order to finish a case they started during their scheduled shift. This means a nurse cannot plan to cover a shift from midnight to 6:00 a.m. and then plan to go to another job at 7:00 a.m. Some teams have the nurse from the next shift start answering calls that come in during the last half hour of the previous shift. Shift change should be determined by safety and quality issues relating to patient care, the ability to maintain proper chain of custody of the evidence, and the individual patient's needs.
|What if the victim has a preference for an examiner of a specific gender?
|It is important to recognize that the gender of the SANE is not as important as their ability to provide compassionate care to promote the healing and resilience of the patient; however, programs should accommodate patients’ requests for responders of a specific gender throughout the exam whenever possible, and as consistent with applicable laws. For a variety of reasons, including cultural considerations, some patients may prefer to work with a male or female law enforcement official, advocate, and/or examiner.
|What should happen if a nurse applying for a job as a SANE discloses a history of sexual assault or sexual abuse?
|With 1 in 3 women and 1 in 5 men having a history of sexual victimization, many SANEs will be survivors of some type of sexual assault or abuse. There are two issues that need to be discussed with the nurse. First, the nurse must understand that self-disclosure to a patient is never appropriate because this changes the episode of care from patient-focused to nurse-focused. The nurse should fundamentally understand that her/his victimization cannot be generalized to the patient's experience. Second, the nurse needs to consider whether they will be able to perform their job safely and accurately if they experience a trauma response. Being a previous survivor should not prevent a nurse from working as a SANE.
|I have a nurse applying for a job whose spouse is a sex crimes detective for the community. Is that a conflict of interest?
|If your program is in a small, rural community, potential conflicts of interest are inevitable. Nurses in all settings must maintain patient confidentiality. If you have concerns about a conflict of interest, consult with the prosecutor and the human resources or legal departments of the facility.