Working with Children in the Foster Care System

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forensic nurses are often among the first medical professionals to interact with children in the foster care system

When children are placed in foster care, forensic nurses are often among the first medical professionals to interact with them and implement best practices for their well-being. As foster care nurses, forensic nurses are entrusted with the health and safety of some of the most vulnerable individuals in the United States.

Forensic nurses working with the foster-care system understand how the legal system and the child welfare system work together to cooperatively address the needs of children who have suffered trauma or loss. Forensic nurses have extensive knowledge of the healthcare needs of children who have been exposed to trauma including sexual abuse, violence and neglect. Overall, forensic nurses work for and with children in the foster care system to ensure their comfort and security.

“All forensic nurses, especially those working in pediatric settings, need to be advocates for children in foster care. A thorough understanding of their unique healthcare needs is essential for the forensic nurse,” researchers said in the Journal of Forensic Nursing. “Pediatric forensic nurses in advanced practice positions are uniquely prepared to meet not only the physical and mental health needs but also the forensic needs of children in foster care.”

Indeed, forensic nurses work in support of children, adults, individuals and families.

An essential element to working with children in the foster-care system is having an education, whether it is through a traditional Master of Science in Nursing (MSN) program or an online master’s in nursing that supports the critical work of forensic nurses.

Forensic Nurses Address the Needs of Children in the Foster Care System

On any given day in the United States, about 440,000 children are in the foster care system, the U.S. Department of Health and Human Services said.

Often these children enter the system as a result of neglect, but many other reasons, including parental drug abuse, physical abuse, behavioral problems and abandonment, can result in foster placement as well. The American Academy of Pediatrics (AAP) said youth in the system are at high risk for chronic and persistent physical, emotional and developmental difficulties due to the cumulative effects of adverse life events.

“Children and adolescents in foster care are a discrete population with more intensive service needs than the general pediatric population or even other children who are poor,” the AAP said in Fostering Health.

When forensic nurses interact with children in the system, they perform physical exams and document evidence that might indicate a crime. Many of the procedures and protocols they follow depend on state and local laws.

In cases of physical abuse, the National Children’s Alliance recommends that providers look for indicators that include bruising on the torso, ears, neck (called TEN-4 bruising) in children under age 4 or any injuries in infants under 4 months old.

To document possible problems, forensic nurses take note of the child’s medical, social and developmental history. An examination can include photo documentation of skin injuries, lab work and radiological tests including CT and MRI scans.

Many forensic nurses are also certified as sexual assault nurse examiners (SANEs), so they can collect evidence that may later be used in legal cases. In performing a sexual assault forensic exam, also called a rape kit, SANEs are also trained to assess and treat injuries, test for sexually transmitted disease and pregnancy, and provide emotional support.

Forensic nurses also offer emotional support to children as they enter and go through the foster care system. Researchers in the Journal of Forensic Nursing said children experience significant trauma when they are removed from their homes. They are separated from their family and friends and often feel abandoned.

Forensic Nurses as Child Advocates

The Journal of Forensic Nursing also said forensic nurses are positioned to act as advocates because of their connections in the community. Some of the advocacy work should include supporting the formation of programs to help children in the foster care system, researchers in the journal said.

“Forensic nurses are innovative care providers; they have revolutionized the care of the sexual assault/abuse victim. This spirit of innovation can assist the pediatric forensic nurse in changing the healthcare system to better meet the needs of children in foster care,” Journal of Forensic Nursing researchers said. “Advocacy at the local, state, and national levels for legislation, programs and policies that show recognition of the healthcare needs of children in foster care allow for the development of interventions that support meeting these needs.”

To work as a forensic nurse in any capacity, including in pediatrics or advocacy, registered nurses (RNs) must earn a Master of Science in Nursing (MSN) degree and become an advanced practice registered nurse (APRN).

At Duquesne University, RNs have an opportunity to earn an online MSN degree in forensic nursing or, for those who already have an MSN degree, a post-master’s certificate in forensic nursing.

The university’s forensic nursing program operates in partnership with the Cyril H. Wecht Institute of Forensic Science and Law, providing nursing students with access to some of the nation’s leading experts in forensic science and law.

About Duquesne University’s Online Master’s in Nursing in Forensic Nursing

Duquesne University’s MSN in Forensic Nursing online allows RNs to continue working in their current positions while preparing for the advanced responsibilities of forensic nursing. A pioneer in forensic nursing education, Duquesne is one of the few universities to offer this increasingly in-demand specialty.

Graduates can go on to work as SANEs, forensic nurse investigators, nurse death investigators and expert witnesses. The program also allows students to add a concentration in nursing education or transcultural nursing to the coursework. For more information about the programs, contact Duquesne University today.



Children in Foster Care: What Forensic Nurses Need to Know: Lippincott

The AFCARS Report: HHS

Fostering Health Book: AAP

Child Physical Abuse: A Guide to the CAC Response: National Children’s Alliance