Moving Beyond SANE Practice: Tell Me About It!

By Dr. Trinity Ingram-Jones posted 10-27-2016 08:34 AM


Good morning friends and colleagues!

Forensic Nurses Week is slowly creeping upon us, and as we prepare to celebrate and honor our profession and what we have done and continue to do in the lives of so many around the world, I am reminded of just how far we have come since 1992 when those 72 visionaries came together as a collective nursing voice to bridge the critical gap between healthcare and the legal system. Our founding members were mostly comprised of sexual assault nurse examiners (SANEs) who worked in or closely with emergency departments in that subspecialty capacity. At that time the impact of forensic nursing could not yet be fully appreciated. The science to support the value of forensic nurses and the high-quality of care we provide was not yet well established.

In the 24 years since that time forensic nurses have been recognized as a nursing specialty by the ANA, and we have seen our numbers as an organization explode, additional forensic subspecialties emerge, the development of forensic nursing education programs, developed certifications within our specialty, consistently demonstrated our worth to nursing and society as a whole, and through research and quality improvement, played an instrumental role in developing standards and resources that are utilized to promote the highest quality and standards of care for victims and perpetrators of violence. Most importantly, we have demonstrated our worth in nursing, medicine, and the criminal justice system through patient advocacy, science, favorable patient outcomes, and enhanced quality of life for those entrusted to our care.

Though we have come so far as a nursing specialty, we still have so far to go. Since our inception 24 years ago, we have come to fully appreciate the tremendous impact that violence has on long-term health and well being as clearly evidenced by the ACE study. There is absolutely no doubt about it: Violence is a healthcare issue. Violence is contagious, and it is absolutely a public health issue. This issue takes us far beyond sexual violence and the need for properly trained SANEs, yet this concept is not fully embraced by any discipline, including our own. As demonstrated by the utilization of well-trained SANEs in sexual assault cases, forensic nurses play an instrumental role in improving quality of life for our patients and the pursuit of justice.

Our founding members fought long and hard for the utilization of SANEs to improve patient care and enhance sexual assault investigations, and they have continued to fight for the recognition of other subspecialties of forensic nursing; however, it has been and continues to be an uphill battle for so many of us in so many ways. I began my forensic nursing career as a SANE because it was the only recognized forensic nursing subspecialty in southeast Georgia. My work as a SANE, SANE educator, and SANE team leader sparked a passion for forensic nursing and provided me with a vision for moving the specialty beyond SANE in our local area. As a pediatric nurse practitioner, I worked hard to demonstrate to my own discipline and those outside of nursing and medicine the value that I bring to the table, and the value I bring to their cases - beyond that of the role of SANE. I have taken every opportunity that I can to present the research of my colleagues in healthcare and forensic nursing to anyone who is interested in learning the value a forensic nurse brings to their team and those we serve. As a forensic nurse I now serve in multiple forensic subspecialties roles, including child maltreatment, death investigation and review, domestic violence, and SANE.

My point this morning is that we all continue to face challenges as we branch into forensic nursing subspecialties beyond the role of SANE. The SANE role is so valuable, and as forensic nurses, we can add value to our many subspecialties through advocacy, research, and policy development. Understanding the challenges of individual forensic nurses and forensic nursing teams is the first step in eliminating barriers to forensic nursing practice. The most common and effective barriers I have faced are funding, organizational support, and value recognition. Even our state crime victims fund only reimburses for services provided to victims of sexual assault. Funding for forensic medical treatment of other forms of maltreatment and domestic violence is scare, and few of us have ever been lucky enough to secure such funding.

I am interested to know what your challenges are. Have you faced challenges in your attempts to expand your role as a forensic nurse? What barriers have you identified? How have you overcome those barriers? What sources have you been able to tap in to?

As clearly demonstrated by our founding members, it is amazing what you can do when you begin having conversations and initiate collaboration. There is power in numbers. Let’s tackle this issue as a collective voice and move forensic nursing practice beyond SANE! Please reply here or privately. I am interested in hearing what you’ve got!

Guess what? It’s almost Friday!

Take care,