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Forensic Nurses: Save Lives, Solve Crimes

Long before the field of forensic nursing was officially sanctioned, nurses cared for crime victims by attending to their medical needs and took a stand for legal justice. Today, nurses who fill that role specialize in the field of forensic nursing. It is one of the fastest growing specialties in nursing and integral to assisting law enforcement agencies in solving crimes and helping victims of all kinds.

As the United States recognizes April as National Sexual Assault Awareness Month and National Child Abuse Prevention Month, the field of forensic nursing continues to grow. The International Association of Forensic Nurses (IAFN) calls the work “an essential component of healthcare’s response to violence and trauma.” Forensic nurses assist victims of intentional crimes that include physical and sexual assault, domestic violence, and child and elder neglect. They are experts in assessing trauma and violence and the psychological effect on victims. They are also responsible for collecting evidence for later use in court cases.

“When a person is violated, someone has violated their trust. Nurses, the most trusted health professionals, are the ones who are up close and personal with patients who are frightened, hurt, or ashamed. The nurse who is knowledgeable about forensic procedures can establish and maintain trust with the patient and collect important evidence that otherwise might be lost,” forensic nurse Paul T. Clements said.

At Duquesne University’s Master of Science in Nursing (MSN) forensic program, students learn about restorative and curative health practices in addition to investigative procedures that assist in legal proceedings. The American Nurses Association (ANA) said forensic nursing is “grounded in the rich bio-psycho-social-spiritual education of registered nurses and uses the nursing process to diagnose and treat individuals, families, and communities affected by violence and trauma, and the systems that respond to them.”

The Beginnings of Forensic Nursing

The roots of modern forensic nursing can be traced back to the role of sexual assault nurse examiner, a nursing program of study that was established in the 1970s to allow educated nurses examine sexual-assault victims in place of physicians. About the same time, nurse Virginia Lynch developed an interest in death investigations and forensic studies. By 1992, Lynch had developed an educational track for forensic nursing and played a role in creating the International Association of Forensic Nurses (IAFN) as a way for like-minded nurses to gather and share information. She became the group’s first president and continues to be a leader in the field. In 1995, the ANA’s Congress of Nursing Practice officially recognized forensic nursing as a sanctioned specialty.

“An experienced practitioner can provide critical assistance in identifying and analyzing social factors related to violence, murder, suicide, sexual abuse, disease, and criminal acts that threaten the lives of those who exist under destructive social conditions such as poverty and all its consequences,” Lynch said in a 2007 Egyptian Journal of Forensic Sciences article.

A Day in the Life of a Forensic Nurse

Every day, forensic nurses work in locations where medical intervention and the law intersect, including hospitals, prisons, and police departments. Forensic nurses work alongside law enforcement. They do not determine if a crime has been committed, but instead takes steps to collect and preserve evidence in advance of any future legal action. They are continuing to advance the response to violence and trauma.

“Increasingly, the United States and a significant number of other countries are turning to forensic nurse examiners with the expectation to augment the often insufficient resources that have resulted in the destruction of evidence, long delays in medical response time, the loss of human lives, and inadequate prosecutions,” Lynch said. “Among the core challenges that face health and justice providers are protection of the patient’s legal, civil, and human rights.”

The following are steps most forensic nurses take during the evidence-collecting process:

  • Record patient history – The first step is finding out any details about injuries that were sustained and relevant medical background. Record exact quotes from the victim for later use in court cases.
  • Take detailed photographs – Ideally, photos should be taken of wounds before they are treated. Make sure to identify all photos and injuries. Also, photograph associated clothing and accessories
  • Describe injuries – Clearly record details about the injuries including location and size. Use a body chart to identify the location of the injuries.
    Collect evidence – Physical evidence includes body fluids, fibers or hairs transferred from the perpetrator to the victim. Gloves should be worn when collecting evidence to avoid cross contamination.
  • Ensure a chain of custody – Forensic nurses must ensure all evidence and documentation is properly cataloged, stored, and protected. The chain of custody is the paper trail that shows accountability in the security of evidence.

Roles of Forensic Nurses

The primary focus for any nurse is life-saving interventions. However, when administering these interventions, forensic nurses ensure crucial evidence is not destroyed. According to the IAFN, there are several fields for forensic nurses:

  • Sexual assault nurse examiner (SANE) – Probably the most common field for a forensic nurse to assist victims of sexual assault. They primarily work in hospitals and rape crisis centers.
  • Nurse Death Investigator (NDI) – Nurse Death Investigators investigate causes of death and, in some cases, testify about the findings in court.
  • Forensic Psychiatric Nurse – They often work in prisons and jails with criminal offenders who have suspected mental illness or behavioral disorders.

Duquesne University Master of Science in Nursing program

Students enrolled in Duquesne University’s Master of Science in Nursing (MSN) program have an opportunity to specialize in forensic nursing. The collaborative program, coordinated with Duquesne University’s Cyril H. Wecht Institute of Forensic Science and Law, allows for a general nursing curriculum coupled with a focus on investigative techniques to assist in the legal process. The curriculum includes classes that focus on criminal law, pharmacology, healthcare ethics and healthcare administration.

Sources

  • Forensic Nursing http://c.ymcdn.com/sites/www.forensicnurses.org/resource/resmgr/Docs/SS_Public_Comment_Draft_1505.pdf?hhSearchTerms=%222015protect%20$elax%20pm%20$andprotect%20$elax%20pm%20$draft%22
  • Forensic Nursing: Part 1. Evidence Collection for Nurses http://www.medscape.org/viewarticle/571057
  • Virginia Lynch on Forensic Nursing http://www.sciencedirect.com/science/article/pii/S2090536X11000049
  • International Association of Forensic Nurses http://c.ymcdn.com/sites/www.forensicnurses.org/resource/resmgr/media/Forensic_Nurses_on_the_Hill_.pdf
  • Virginia Lynch http://www.forensicnurses.org/page/750/OTE-Volume-18-Number-2---Summer-2012-IAFN-Anniv.htm
  • Forensic Nursing Science and the Global Agenda http://www.medscape.com/viewarticle/565600_2
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