SANE Certification: What’s the Scoop?

Approximately every 68 seconds in the United States, someone is sexually assaulted. That equates to 1 in 6 women and 1 in 33 men. Emergency room providers—typically the first to encounter survivors of sexual assault—are often undertrained in providing trauma-informed care to these patients. A person who has been sexually assaulted requires a unique approach to meet their physical and emotional needs. This is why sexual assault nurse examiners (SANEs) exist. This blog highlights what a sexual assault nurse examiner is, how to become one, and the certification process established by the Commission for Forensic Nursing Certification, the certification body of the International Association of Forensic Nurses (IAFN).


What Is a SANE?

A sexual assault nurse examiner (SANE) is a registered or advanced practice nurse who has received specialized training to provide comprehensive, trauma-informed, patient-centered care to survivors of sexual assault. Depending on the jurisdiction or state/province, a SANE may go by another name, such as a forensic nurse examiner. The SANE’s responsibilities include:
  • Evaluating the survivor’s ability to provide consent for a forensic exam
  • Conducting a thorough and comprehensive medical history, including specifics of the sexual assault
  • Educating the patient about and discussing the need for potential testing or treatment for sexually transmitted infections (STIs)
  • Addressing pregnancy potential and the available options
  • Conducting a thorough physical exam, collecting samples or photo imaging along the way, as necessary and according to the patient’s wishes
  • Being prepared to testify as a witness in any criminal or civil trials, when necessary.


Benefits of Certification

Nurses who achieve SANE certification demonstrate the highest standards of forensic nursing. Becoming certified ensures peers, employers, patients, and SANES themselves that they have developed the knowledge and expertise to provide comprehensive, compassionate care to survivors of sexual assault. The IAFN developed its first board certification in 2002 for nurses providing care to the adult population. The pediatric SANE board certification later followed in 2007. Unless a local jurisdiction or facility requires otherwise, a nurse does not need to be board certified to practice as a SANE. However, it is strongly recommended. SANEs report that certification enhances their credibility when testifying in court, they receive validation of their knowledge and skills, they enjoy recognition among their peers, and other benefits.


Steps to Certification

A registered or advanced practice nurse may pursue SANE certification after completing a 40-hour didactic course (either online or in-person), assuming the didactic training course meets the SANE Education Guidelines. Since 2006, that means that the course must be taught as one contiguous course by one accredited provider of nursing professional development and grant the attendee a minimum of 40 contact hours. Nurses who wish to sit for the certification exam must achieve this as their first step, followed by a clinical preceptorship, 300 hours of SANE-related practice, and then taking the exam.


Exam Eligibility Requirements

To be eligible to sit for the certification exam, the nurse must meet certain criteria. Certification eligibility requirements are:
  • Holding a current, unrestricted license as a registered or advanced practice nurse
  • Having practiced at least 2 years as a registered or advanced practice nurse (for SANE-A); 3 years (for SANE-P)
  • Having completed a 40-hour sexual assault nurse examiner (SANE) course that meets the SANE Education Guidelines
  • Having completed a SANE clinical preceptorship
  • Having accrued at least 300 hours of SANE-related practice within the past three years. At least 200 hours must be related to the patient population in which one seeks certification.
SANE-related practice currently includes any combination of the following:
  • Providing direct patient care as a SANE
  • Taking on-call shifts as a SANE (regardless of whether you see a patient)
  • Teaching or precepting SANES
  • Consulting as a SANE on SANE-related issues (e.g., presenting SANE-related education, testifying as a SANE, engaging in advocacy or process development for SANE issues, etc.)
  • Peer review of SANE cases


Sources of Clinical Training

Just as clinical preceptorships are required during nursing programs, they are used in training SANEs. In nursing school, student nurses are often assigned to a preceptor to assist in the student’s clinical, hands-on training. SANE preceptorships are often conducted with guidance from a certified SANE/forensically trained nurse, a physician, or an advanced practice nurse. Certain skills are necessary for a nurse to be competent to practice as a SANE. The IAFN SANE preceptorship does not require a certain number of exams or set period of time. Instead, it is learner-driven—and the metric is competency. The SANE is deemed competent when their preceptor assesses the SANE’s demonstration of a skill as competent. Clinical opportunities abound. They may include simulated experiences, clinical preceptorships, or skills training workshops. Nurses should check with their local Board of Nursing to determine what is offered and/or required in their region. If no local programs or opportunities exist, the IAFN has approved various facilities offering 2-day clinical training. In addition, clinical preceptor opportunities are available throughout the United States. The IAFN makes it easy for nurses to find locations known for their clinical training opportunities.


Preparing for the Certification Exam

Congratulations on meeting the requirements to sit for the certification exam! As with most exams, test anxiety may start to set in, so please follow along as we provide prep and study tips!
  • Read the IAFN’s Certification Exam Handbook–This maps everything you need to know!
  • Review the Test Content Outline for the exam you plan to take—It tells you all the topics that will be covered on the exam—and the percentage of items devoted per major topic (or domain)
  • Peruse the reference list for resources that you can use to your advantage
  • Seek a review course for the test you are sitting for
  • Combine your need for continuing education (CE) courses with SANE content to maximize your preparation
  • Review the IAFN Study for the SANE Exam page (Pro tip: FULL of great info!)
  If test anxiety is something you experience, please know you are not alone. Review this guide to help manage your test anxiety.


How to List Credentials

Once you have successfully passed the SANE-A® and/or SANE-P® certification exam, how should you list your new credentials? As with most nurses and healthcare providers, the more degrees and certifications we achieve, the more confusing it can be. The IAFN provides a great explanation of how to list credentials properly. Academic degrees are listed first, then licensure, and then certifications (e.g., Jane Doe, BSN, RN, SANE-P).


Final Thoughts

Being a SANE can be as challenging as it is rewarding. To be the one who responds after a patient’s traumatic experience of sexual assault can be hard, but SANEs are highly skilled at their craft. SANEs are trained in taking thorough histories, conducting forensic exams, and providing trauma-informed, patient-centered, and compassionate care to survivors. The IAFN is the leader in all sexual assault and forensic education, training, leadership, and resources. If you are a nurse who is interested in becoming a certified sexual assault nurse examiner, we invite you to start here.         About the Author: Krystle Maynard is the creator of Innovative RN Solutions, which focuses on healthcare content writing (e.g., blogs, E-books, emails, academic coursework, and educational content for healthcare personnel and patients). She has been a nurse for more than a decade, specializing in medical-surgical and critical care nursing. Krystle is a proud SANE; she works with a local nonprofit in providing services to survivors of sexual assault at multiple local healthcare facilities in her community. She also has a long-standing history as serving as an adjunct faculty member for a college of nursing. Krystle lives in Kentucky with her husband and children and her two favorite hobbies are traveling to various destinations (mainly beaches) and concerts. Pleaser reach out to her at LinkedIn, if you’d like to connect.

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