According to the Rape, Abuse & Incest National Network, out of 1,000 rapes, 995 rapists are never convicted. “I’m shocked more people aren’t charged,” said Sherry Shepard, a state-certified sexual assault nurse examiner (SANE) in North Carolina during a recent interview with North Carolina Public Radio.

During that interview, Shepard shared the process of the work she does with assault victims, which can include a 2- to 4-hour exam that requires compassion and patience. To become SANE certified, Shepard spent many hours with attorneys and law enforcement personnel and observed and performed multiple assault victim exams.

Nurses who are SANE certified have an opportunity to improve patient and legal system outcomes, and they can specialize to work with adolescents and adults (SANE-A) or pediatric patients (SANE-P). And in some states, the SANE role also has expanded to include providing care for patients affected by interpersonal violence, strangulation, torture, physical child abuse, child neglect, and elder abuse.