Having worked as a Registered Nurse (RN) for twenty-five years, Amanda comes to us with decades of experience in public and women’s health. Her passion for treating and educating women of all ages led to her desire to become a Sexual Assault Nurse Examiner (SANE), which she has been trained in since 2020. We are incredibly lucky to have Amanda as a member of our multidisciplinary team at Heroes Landing. 


Q&A

Question: What drew you to the work at Heroes Landing?

Many of the adult women and adolescents I work with as a nurse practitioner have had sexual abuse in their past, and there are still repercussions of the abuse years, even decades, later for them regarding their health and wellness. I was drawn to the model of Heroes Landing because it is very child centered, offers a home-like environment, and provides resources that can help survivors live the lives they deserve. While we cannot change the past, we can empower them with their futures.


Question: Can you explain how a child survivor of abuse interacts with you at their Heroes Landing appointment? 

After being interviewed by a forensic interviewer, they will come into my exam room. It looks a lot like most pediatric offices, so it should be a somewhat familiar environment and hopefully makes them feel like they are going to be safe and taken care of.  

We start out by talking. I sit down and don’t hover over them or rush them. We might talk about the characters on their shoes or the band on their shirt. I aim to make the environment peaceful and safe. I explain to them that they are in control of the room and in control of their bodies. They are allowed to decline any part of the exam. Knowing this gives them bodily autonomy and permission to take care of themselves. 

Then we talk. I explain that I am there to make sure they are healthy and to help them if they are hurt, and that I will be checking them from head to toe. Most importantly, I ask permission before touching them or assessing anything on their body. I start with a weight and height check, then vital signs, and then a picture of them that they usually want to take with my push button or voice-controlled camera. 

After the complete exam, we work on questions they may have and on education with the child and their caregivers. This education can be from hygiene and childhood vaccines to puberty and the stress of being a teenager. We have books and handouts to help them after they leave and go home.

 

Question: How might it be different than a regular medical check-up?

Pictures are not a usual part of a pediatric exam but are necessary for the peer review process and to assess healing over time with certain cases.  We also probably talk longer than a regular checkup, but the length doesn’t seem to bother them once they feel comfortable.  

 

Question: Noting the credentials you hold as a nurse (the acronyms after your name), how specialized or needed is SANE training?  

Performing a sexual assault exam is not included in general nursing education, which is not enough to prepare a nurse, even an experienced one, to do the job correctly. My master’s degree in Women’s Health, while rigorous, did not offer the breadth of knowledge my SANE training has given me. 

The SANE A—which is for adults and adolescents—is at least 40 hours of classroom work. The SANE P course, which is specifically for pediatric victims, was 42 hours for me. This is all classroom work and doesn’t include observing clinical exams from experienced peers.  I continue to work on improving my skills and knowledge, having just finished a 16-hour clinical course for SANE A at Duquesne University’s forensic nursing program this past June. I hope to sit for my certification exams for both SANE A and SANE P in the next 3-5 years. There is always more we need to know!

 

Question: How do you prepare for the tough conversations you may need to have with adolescents and kids?

Years of nursing has helped me be with people at their most vulnerable times. I find that if I make myself small and am quiet and calm, they can open up and show me who they are. I can then take their lead and be silly or serious chatty or quiet—whatever they need. It takes time to learn how to read a room quickly and provide the patient with what they need, but nurses do this every time they enter a new room. We adapt to what the patient needs to achieve the level of care they deserve. 

Over the years I have learned to start the tough conversations simply, and to not use twenty words when 10 will do.  Be direct, be kind, don’t rush, be empathetic. Sometimes you just sit with them in the quiet until they are ready to talk more. I want them to feel seen and heard and to know they are safe with me.