Determining competency in the sexually assaulted patient: a decision algorithm

The determination of competency for decisions regarding one's care is of great individual importance as it represents a basic human right. Often, in Emergency Nursing, we are presented with situations that require difficult decisions that must be made in a brief time frame. The role of the Sexual Assault Nurse Examiner (SANE) in providing assessment and care to victims of assault is crucial to initiating the restoration of health and dignity of the patient in a tragic set of circumstances. Patients who present for SANE examination may have issues surrounding their capacity to make competent decisions regarding their assessment and care, further complicating an already tenuous situation. SANE nurses should be knowledgeable concerning competency and care issues and utilize a methodical process to guide their decision-making.