By Megan M. Krischke, contributor
Nov. 9. 2009 - “Violence is a Health Care Problem” is the theme of the first Forensic Nurses Week, taking place November 9-13, 2009. This week, which is expected to become an annual event, was created to honor and celebrate forensic nurses. This year’s theme reflects data showing that up to 37.5 percent of health care costs may be the result of violence, and research such as the Adverse Childhood Experiences Study that found a strong correlation between childhood experiences of violence and adult health problems such as diabetes and tobacco addiction.
Forensic nurses work to combat these problems, properly care for the victims and provide information and assistance to law enforcement to help them prosecute violent offenders.
Carey Goryl, MSW, IAFN executive director, says that forensic nurses apply their medical skills in a variety of patient care settings.
The International Association of Forensic Nurses (IAFN) Web site defines forensic nursing as “the application of nursing science to public or legal proceedings.” Nurses in this specialty may work in a variety of settings and situations. Many care for victims of sexual assault and other violent attacks in emergency medicine, or work with victims of domestic violence, elder abuse, child abuse or natural disasters. Some hold positions as coroners or legal nurse consultants for attorneys.
“Forensic nurses build upon their medical skills of patient care and add skills in injury identification, evaluation of the nature and scope of injuries, documentation of the patient’s incident, and collection and proper storage of biological and physical evidence,” explained Carey Goryl, IAFN executive director. “They also learn to interface with law enforcement and attorneys and provide factual and expert testimony. “
In the United States, the training and education of forensic nurses varies, but most begin as a sexual assault nurse examiner, which typically requires 40 hours of classroom training followed by a 40-hour clinical training.
“Nurses can also go beyond this initial training and become board certified,” Goryl commented. “The two most common certifications are the SANE-A® and SANE-P®. These are professional board certifications for a sexual assault nurse examiner with a specialty in the care of adult and adolescent patients (SANE-A) or pediatric patients (SANE-P). Both are the earned credentials that recognize that the highest standard of forensic nursing for sexual assault nurse examiners has been achieved. To become certified, nurses must meet the eligibility criteria determined by the IAFN Forensic Nursing Certification Board as well as take and pass an examination that is offered bi-annually.”
“Registered nurses can also consider taking a death investigator course, but first they should look to see if any of their local communities hire nurses as death investigators.”
Goryl believes that every emergency department should, minimally, have one forensic nurse on staff.
IAFN, which has 3,100 members, including 192 from 26 countries outside the United States, held their 17th annual scientific assembly October 21-24, 2009, in Atlanta, Ga. The conference had a record 640 attendees and nearly 40 exhibitors from across the globe.
Kim Day, RN, FNE A/P, SANE-A, SAFE technical assistance coordinator at IAFN, urges nurses who treat victims of violence to be thorough in their assessment and documentation.
“The conference was a great opportunity to network with people from the U.S., Canada and around the world,” remarked Kim Day, RN, FNE A/P, SANE-A, SAFE technical assistance coordinator at IAFN. “What stood out to me was that no matter their specialty or where they were from, every forensic nurse’s focus was on caring for the patient. The conference renewed my passion for the work.”
IAFN’s 18th annual scientific assembly will be held October 27-30, 2010, in Pittsburgh, Penn.
“It is important for nurses considering forensics to realize that in this field you need to educate yourself, your coworkers, and the public about the need for forensic nurses,” said Day, who has worked in forensics 11 of the 31 years of her nursing career. “Also, there is a community piece. You interact with a broad spectrum of people and educate the public about violence prevention.”
Day urges medical staff who treat victims of violence to be thorough in their assessment of the patient and in documentation, because of the criminal justice ramifications. Additionally, they should be conscious not to destroy evidence by cutting through bullet holes or stab wounds in clothing or carelessly handling items that might reveal fingerprints.
“Crime and violence bring together two of the most powerful systems that can impact daily life: health and justice,” remarked Goryl. “Forensic nurses are not and never should be extensions of law enforcement or relegated to the role of collection of evidence. It is important to remember that in forensic nursing, it is nursing that is first and foremost and is the primary dictator of practice.”
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