Podcast Summary: Something Was Wrong

S25 Ep12: Trauma-Informed SANE Exams with Kayla Hartman

Host: Broken Cycle Media
Guest: Kayla Hartman, MSN, RN, FNP-BC, NYSAFE
Release Date: March 3, 2026

Episode Overview

This episode delves into the world of Sexual Assault Nurse Examiners (SANE) with expert guest Kayla Hartman, a certified SANE nurse based in New York. The discussion centers on the mechanics and importance of trauma-informed care during forensic exams for survivors of sexual violence and related crimes. Kayla provides a compassionate look at the SANE role, demystifying the exam process, and offering crucial advice for survivors, their supporters, and anyone interested in understanding this essential field of forensic healthcare.

Key Topics & Insights

What is a SANE Nurse? (02:31–03:52)

• Definition: SANE nurses are registered nurses with specialized training in forensics and trauma-informed care, primarily caring for survivors of sexual violence, but also supporting those who experience domestic violence, human trafficking, elder abuse, and more.
• Quote:

  "We're nurses first beyond all else... but Sexual Assault Nurse Examiner is someone who has specialized training in forensics as well as trauma-informed care."
  — Kayla Hartman [02:43]

Kayla’s Journey to Forensic Nursing (04:02–06:35)

• Inspiration: Personal connection to survivors of violence and desire to be an immediate source of support.
• Background: Started in nutrition, switched to nursing, then gravitated to SANE after discovering the training opportunity.
• Quote:

  "Helping victims make the transition mentally into that of a survivor."
  — Kayla Hartman [04:26]

SANE Training & Principles of Trauma-Informed Care (06:35–10:54)

• Training: 40-hour course (didactic + clinical), learning trauma-informed approaches, legal aspects, and medical/forensic processes.
• Six Principles: Safety, trustworthiness/transparency, peer support, collaboration/mutuality, empowerment/voice/choice, addressing cultural/historical/gender issues.
• Quote:

  "My goals are whatever the patient's goals are, but it's my responsibility to inform them of their choices and empower them to make the choice that feels most aligned with their goals."
  — Kayla Hartman [08:48]

SANE Programs’ Availability (10:54–12:02)

• SANE programs are not universal in the United States; more widespread in New York due to state mandates, less so in rural areas.

What to Expect: The Exam Process (12:02–16:37)

• First Steps: Survivor triaged in ER, prioritized for safety, referred to on-call forensic nurse.
• Consent: Exams and “rape kits” are always optional.
• Reporting: No police report required for medical care except when mandated (e.g., minors).
• Consent vs. Assent: Assent is permission from someone unable to give legal consent (minors, intoxicated, or developmentally challenged), required for exam to proceed.
• Quote:

  "The rape kit is entirely optional. No one can ever be forced into doing one."
  — Kayla Hartman [15:07]

Rape Kit: What It Is and How It Works (17:18–22:20)

• Contents: 15-step kit; swabs, envelopes for evidence collection (saliva, fibers, hair, bodily fluids), all steps optional.
• Time Window: Best within 96 hours but can be done later.
• Showering/Changing: Not a disqualifier for evidence collection.
• Quote:

  "It sounds much scarier than it is... It's a head-to-toe assessment of a survivor's body and making sure we are collecting evidence along the way."
  — Kayla Hartman [17:23]

Chain of Custody & Financing (22:20–23:09)

• Custody: Forensic examiner maintains evidence until secured or given to law enforcement (if survivor chooses to report).
• Labs: In NY, kits run via a crime lab, only if there's an associated police report.

Survivor Experience: Pain, Reactions & Emotional Barriers (23:12–27:46)

• Pain: Can be uncomfortable; consent sought at every step; pelvic exam not always required.
• Emotional Reactions: Wide range—crying, laughter, flat affect; all are normal.
• Barriers: Denial, fear of hospitals, medical trauma, and historic/systemic inequity (especially for marginalized groups).
• Quote:

  "There's no right or wrong way to react to trauma. It's a very individual experience."
  — Kayla Hartman [25:25]

SANE & Law Enforcement Collaboration (27:46–29:04)

• SANE nurses act as advocates, can interrupt and reframe inappropriate police questions, and provide only what evidence is consented for/arises from legal process.

Supporting Survivors: Advice for Loved Ones (29:04–30:44)

• Show Up: Be present, listen, don’t push agendas, help absorb information.
• Quote:

  "Supporting them through that... being there as an extra set of ears and eyes can be really helpful as well."
  — Kayla Hartman [30:30]

Skills for SANE Nurses (30:44–33:08)

• Nonjudgment, advocacy, separating bias, active listening, adaptability, humility, and authenticity.

Patient’s Rights & Empowerment (42:58–44:35)

• Survivors have the right to request a new examiner and set boundaries. Nurses encourage empowerment, collaboration, and sensitivity to cultural context.

Particulars: Male Survivors & Exam Length (44:35–47:30)

• Approach: Individualized care regardless of anatomy or gender; education and empowerment are central.
• Time: Exams can be lengthy due to medical needs, logistics, interruptions, and the need for breaks and careful pacing.

Aftercare, Costs, and Legal Follow-up (39:55–41:51)

• Cost: In NY, rape kits and associated care are state-funded with signed consent.
• Follow-Up: STI testing recommended at 3, 6, 9 months; trauma counseling referrals often provided.
• Testifying: SANE nurses may testify if cases go to trial, though this is rare.

Self-Care for SANE Nurses (47:30–48:53)

• Balance: Energizing but heavy work. Peer support, decompression activities (e.g., hot yoga, TV), and healthy boundaries are key.

Notable Quotes & Memorable Moments

• "Helping victims make the transition mentally into that of a survivor."
  — Kayla Hartman [04:26]

• "The rape kit is entirely optional. No one can ever be forced into doing one."
  — Kayla Hartman [15:07]

• "There's no right or wrong way to react to trauma. It's a very individual experience."
  — Kayla Hartman [25:25]

• "My goal is to offer them as many choices going forward as I can that will bring them back to a point of empowerment and feeling like they're back in control."
  — Kayla Hartman [37:34]

• "You are the expert of you and you’re helping me navigate... Ultimately it is collaborative."
  — Kayla Hartman [31:30]

Timestamps for Important Segments

• 02:43 – What is a SANE nurse?
• 04:02 – Kayla’s pathway into forensic nursing
• 07:36 – Trauma-informed care principles
• 12:08 – What typically happens when a survivor comes to the hospital
• 15:07 – Consent for rape kit exams
• 17:23 – Step-by-step breakdown of the rape kit process
• 23:12 – Pain and discomfort in the examination
• 25:21 – Trauma responses during exams
• 27:52 – SANE and law enforcement collaboration
• 29:26 – How to support survivors
• 30:53 – Key skills for SANE nurses
• 36:22 – How the public and juries should view SANE exams
• 40:02 – Costs and insurance for the rape kit exam
• 41:14 – Recommendations for follow-up care
• 43:24 – Patient rights and requesting a new examiner
• 45:40 – Why exams can take a long time
• 47:41 – SANE nurse self-care

Final Thoughts

Kayla Hartman’s expert perspective shines a light on the critical role of SANE nurses, emphasizing empathy, consent, and survivor autonomy throughout the forensic exam process. The episode provides clear, actionable insights for survivors, supporters, and professionals alike, breaking down both the practical and emotional aspects of seeking and providing trauma-informed care.

Connect with Kayla:
Kayla offers her LinkedIn and Instagram for professional connections (links in episode notes).

Host's Closing Words:

"When we're informed, that helps break down a lot of barriers for us... It certainly helps us feel more confident going into a situation."
— Host [36:42]