Forensic Nurses: Understanding PTSD

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forensic nurses care for victims of violent crimes and collect evidence to use in criminal proceedings

Forensic nurses work closely with victims of violent crimes, providing compassionate medical care while collecting evidence to bring perpetrators to justice. Within the scope of their work, forensic nurses must be prepared to identify signs of post-traumatic stress disorder (PTSD) and help victims as they navigate the difficulties that come with the diagnosis.

PTSD symptoms can start days, weeks or years after experiencing or witnessing traumatic events and can manifest in several ways, including distressing and unwanted memories, mood changes, sleep disruptions and angry outbursts. In treating crime victims, forensic nurses should look to identify signs of PTSD as a result of recent and past events.

“Because these symptoms are pervasive and may reappear throughout one’s lifetime, the survivor may become paralyzed in a type of emotional stalemate by the loss of their pre-trauma identity,” Jennifer Mora, RN, wrote in “PTSD – The Application of Forensic Nursing” on the International Association of Forensic Nurses (IAFN) website. “It becomes critical, then, to understand symptoms, causation and the steps to recovery in order to treat PTSD victims in crisis.”

In helping crime victims, forensic nurses, including those who work as sexual assault nurse examiners (SANEs), need an education that connects the compassion of nursing with understanding for PTSD care. Through online master’s in nursing degree programs, aspiring forensic nurses learn the essential elements to help people living with PTSD.

Understanding PTSD

PTSD was first recognized in 1980 in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Before then, the disorder was thought to be exclusive to combat veterans who were overwhelmed by the traumas of war.

Researchers now know the disorder can impact anyone who experiences, witnesses and, in some cases, is involved in traumatic events. Trauma is described in several ways, including:

Direct trauma

When a victim experiences or witnesses a traumatic event firsthand, the victim is subjected to direct trauma.

Indirect trauma

Also known as vicarious trauma, indirect trauma occurs as a result of second-hand trauma exposure. Healthcare workers, including nurses, can be victims of vicarious trauma as a result of working closely with crime victims.

Acute trauma

Acute trauma occurs after exposure to a single event, such as a car crash, natural disaster or violence.

Complex trauma

Complex trauma results from being exposed to multiple traumatic events, such as ongoing child abuse, domestic violence or combat-zone situations

Repetitive trauma

Repetitive trauma occurs when an individual is subjected to the same traumatizing event repeatedly.

Developmental trauma

Developmental trauma concentrates on the impact of child abuse, including physical abuse and neglect, throughout a lifetime.

Intergenerational trauma

Also called transgenerational trauma, intergenerational trauma impacts cultural groups or generations of families. Examples of intergenerational trauma include racism and genocide.

In addition, individuals can be exposed to a variety of traumatic experiences, each of which requires different types of interventions. Some more common types of traumatic experiences include:

  • Military combat
  • Car accidents
  • Death of a loved one
  • Natural disaster
  • Serious injury or illness
  • Terrorism
  • Sexual abuse
  • Physical abuse
  • Community violence
  • Early childhood (through age 6) trauma
  • Sexual abuse or assault
  • Witnessing violence

Research shows that exposure to trauma, particularly trauma that occurs in childhood, is associated with ongoing behavioral and physical conditions. Trauma is linked to substance abuse (cigarette smoking and recreational drug use), mental health problems (ongoing depression and suicidal ideation) and risky behaviors (unsafe sexual encounters and self-injury).

The Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health & Human Services, said anyone could experience trauma that triggers PTSD. While some people can move on from traumatic experiences without lasting impacts, others suffer from ongoing problems.

“Because these behavioral health concerns can present challenges in relationships, careers and other aspects of life, it is important to understand the nature and impact of trauma and to explore healing,” the SAMHSA said.

The deep-rooted medical and physical health concerns also underscore the need for forensic nurses to learn the best ways to provide aid to those who are suffering as a result of trauma.

Forensic Nurses Helping People with PTSD

When a forensic nurse works with a crime victim, the nurse’s first responsibility is to use the nursing process for compassionate, holistic care, Julie L. Valentine, PhD, RN, said in American Nurse Today. At the same time, forensic nurses must focus on collecting evidence for use in criminal proceedings and helping victims cope with the trauma of the events.

“They address the bio-psycho-social-spiritual needs of patients affected by violence and trauma to promote physical and psychological health and recovery. Additionally, forensic nurses use proper evidence documentation, collection and preservation practices to ensure optimal analysis findings,” Valentine said in “Forensic nursing: overview of a growing profession.”

Forensic nurses help victims navigate the emotions that come with trauma early on by providing a safe and comfortable environment and asking victims for permission to provide care. Mora, the author on the IAFN website, said asking permission gives some power back to the victim who may feel, among other things, helpless and frustrated.

Mora went on to say forensic nurses play a crucial role in the many stages of PTSD care:

  • In many cases, forensic nurses are the first providers to hear the victim’s description of the events. During this early process of remembrance and mourning, the victim may also express vulnerability. Forensic nurses help victims by acting as support and witness to their story, which aids in the healing process.
  • Forensic nurses can help survivors better understand and handle ongoing PTSD symptoms by providing resources for care.
  • Forensic nurses can present law enforcement with evidence in criminal cases that may lead to arrests and provide victims with peace of mind.

“With each step of recovery and with the reality of relapse, the forensic nurse may encounter a patient at any stage and be cognizant of a patient’s danger to oneself and, possibly, to others,” Mora stated.

Overall, forensic nurses help crime victims from the very moments after an assault, so they play an integral role in survival and healing. For RNs who want to help crime victims, working as a forensic nurse provides a bridge between healthcare and the criminal justice system. To become a forensic nurse, RNs must earn a master’s in nursing degree that offers opportunities to learn about nursing and PTSD and nursing terminology.

At Duquesne University, BSN-educated RNs have an opportunity to earn an advanced degree in forensic nursing through the online master’s in nursing program. Duquesne University also offers an online post-master’s certificate in forensic nursing for RNs who already have an MSN degree.

Learn More About Duquesne University’s Online MSN in Forensic Nursing

Duquesne University’s forensic nursing program has garnered national attention for its dedication to melding nursing and criminal justice. The program operates in partnership with the university’s Cyril H. Wecht Institute of Forensic Science and Law.

RNs who graduate from Duquesne University’s MSN in Forensic Nursing online program work as sexual assault nurse examiners (SANEs), forensic nurse investigators, nurse death investigators and expert witnesses. The program also provides opportunities for students to add a concentration in nursing education or transcultural nursing.

Duquesne University has been a pioneer in forensic nursing education and is one of the few universities to offer this increasingly in-demand specialty. For more information about the programs, contact Duquesne University today.




PTSD: Mayo Clinic

PTSD — The Application of Forensic Nursing: IAFN

Post-Traumatic Stress Disorder (PTSD): NIH

Categories of Trauma:

Types of Trauma: Your Experiences Matter

A Close Look at PTSD Among Aging Adults: Senior Living

Trauma Types: The National Child Traumatic Stress Network

Trauma and Violence: SAMHSA

Forensic nursing: Overview of a growing profession: American Nurse Today