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Forensic Nursing
Abstract
Dynamic and complex nature of health care for individuals and communities has led to a reform in the health care scenario and forensic nursing has emerged as a part of it. The title “Forensic Nurse” originated in the year 1992 at a convention for sexual assault nurses in St. Paul, Minnesota when a small group of about 70 nurses met at its first national convention. The International Association of Forensic Nurses was formulated soon after the convention. American Nurses Association (ANA) officially accepted Forensic Nursing as a specialty in the year 1995. Forensic nursing is one among the latest branches of forensic sciences. ANA defines Forensic Nursing as “application of forensic science combined with the bio-psycho-social education of the registered nurse, in the scientific investigation, evidence collection and preservation, analysis, prevention and treatment of trauma and or death related to the medico-legal issue.” The environment of practice of forensic nursing includes clinical forensic nursing settings and correctional forensic nursing settings. The integrated practice model for forensic nursing was developed by Virginia Lynch. This model emphasizes that justice is served when the truth is identified, verified and demonstrated. Forensic nurses work in a variety of forensic settings and care for individuals who are victims from the acts of violence, exploitation, abuse, negligence or mistreatment. Based on the areas of practice, forensic nursing is broadly classified into four specialties as Clinical Forensic Nursing, Sexual Assault Nurse Examiner, Forensic Psychiatric Nursing and Correctional/ Institutional Forensic nursing. There is a huge scope for forensic nursing in India. Forensic nurses can play a crucial role in fields of; crime scene investigation, forensic pathology, forensic psychiatry, forensic traumatology, forensic toxicology, death investigation & correctional settings. Forensic nursing education needs to be strengthened in the country as there is a wide scope for this specialty. It helps in the delivery of high quality nursing care services to sufferers as well as perpetrators of crime. It helps to bridge the gap between the legal and health systems. Forensic nurse examinations are gaining recognition in the court system as reliable sources of evidence which in turn leads to higher conviction rates & fewer crime scene errors.
Keywords: Forensic Nursing, Forensic Medicine, Forensic science.
In the complex tapestry of healthcare and justice systems, there exists a vital thread often overlooked but crucial for weaving together the well-being and rights of individuals affected by trauma and violence. This thread is forensic nursing. As a specialized field at the intersection of healthcare and justice, forensic nursing plays
an indispensable role in providing comprehensive support to survivors of trauma, collecting forensic evidence, and advocating for justice.1,2 In this editorial, we delve into the multifaceted nature of forensic nursing, its significance in bridging healthcare and justice, and the opportunities it presents for enhancing the response to victims of crime and trauma.
Background
Emergency department nurses often deal with victims of violence and trauma. In the emergency department, the main focus is on saving lives and stabilizing patients' conditions. The next important task is to preserve any valuable evidence that could potentially help identify a crime. It is important to describe how nurses currently practice in the emergency department and perceive their role in caring for forensic patients. This study aimed to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among emergency department nurses as well as the correlation between mean scores of performance and perception.
Methods
This is a cross-sectional correlational descriptive study. This non-observational survey study used a questionnaire to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among 274 emergency department nurses.
Results
The total mean scores for frequency of performed behaviors and their perceived importance were 2.36±0.65 and 4.23±0.64 respectively. The overall mean scores of importance were significantly higher than frequency. There was a significant correlation between the frequency of performance and perception of the importance of twenty-eight items (twenty-four positive correlations and 4 negative correlations) (p<0.05). The frequency of performed behaviors positively correlated with participants’ type of shift worked and their personal experiences of legal and judicial claims. The female gender of respondents positively correlated with behaviors’ perceived importance.
Conclusion
The study revealed a significant discrepancy between the frequency of forensic nursing role behaviors performed and their perceived importance in the emergency department. This gap emphasizes the pressing requirement for forensic nursing subjects to be incorporated into graduate and undergraduate nursing curricula, as well as ongoing training programs and courses. It is crucial to establish and implement forensic nursing protocols for the care of trauma victims, and to foster collaboration between healthcare systems, law enforcement, and forensic investigators to streamline the process.
The medico-legal care of victims of sexual assault is very challenging, and requires specific knowledge and skills. Professionals in the emergency departments of hospitals might not have specialised training in forensic science. Nurses have a very significant role in these settings, but they lack any formal forensic training. This study aims to develop a sexual assault nurse examiner-grounding program (SANE-GP) for Indian nurses to inculcate knowledge and skill regarding sexual assault examination. The study adopts a three-stage Delphi technique to develop the training module and uses a time-series design to evaluate the effectiveness of the program. A questionnaire on nurses’ knowledge on sexual assault examination (KQSANE-I) will be developed in phase-I and subsequently used in phase-II. The protocol of SANE-GP will help the medical community to implement the program across India. The implementation of SANE-GP can also help to start a sexual assault nurse examiner network.
The medico-legal care of victims of sexual assault is very challenging, and requires specific knowledge and skills. Professionals in the emergency departments of hospitals might not have specialised training in forensic science. Nurses have a very significant role in these settings, but they lack any formal forensic training. This study aims to develop a sexual assault nurse examiner-grounding program (SANE-GP) for Indian nurses to inculcate knowledge and skill regarding sexual assault examination. The study adopts a three-stage Delphi technique to develop the training module and uses a time-series design to evaluate the effectiveness of the program. A questionnaire on nurses’ knowledge on sexual assault examination (KQSANE-I) will be developed in phase-I and subsequently used in phase-II. The protocol of SANE-GP will help the medical community to implement the program across India. The implementation of SANE-GP can also help to start a sexual assault nurse examiner network.
Photography is a critical factor in solving out the mysteries behind the crimes by giving out critical information applicable to criminal, legal investigation. It was initially based on manually operated camera and film strips and later adopted digital technology for recording and storing the visuals. Digital evidence can show the relative position of evidence at the scene, establish the relative dimension of the evidence and also cross compliment other evidence collection techniques. The inadequate and improper collection, preservation and presentation of evidence can lead to crime scene errors and fewer conviction rates. Training in forensic photography is vital, and a game changer in the medico-legal investigations.
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