What are SAFEs?

Commonly referred to as ‘Rape Kits’ and full of misconceptions, a Sexual Assault Forensic Examination, or SAFE, is a medical examination following sexual assault. SAFEs are performed by a certified Sexual Assault Nurse Examiner; a registered nurse with additional training to examine patients after sexual assault or strangulation. 

When people think of SAFEs, they often think of medical staff swabbing for DNA. Biological evidence (swabs) are only one of the three types of evidence a nurse collects in a SAFE. The most important evidence a nurse collects is the survivor’s oral history of the assault. The nurse also collects visual evidence (photographs, drawings, and verbal descriptions). Sometimes survivors refuse parts of the exam, often due to trauma, fear, or being overwhelmed from the recent assault. Even when survivors decline a portion of the exam, there are still plenty of ways for the nurse to collect evidence should the survivor choose to proceed with legal consequences. 

Common Misconceptions about SAFEs

It’s a common misconception, even by hospital staff and law enforcement, that there’s no evidence to collect after 120 hours (5 days). While biological evidence (swabs) can’t be collected, a survivor’s oral history of the assault can be captured as evidence in a chronic exam. Sometimes survivors can’t get an exam within 5 days; kidnapping, legal status, custody disputes, injury, incarceration, and safety concerns are just some reasons for delays in examination. Chronic exams provide valuable evidence collection after 120 hours that can support a survivor if they choose to proceed with legal prosecution. 

Law enforcement and hospital staff often recommend the survivor not eat, drink, wash their teeth, body, hands, or genitals, or use the toilet in fear of ruining biological evidence. While these actions potentially can remove biological evidence it should not discourage a survivor from seeking an exam if they have already done one of these things. The SAFE nurse and assault advocate treat the patient as a whole person, instead of a crime scene. The survivor has already experienced a traumatic event, the nurse and advocate do not want the forensic exam to create additional trauma. 

Speaking of creating additional trauma, a major misconception is the inherent trauma of a sexual assault or strangulation exam. The nurse and advocate work very hard for the experience to be supportive of the survivor’s needs. Survivors are encouraged to decline any part of the exam they are uncomfortable with and are assured that there are many ways to collect evidence. If a speculum or a photograph will be too triggering for the patient- we always respect that. The exam can be a big first step in the healing process, a happy byproduct of the nurse and advocate centering and supporting survivor’s needs. 

SAFEs and Law Enforcement

Recent legal reform in Texas has made it easier for survivors to get exams they have needed. Law enforcement no longer required to preapprove SAFEs. SAFE nurses report an increase of SAFEs, especially for strangulation and chronic exams. Law enforcement is still available for survivors wanting to report their assault, but there isn’t a requirement of police presence. This can make SAFEs feel more accessible for survivors that are unsure if they want to proceed with a criminal investigation. 

In a sexual assault or strangulation exam, patients can expect to have their story heard, their experience believed, and their needs supported. Increased awareness and reduced restrictions have made SAFEs more accessible for survivors during their time of need, despite the common misconceptions we hope to dispel. 

Authors

  • Claudia Menchaca

    Claudia Menchaca is the Caldwell County Prevention Educator at the Hays-Caldwell Women's Center. They've taught many subjects over the years, but currently focus on healthy relationship skills for teens. They like chickens, snakes, bugs, and aquatic plants. Their hobbies include including visiting the river, reading, hosting movie nights, and being neighborly.

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  • Noella Hill, RN CA/CP SANE