Application of Forensic Nursing

Forensic Nursing

Forensic nursing is defined as “application of the nursing process to public or legal proceedings, and the application of forensic health care in the scientific investigation of trauma and/accidents” (Nies & McEwen, 2019, p.646). In my home town of Ohio, 70,000 people reported being victims of domestic violence in 2016. There were more than 7,800 reports of sexual abuse and 135 human trafficking cases discovered by law enforcement. What is more astounding is the amount of unreported cases that exist within my community and nationwide. Forensic nurses see patients that have been victims of sexual assault, human trafficking, elder abuse, neglect, child abuse and domestic violence. The purpose of this paper is to shed light of the important of forensic nursing in communities around the country. (Eddor, 2017)

Community Setting

Most cases are reported from the Emergency Department which is where most of the victims choose to go. An Emergency Department is a safe place for a victim/patient to be. However, given the gravity of the victim very few people in an emergency department have the gift of time and patience. This is where a forensic nurse comes in and works at the patient’s pace, so they can obtain the story and make the patient feel as comfortable as they can. Many victims/patients that present to the  Emergency Department are victims of sexual assault, child or elder abuse or have an already active case in which they need care emotional support. (Nies & McEwen, 2019)

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A Sexual Assault Nurse Examiner (SANE) nurse has extensive training in working with patients/victims in collecting their stories as well as appropriately handling evidence collection. An exam of a sexual assault nature can take up to five hours. Many times, these nurses work on call. To have this certification for both adult and pediatric a nurse must be practicing for at least two years, complete a forty-hour didactic instruction as well as demonstrate competencies sexual assault exams. (Nies & McEwen, 2019)

Clinical Forensic Nurse Examiners are employed by Emergency Departments. These nurses are trained in helping survivors of physical and emotional trauma, toxicologic emergencies, domestic violence and mass casualty incidents. There duties are to properly collect and preserve evidence and follow proper chain of custody. Documentation often starts in the Emergency Department and can have a major impact on legal decisions. (Nies & McEwen, 2019)

Forensic Psychiatric Nurses aid legal and mental system’s in providing care to victims that may be awaiting trial. This position is to remain neutral and objective when providing support. This nurse often has an interest in understanding mental illnesses and personality disorders. This nurse provides information such as sanity competency evaluations, assessments of capacity to formulate intent, sexual predator screenings and can be an expert in witness testimony. (Nies & McEwen, 2019)

Health Promotion Nursing Intervention

Sexual Assault Response Teams (SARTs) are new teams that are bringing police, forensic examiners and rape victim advocates to improve the response to this type of violence in communities. SARTs goal is improve victims’ ability and ease of seeking help. Their goal is to provide the best possible narrative for victims regarding their case outcomes. Having cooperation from police, legal aids, advocates and forensic examiners. SARTs initiative collaboration of the process included case review and protocol development. Their hope was to have as many trained people for a team of supports for their victims. (Adams, Fitzgerald, Holbrook, 2016)

In addition to SART there is SOAR (Stop, Observe, Ask, Respond) training. This brings awareness and education to the community on human trafficking. Specialty nursing organizations are likely to first see victims of human trafficking. SOAR Training on Human Trafficking was developed in 2017. It is taught in  schools and hospitals to acute care nurses and community nurses. Soar stands for “Stop! (Describe the scope of human trafficking in the United States). Observe! (Recognize the verbal and non-verbal indicators of human trafficking). Ask! (Identify and interact with individuals who have experienced trafficking using a victim-centered and trauma-informed approach) Respond! (Respond effectively to potential human trafficking in your community by identifying needs and available resources to provide critical support and assistance)” (Speck, Mitchell, Ekroos, Sanchez & Messias, 2018). (Speck, Mitchell, Ekroos, Sanchez & Messias, 2018).

Professional Nursing Organization

The international association of forensic nurses is an organization made up of forensic nurses around the world as well as other professionals who support the work of forensic nurses do. Their mission is simple. It lends itself to “developing, promoting, and disseminating information internationally about forensic nursing science”. Forensic nursing is recognized worldwide as an essential piece of a response to violence and trauma. The organization believes in a worldwide initiate in all people having access to forensic nursing care. They promote a world without violence, an obligation to science and a commitment to social justice. (forensicnurses.org)

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The Association is the hopes to increase access universally to forensic nursing care for all patients that have suffered violence and trauma. Members are leaders in policymaking , media and  government relation and lend their expertise and knowledge worldwide.  The Association works to advance global research to provide an evidence-based response to the need of the forensic populations. The Association prides itself of serving as the leading global network for nurses in the forensic field provide mentorship, exchange ideas and improve access to quality forensic care. (forensicnurses.org)

Summary

Forensic Nursing brings a trauma-informed approach to helping patients. Connecting with patients during their examination is key to the healing process. Forensic nurses need to provide a path for patients to begin their healing process. Having an extended one-on-one with patients and slowly explaining the process makes a difference. In my community the Forensic nurses set up hospital advocates from the Victim Assistance Program or provide resources through the rape crisis center. They also provide patients with “Fear 2 Freedom”, which is a local a nonprofit organization that aims to restore hope and dignity to survivors. The organization gives “after-care kits” for patients leaving the hospital. The kits include clothing because the clothing the patient presented in has been collected for evidence. The kit also includes toiletries, a self-reflecting journal, a “Freedom Bear” and a letter of encouragement from another survivor. Providing forensic nursing care to patients/victims is a vital piece of nursing in every community. Restoring trust, faith, compassion and dignity to these victims can change the course of their lives. (Eddor, 2017)

References

• Adams, M., Fitzgerald, S., & Holbrook, D. (2016). Connecting Hispanic Women in Baltimore to the Mercy Medical Center Sexual Assault Forensic Examiners/Forensic Nurse Examiners Program: A Preliminary Assessment of Service Utilization and Community Awareness. Journal of forensic nursing, 12(3), 104-110
• Eddor, N. (2017, November 06). Caring for Victims of Violence: Forensic Nurses Are on the Front Line. Retrieved from https://consultqd.clevelandclinic.org/caring-for-victims-of-violence-forensic-nurses-are-on-the-front-line/
• Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.
• (n.d.). Retrieved from https://www.forensicnurses.org/page/Overview
• Speck, P. M., Mitchell, S. A., Ekroos, R. A., Sanchez, R. V., & Messias, D. K. H. (2018). Policy brief on the nursing response to human trafficking. Nursing outlook, 66(4), 407-411.