Brigham Young University BYU ScholarsArchive Faculty Publications 2018-12 Forensic nursing: Overview of a growing profession Julie L. Valentine Brigham Young University - Provo, [email protected] Follow this and additional works at: https://scholarsarchive.byu.edu/facpub Part of the Other Nursing Commons BYU ScholarsArchive Citation Valentine, Julie L., "Forensic nursing: Overview of a growing profession" (2018). Faculty Publications. 5218. https://scholarsarchive.byu.edu/facpub/5218 This Peer-Reviewed Article is brought to you for free and open access by BYU ScholarsArchive. It has been accepted for inclusion in Faculty Publications by an authorized administrator of BYU ScholarsArchive. For more information, please contact [email protected], [email protected]. Career Sphere Forensic nursing: Overview of a growing profession By Julie L. Valentine, PhD, RN, CNE, SANE-A the United States more victims are reporting the crimes • to receive forensic medical examinations by sexual as- Combine your nursing skills with sault nurse examiners (SANEs). forensic science to help victims of Many healthcare personnel and nurses are familiar with SANEs but may not realize that forensic nursing violence and trauma is a much broader nursing specialty that encompasses caring for patients who’ve experienced all kinds of vi- IN THE CURRENT ERA of the #MeToo movement and olence and trauma. prominent sexual assault disclosures, these types of crimes are finally receiving the attention they deserve. Forensic nursing scope and specialties Our society is acknowledging what research has been Forensic nursing combines nursing care with the legal telling us for years about the high incidence of sexual vi- system and forensic sciences. Forensic nurses care for olence in the United States. According to a recent Centers patients who’ve experienced violence and other traumas, for Disease Control and Prevention (CDC) report, more such as natural disasters. Patients include living and de- than 36% of women have experienced contact sexual ceased victims as well as perpetrators of violence. The violence in their lifetime and 19% have experienced at- patient population also extends to communities and so- tempted or completed rape. Men also report high rates of ciety at large. Forensic nurses collaborate with other pro- sexual violence; more than 17% have experienced some fessionals outside of healthcare, but they’re nurses first form of contact sexual violence in their lifetime and near- and use the nursing process to provide compassionate, ly 2% have experienced attempted or completed rape. holistic care. This distinction clearly defines forensic A benefit of the increased media and cultural atten- nurses as healthcare professionals rather than criminal tion on sexual assault crimes is that in many areas of justice or forensic science professionals. 42 American Nurse Today Volume 13, Number 12 AmericanNurseToday.com Forensic nursing As forensic nursing grows, subspecialties will advance subspecialties to meet healthcare and societal needs. (See Forensic Currently in the United States, forensic nurses can special- nursing subspecialties.) But regardless of the subspecial- ize in any of these areas: ty, forensic nurses focus on improving patient and legal • sexual assault system outcomes. They address the bio-psycho-social- • interpersonal violence spiritual needs of patients affected by violence and trau- • intimate partner violence • child abuse and neglect ma to promote physical and psychological health and • recovery. Additionally, forensic nurses use proper evi- elder abuse and neglect • human trafficking dence documentation, collection, and preservation prac- • tices to ensure optimal analysis findings. death investigation • incarceration Only RNs can take specialized forensic nursing educa- • refugees with torture victimization history tion, but forensic nurses come from a variety of educa- • mass and natural disasters. tional backgrounds—from associate to doctoral degrees. Many forensic nurses have experience in emergency de- partments, intensive care units, women’s health, medical- range from master’s to doctoral degrees. When explor- surgical units, or mental health/psychiatric units. ing SANE education opportunities, look for programs SANEs make up the largest group of forensic nurses that meet IAFN guidelines. And keep in mind that to in the United States. In fact, about 72% of the Interna- practice as a forensic nurse, you need both classroom tional Association of Forensic Nursing (IAFN) members education and clinical experience. are SANEs. IAFN provides online education for SANE training and sponsors the certification examinations for Key forensic nursing concepts both adolescent and adult SANEs (SANE-A) and pedi- RNs already practice many forensic nursing concepts, atric SANEs (SANE-P) as recognized by the American including compassionate, patient-centered, objective, Nurses Credentialing Center’s Magnet Recognition Pro- culturally sensitive, and evidence-based care. However, gram®. Nurses must meet the eligibility requirements forensics’ education expands on these key concepts to before taking the credentialing examination. incorporate a thorough understanding of trauma-in- In some parts of the United States, the SANE role formed care, including knowledge of the neurobiology has expanded to include providing nursing care and of trauma and interventions to promote healing and re- examinations for patients affected by interpersonal vio- store power and control to patients who’ve experi- lence, strangulation, torture, physical child abuse, child enced violence and other trauma. neglect, and elder abuse. They also care for the sus- pects of violent crimes. Objectivity Objectivity is critical to forensic nursing, both in terms Employment settings of nonjudgmental care when documenting findings Forensic nurses work in a variety of healthcare settings: and facts and in interactions with the legal system hospitals, emergency departments, clinics, correctional when serving as an expert witness or consulting for health centers, and medical examiners’ or coroners’ of- prosecuting and defense attorneys. fices. (See Forensic nursing care settings.) Many foren- sic nurses work on-call, ready to respond when a pa- Cultural sensitivity tient needs their specialized care, while others are Culturally sensitive forensic nursing care involves an employed as full-time forensic nurses. States, jurisdic- awareness of cultural and societal influences on vio- tions, and healthcare facilities vary on their payment lence, abuse, and trauma. It also requires a commit- structure for forensic nursing services, providing on- ment to social justice and access to care. call, case-by-case, hourly, or salaried wages. Evidence Educational options All aspects of forensic nursing care—from patient as- Forensic nursing education is holistic, ranging from sessment to evidence collection and documentation of learning about assessment of the psychological impact injuries—must be based on research and best practice of trauma to documenting physical injuries and pre- guidelines. serving evidence. As forensic nurses intersect with the criminal justice system, education also is provided on Violence prevention expert testimony. A variety of online forensic nursing Violence prevention is also a foundational concept education programs are available through IAFN. Several within forensic nursing. Under IAFN’s Vision of Ethi- universities offer courses specific for SANEs or death cal Practice, the scope of forensic nursing practice investigators, and graduate forensic nursing programs includes a responsibility to address violence preven- AmericanNurseToday.com December 2018 American Nurse Today 43 Forensic nursing care settings petrators of violence. Forensic nursing expands that The broad scope of forensic nursing encompasses many role to individuals and communities to promote recov- care settings. ery, health, and justice. • Forensic psychiatric nurses with an undergraduate de- To learn more about forensic nursing, visit the IAFN gree may work in mental health settings, while nurses website (IAFN.org). Note that many states have IAFN with an advanced practice degree may provide evi- chapters with contact information. You also can read dence-based therapies to both survivors and perpetra- more about forensic nursing in the official peer-reviewed tors of violence. • journal of IAFN, Journal of Forensic Nursing, and in Forensic nurse death investigators work within the struc - American Nurse Today (americannursetoday.com/forensic ture of medical examiners’ or coroners’ departments to -nurses-strides-social-justice/). investigate deaths, support family and survivors, and ex- plore the impact of the death on the community. • Julie L. Valentine is an assistant professor at Brigham Young University College of Correctional forensic nurses care for patients incarcerat- Nursing in Provo, Utah, and a forensic nurse with Wasatch Forensic Nurses in Salt ed in jails, prisons, and juvenile detention centers. Lake City, Utah. • Nurse legal consultants and nurse attorneys also fall un- der the umbrella of forensic nursing, addressing legal is- Selected references sues as they intersect with healthcare. Nurse legal con- Amar A, Sekula LK. A Practical Guide to Forensic Nursing: Incorpo- sultants assist attorneys, while nurse attorneys represent rating Forensic Principles into Nursing Practice. Indianapolis, IN: clients and healthcare organizations in legal cases. Sigma Theta Tau International;