February's From the Experts: Diana Faugno

Greetings, everyone. This year, we've decided to bring back the "From the Experts" section to our monthly newsletter. If you're already a recipient of the newsletter, you might have already read the first section of Diana Faugno's exemplary essay on conducting effective interviews with victims of abuse and you're anxious to complete it. If you're not currently receiving the newsletter, you may remedy that no-no by simply entering your email address in the newsletter bar on the homepage. In addition to keeping you current with all the insight offered by these experts, doing so will allow you to keep abreast of all the exciting events happening at G.W. Medical.

Without further adieu, here's the article written by Diana Faugno, MSN, RN, CPN, SANE-A, SANE-P, FAAFS from End Violence Against Women International:
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As a sexual assault nurse examiner, I often find myself on a search for the best way to ask questions when gathering the history from a patient who has reported a sexual assault. Based on one’s documentation form, there are very specific questions that will need to be asked with answers documented by the examiner. It is imperative that a SANE understand his or her form and the order of the questions that will be asked during the history gathering time with the patient. Starting with some general health questions provides an opportunity to find out more about the patient’s health and life style. For example, “Tell me, what medications or pills do you take daily?” Many times, patients will not hear or understand the question that you are asking, so the information must be presented in another way. For instance, when I ask the questions about daily medications, many young women will answer they do not take anything. When I inquire about what they do for birth control, however, they will reply by saying that they take a birth control pill. So, it is important to remember to ask many of the questions in another way.


After the introduction and general health questions, typical openings are “Why are you here today?” or, “Tell me about what happened to you.” These open-ended questions allow the patient to tell the interviewer about what might have happened to them. These are good questions that allow a SANE to state that he or she let the patient first explain about the event that happened to them before the interviewer begins the very specific questions about penetration or the specific violence. Some patients will want to immediately tell the interviewer about the event before he or she has a chance to begin with the general health questions. Allowing the patient to direct the interview out of the typical order of questions is fine. If an examiner does not allow this or shuts the patient down, the victim may not disclose all the information. After the patient has completed detailing his or her event, the examiner will go back and ask the specific questions. Again, keep in mind that the questions will have to be asked in several ways, as the patient may not understand the terminology. The question about strangulation is a good example of this, as many people do not fully understand this word. They might, however, understand the following inquiry: “Did he put his hands or feet on your neck or throat? Show me how he did this.” Many times, the patient will not express his or her feelings or what might have caused action or inaction. I find it is always helpful to inquire about what they were feeling when this was happening. For example, use direct quotes, such as, “I did not say anything,” “I was scared he would hurt me,” or, “I just did not know what to do.” Some patients may not have any history as well, exemplified by the following common statement: “I do not remember much of what happened.”


Establishing closure with the patient is important before beginning the examination. Asking the patient whether there was anything that he or she believes was not covered in the interview that they would like to expand upon is good way to to finish the interview. This also provides for the patient another opportunity to disclose anything that is important but was not asked or discussed. The examiner will typically close by stating, “That is all the questions that I have for you now. We will start your examination.” Please do not forget that the examiner will have another opportunity to clarify items that might be vague or need more clarification during the examination. An example of this would be saying, “I did not understand what happened after you went into the bedroom. Can you please tell me again about that?”


Completion of the report will provide the documentation of the history and evidentiary examination of this patient. Usually, the criminal case process takes a year or longer. Independent recollection of this event is very difficult for examiners as we see many patients. A key point is to ensure that documentation is legible. Also remember that the history obtained by the examiner is for the purpose of knowing where on the body to look for evidence. With these methods and tips in mind, every sexual assault nurse examiner should be able to conduct an effective and sensitive interview.

1. Lyon, T. Interviewing Children: Getting More With Less; 2009. http://law.usc.edu/contact/contactInfo.cfm?detailID=232. Accessed February 9, 2009.

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We at G.W. Medical Publishing would like to initiate some discussion with these new "From the Expert" sessions. If you're a professional working in a similar discipline who wishes to offer some additional information on the subject, a customer desiring to learn more about the topic, or merely a wayward web wanderer wanting someone with whom to chat, please feel free to make liberal use of the comment option. With an open discussion between members of the general community, a network of awareness would be created and the eventual elimination of child and family maltreatment would become a little closer to hand.

If you'd like to write a "From the Experts" section in a subsequent month's newsletter, please feel free to send me, Johnny Gabbert, an email at john@gwmedical.com. I would be pleased to hear from you!