Forensic nurses use skills from multiple disciplines to help people in difficult circumstances. They work at the intersection of nursing and forensics. They may assess or treat victims or perpetrators. They may also offer expert opinion.
Cleveland State University lists five forensic nursing roles:
• Clinical forensic nurse
• Legal nurse consultant
• Forensic death investigator
• Psychiatric forensic nurse
• Forensic correctional nurse
Clinical forensic nurses may specialize in work with children.
Forensic Nurse Educational Foundations
Forensic nursing is a career that some move into step by step. RNs need training beyond what is included in the typical registered nursing program in order to carry out basic duties such as evaluation of sexual assault victims. The level of expertise expected for serving as an expert witness is higher. Comprehensive forensic nursing programs are typically graduate level.
Master’s students may develop their expertise in individual areas of interest through capstone projects. Oakland University has provided a list of some past projects:
• Neurobiology of Trauma- Understanding Behavioral Changes as a Result of Trauma
• Improving Elder Abuse Screening and Reporting in the Hospital Setting
• The Forensic Nurse as an Expert Witness
Most formal forensic nurse programs are offered at the master’s level. The International Association of Forensic Nurses lists 13 master’s programs (https://www.forensicnurses.org/page/ForensicNursingSchools). On-campus programs are located in Alabama, Michigan, New Jersey, and Ohio. There is an on-campus certificate program available in New York.
Programs typically a core of advanced nursing coursework. Some will be applicable for work in a variety of settings.
A majority of programs are online. Online coursework may be supplemented by practicum work in multiple settings.
There are a limited number of online certificate programs available to nurses who do not already hold degrees at at least the bachelor’s level. Graduate programs may have some courses that are open to a wider audience, such as licensed RNs.
There are many more options for nurses who seek certification only in sexual assault examination. Sexual Assault Nurse Examiners (SANE) is a highly sought after certification available to RNs who have at least a couple years of experience in roles that require advanced physical assessment (https://www.forensicnurses.org/page/aboutSANE). It involves training and coursework.
The first step is becoming an RN. This entails completing an educational program, passing an examination, and applying for state licensing. RN programs are available at the associate’s level and higher. Nurses may complete their educational incrementally – they will need to determine what level is most feasible to enter.
The Role of the Clinical Forensic Examiner
Forensic nurse examiners have a dual role, providing assessment and treatment for the patient and also collecting evidence. They carry out a thorough physical examination and use equipment to find evidence that may not be visible to the eye. They see that a pregnancy test is done (if applicable) and that the patient has medication that may be needed.
The job requires strong people skills. Nurses will need to reassure and offer explanation. They will also need to collaborate with professionals in other disciplines. Oakland University has produced a video depicting a day in the life of a forensic nurse (https://oakland.edu/nursing/graduate-programs/msn-forensic-nursing-program). Among the things she can be seen doing is combing hair: looking for strands that do not belong to the person being examined. She can also be seen interacting with law enforcement; after conducting the assessment, she makes sure the evidence is secured.
Forensic Nursing Programs
Texas A&M University Health Science Center, ranked as the 9th best online MSN program in the nation, offers an online program with minimal on-campus clinical requirements. A graduate certificate program is also available.
Oakland University has both MSN and certificate online options. Students complete clinical courses in Emergency Preparedness and Disaster Management, Interpersonal Violence and Maltreatment, Forensic Nurse Death Investigation, and Advanced Forensic Nursing.
Cleveland State University offers forensic nursing as an ‘MSN: Specialized Population’ degree option. The Cleveland State program is on campus in Ohio.
Fitchburg State University offers an online MSW program. The program includes 420 total clinical hours, spread across multiple classes. The program concludes with a capstone project. The program is open to RNs with bachelor’s degrees, though the bachelor’s degree may, in some cases, be in a field other than nursing.
Forensic Nurse Employment
An early 2021 search of ‘forensic nurse’ positions suggests that a majority are for forensic nurse examiners. While the primary role is considered to be examiner, nurse examiners might have ongoing work with clients.
Institutions are also looking for professionals who can work with mentally ill offenders. Mental and physical health duties are sometimes combined.
The following are examples of recently posted positions:
• Forensic Nurse Examiner: to meet immediate care needs, collect evidence, and provide medical testimony
• Forensic Nurse Examiner, Children’s Medical Group, with duties to include both examination and case management
• Registered Nurse – Forensic Mental Health: to work in a competency restoration program, assessing psychological and medical status, managing treatment plans, and providing both primary care and psychological services
• Supervising Nurse -Correctional Facility, with duties to include staffing and staff oversight, serving as liaison with other units, and participating in policy and program development
The International Association of Forensic Nurses is a professional resource (https://www.forensicnurses.org/). The organization has set educational guidelines for forensic nursing and for the following sub-disciplines:
• Sexual Assault Nurse Examiner, Adult and Pediatric
• Forensic Nurse Death Investigator
• Intimate Partner Violence Nurse Examiner
Information about the above educational standards is available to those who request it.
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