For several decades, Memorial Hermann has been a leader in advocating for victims of sexual abuse and assault throughout the Greater Houston area through their trailblazing SANE (Sexual Assault Nurse Examiner) Program. In addition to providing a personalized and compassionate care experience for this patient population, the program is committed to community partnerships and educational opportunities to share knowledge and resources both locally and nationally. In recognition of Sexual Assault Awareness Month, we sat down with Jamie Ferrell, RN, director of Forensic Nursing Services at Memorial Hermann Health System, and Dr. Sally Henin, chief of medical operations for Forensic Nursing Services at Memorial Hermann Health System, to talk about the critical role of SANE nurses and what sets Memorial Hermann’s forensic nursing program apart.

Q: What is a SANE nurse and how does someone specialize in this type of nursing?

Ferrell: SANE is an acronym for Sexual Assault Nurse Examiner, a designation awarded by the International Association of Forensic Nurses to nursing professionals who have qualifications to provide treatment to individuals through the lifespan who are victims of abuse or sexual assault. To become a SANE nurse and part of the forensic team at Memorial Hermann, we require you to be a registered nurse who has been practicing in that role for a minimum of two years. With that said, the program is open to any RN who meets that minimum criteria and has a desire to serve this special patient population. While the assessment skills in forensic nursing are crucial to this role, knowing and understanding the psychological and emotional aspects of this trauma is equally important, and we are able to provide our nurses with the education and skillset to excel in both areas. We do an individual assessment of each nurse coming into our program and then build their orientation and education specifically for them. We have Adult SANEs and Pediatric SANEs.

Q: In addition to their clinical roles, SANE nurses are also involved in advocacy and legal work. What does that entail? 

Ferrell: First and foremost, we are clinicians, but we also advocate for our patients on many levels and provide them with appropriate resources. We work closely with key community partners and stakeholders, including law enforcement agencies, judicial process teams and crime labs. A unique aspect of this role is that SANE nurses are often called to the courtroom to provide expert medical testimony and advocate on their patient’s behalf. In this profession, we play an important role in speaking out against sexual violence and abuse, not only for our patients, but also to help shape policy. It takes a lot of courage for our nurses to step in and help when they know that for every patient, there is a potential that they will be asked to speak at a trial about their nursing knowledge and what they did for their patient. For many nurses, this type of public speaking requires them to step far outside their comfort zone, but they are willing to do that because they are dedicated to meeting the needs of their patients in such a dark moment and to be that candle of light for them.

Q: Can you talk about the SANE program at Memorial Hermann and what sets it apart from other forensic nursing programs?

Ferrell: We have nurses that have come to us from other programs and from other states, and what we hear time and again is that our close collaboration with our medical director and physician teams is extremely valuable but also rare. SANE nurses are autonomous and critical-thinking clinicians available 24/7, but at Memorial Hermann, we know that we are never alone and always have our physician and leadership team just a text or phone call away. On top of that, I think the compassion we give each other and the energy and resiliency of support within our team is truly unique. We want the best outcomes for our patients and the strength of our team helps us achieve that.

Henin:  The collaboration between physician and nurse is so important, but I also want to say how proud I am that we are the longest running program in the Greater Houston area and of the commitment that Memorial Hermann has made to this vulnerable patient population for several decades. Not only do we provide the training and education to our nurses to become a sexual assault nurse examiner, but we also provide continuing education to our nurses so that we can continue to evolve and improve for our patients. We also provide education to individuals who are not necessarily pursuing a career in forensic nursing, including thousands of physicians, nurses, advanced practice providers, medical students, residents, nursing students, paramedics and individuals in law enforcement. That is a key and impactful aspect of our program. Ultimately, this is not a Memorial Hermann program—it is a community program.

Q: This is a highly specialized and sensitive career. What does it take to be a successful nurse in this field?

Ferrell: I would definitely say compassion—not only for the patients and their families, but also for yourself and for your team. Exhibiting resiliency and positive energy is so important. In addition, the level of competency needs to be extremely high when providing quality care from trauma to trial, including evidence collection and preservation, maintaining chain of custody and a personalized experience.

Henin: To add to that, as a physician leader, I am so appreciative of our nurses who have decided to step up and who are willing to undergo this intensive training and commitment to better care for these individuals who have been victims of sexual violence. The courage and commitment they exhibit is truly admirable, and they do it because they know these patients deserve it.

Q: Why is it critical to have SANE nurses?

Henin: As an emergency physician, it is incredibly reassuring to know that our patients have access to this kind of specialized care. SANE nurses are able to step away from their other duties and provide the patient with the time required in these circumstances. They can go at the patient’s pace; with these exams, sometimes gathering history can take over an hour. It is tremendous that this kind of expertise and care is available in our system.

Ferrell: Our SANE nurses focus first on making our patients feel safe and comfortable. We provide a refuge for patients. Not only is it important to have the dedicated time with specialized and knowledgeable staff, but a dedicated space also assures privacy. Memorial Hermann currently has dedicated rooms for these patients in nine facilities, which is exceptional. These patients may not have medically life-threatening injuries and their vitals may be stable, but we want to get them out of the waiting room as quickly as possible and into a private and safe space. It all comes back to compassion.