Forensic Nursing Overview
Registered Nurses practicing as forensic specialists is one of healthcare’s emerging roles. Societal trends, such as the rise in chemical dependency, inadequate behavioral health services, and other socio-economic pressures, give rise to increased criminal activity and violence. These trends increase the demand for professional manpower to gather evidence, address the needs of victims and their families and bring perpetrators to justice.
The registered nurse with specialized training in forensic medicine is an example of integrating the art and the science of nursing practice in some of the most stressful and challenging circumstances. The science of nursing in the forensic space is demonstrated by the nurses’ provision of the following services:
- Precise psychosocial and physical assessments
- Expert collection and recording of data
- Great attention to detail (observations and findings)
- Strict adherence to evidence-based protocols
- Evidence-based data analysis
- Evidence-based treatment is based upon established protocols and collaboration with the medical team.
Of equal importance, the forensic nurse must be able to demonstrate the following skills commonly associated with the art of nursing:
- Superb interpersonal skills, including objective listening, skillful questioning, and therapeutic touch.
- Maintaining a professional demeanor under stressful circumstances.
- The ability to demonstrate compassion and empathy.
- Building therapeutic relationships with victims and families.
- Provision of education related to legal rights and community resources.
- Provision of education related to treatment plans, treatment options and follow-up.
- Developing collaborative relationships with the treatment team, legal authorities (including law enforcement) and community resources.
What Does a Forensic Nurse Do
When a patient presents to a treatment facility under suspicion of a crime, a forensic nurse becomes an integral member of the treatment team. The forensic nurse engages the treatment team, law enforcement (if present), the patient, and other witnesses to gather relevant background information.
Attention is then focused on the victim as physical and psychosocial assessments are completed. The nurse is responsible for the precise gathering of physical evidence in the form of clothing, potential sources of physiologic evidence and DNA, including but not limited to blood samples, tissue samples, vaginal/rectal swabs and photographs.
The collection and recording of these samples require precision to ensure that evidence is not lost, contaminated, or disrupted during the investigation. Upon completion of the data collection, the forensic nurse is responsible for concise and accurate documentation and ensuring a sound chain of custody of all collected materials.
Finally, the forensic nurse ensures the treatment team knows pertinent data that may impact the treatment plan. The nurse also provides the patient/family with resources for protective services, social services and legal assistance and offers advice related to follow-up care.
How Do I Become a Forensic Nurse
While advanced forensic nursing roles may require a master’s degree, entry-level positions in forensic nursing, such as a Sexual Assault Nurse Examiner (SANE), can be pursued with a Bachelor of Science in Nursing (BSN) and additional certification. These programs are available via in-person, online and hybrid modalities. Admission to a master’s program in nursing generally requires a Bachelor of Science in Nursing (BSN), a passing score on the NCLEX-RN exam to obtain RN licensure, and relevant nursing experience, with specific requirements varying by program.
The role of ‘Nurse Coroner’ is not widely recognized as a standard forensic nursing role across all states and may vary significantly in responsibilities and requirements; instead, forensic nurses can work closely with medical examiners and coroners but typically do not assume the title of ‘Nurse Coroner. In this role, forensic nurses are trained to assist medical examiners in the gathering of evidence at the scene of homicides, suicides and accidents. The nurse coroner also assists in gathering forensic evidence through autopsy. This role requires additional training beyond the master’s level and varies from state to state.
Some practicing nurses may choose to pursue SANE certification. Most states offer SANE certification programs to RNs pursuing a forensic career path. The SANE certification focuses on providing care to sexual assault survivors and requires specific training and clinical experience in forensic examination; it does not limit a nurse’s practice but rather specializes it within forensic nursing. A graduate-level education is not a prerequisite for SANE certification. Despite its focus on a segment of the broader patient population served by forensic nurses, many of the roles and functions described above apply to the SANE-certified RN. (1)
Is Forensic Nursing Good for Me
Forensic Nursing is one of many specialties included as advanced nursing practice. The average starting salary for advanced practice nurses across the nation is $118,000, according to the US News.
As a registered nurse contemplates pursuing a career path in forensic nursing, the following factors should be taken into consideration:
- The role demands precision and a passion for detail.
- Forensic work requires a keen interest in the legal and law enforcement fields.
- Forensic nurses must be able to adjust to dynamic, demanding schedules resulting from being on-call, being deposed, and testifying in court proceedings.
- Emotional fortitude and physical stamina are essential characteristics of forensic nurses.
- Forensic nurses can be employed in a variety of settings, including hospitals (particularly in emergency departments and special sexual assault examination programs), community anti-violence programs, coroner and medical examiner offices, and law enforcement agencies. Employment is not limited to state and/or local municipalities.
- In addition to interfacing with traditional healthcare team members, forensic nurses must become comfortable with developing relationships with public officials, law enforcement personnel, attorneys and the judicial system.
In conclusion, the field of forensic nursing is challenging and rewarding. It demands full actualization of both the art and science of nursing practice. As a nontraditional role, the forensic nurse can find a great deal of satisfaction in impacting the lives of victims in challenging circumstances and contributing to the justice system. It is a truly unique and exciting role with an exciting future.
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