What is a SANE Nurse’s Role in a Sexual Abuse Case?


If you have been charged with a crime involving allegations of sexual assault, the accuser will often undergo a series of physical and psychological examinations by healthcare professionals. For example, a child who is alleged to have been abused will be brought to Pat’s Place, a child advocacy center where they will be interviewed in detail by a licensed social worker. An adult may speak in detail directly to police investigators and provide an interview of their recollection of what happened. But in cases where the incident in question occurred within 120 hours, the prosecuting witness may also be taken to the hospital where they will undergo a physical examination conducted by a SANE nurse or Sexual Assault Nurse Examiner.

A Sexual Assault Nurse Examiner (or SANE) provides specialized care for patients who are victims of trauma. The specialized role of these forensic nurses goes far beyond medical care; forensic nurses also have specialized knowledge of the legal system and skills in injury identification, evaluation, and documentation. After attending to a patient’s immediate medical needs, a forensic nurse often collects evidence, provides medical testimony in court, and consults with legal authorities.

A Sexual Assault Forensic Examination (or SAFE) is usually conducted over the course of several hours by a SANE and can include all of the following:

  • Conducting a full battery of STI testing and offering preventative care for STIs and pregnancy
  • Taking an account of what happened from the patient, in addition to other information that is relevant, for evidence collection
  • Obtaining the patient’s clothing that they were wearing during the assault
  • Assessing for outward physical injuries like cuts, scratches, and bruising (including strangulation)
  • Taking photographs of injuries
  • Genital and rectal examinations with diagrams and notes of injuries or abnormalities
  • Taking swabs to test for DNA or for serology purposes to determine the presence of semen, saliva, or other bodily fluids
  • Taking blood and urine samples to test for drugs or alcohol

In North Carolina, to become a SANE a nurse must have at least two years of clinical practice as an RN and then complete a minimum of 16 clinical practice hours performing SAFEs under supervision, along with a 40 hour training course. After that, they must take courses in continuing education to remain certified as a SANE.

How is the SANE Important in my Case?

The testimony of a SANE can be very dangerous to the accused and can often make or break an allegation of sexual assault. A SANE is trained in evidence gathering, interviewing, and testifying in court which means that they are just as experienced in investigation as law enforcement. Arguably they are more powerful than police, since a SANE will be certified during trial as an expert in forensic examinations related to sexual assault. That means the SANE will be able to use that medical knowledge to testify that in their expert opinion, the evidence they gathered is consistent with a person who has been sexually abused.

In various North Carolina trials, SANE nurses have been able to argue that “80% of sexual assault victims show no signs of physical injury,” that an examination was “consistent with having had engaged in vaginal intercourse,” that they don’t think a child had “inaccurate thoughts” regarding what occurred, as well as other incriminating testimony. Regardless of what the prosecutor and the SANE will admit, this testimony is designed to make sure that the jury believes what the accuser has to say in court.

A conviction for this type of offense will result in registration on the sex offender registry for at least a decade and make finding work or a place to live very difficult. Sex offenses often come with lengthy active sentences of imprisonment for many years, even for someone with minimal or no prior criminal record. Judges and juries are very sensitive to this kind of material and therefore they are the target audience of the SANE.

What Can I Do to Defend Against the Testimony of a SANE?

There are two things you can do to help yourself when a SANE intends to testify against you: hire a good lawyer who knows how to question the SANE and object to their testimony when necessary, and potentially fight fire with fire by retaining your own SANE to testify to their own findings. The lawyers at Jetton & Meredith are well-versed in how to question and pick apart the reports made by a SANE. We can help you lessen the impact of the SANE’s testimony on the jury by thorough cross-examination. We will also object frequently and timely whenever a SANE makes statements attempting to bolster an accuser’s credibility.

We can also assist you in exploring options in retaining a SANE expert for the defense. There are reliable, experienced SANEs who believe in fair testimony at trial for both sides. While these experts can cost money to retain, their expertise can be invaluable to your defense. Many of these experts have taught SANE nurses, and allowing them to review the hospital records of the examination as well as the corresponding report from the prosecutor’s SANE can yield good results.

So if you find yourself charged with a sex offense and confused about what a SANE is or what they do, reach out to our attorneys as soon as possible so that we can help you fight their testimony in court and get you the fair trial you deserve.