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KEY POINTS IN THIS CHAPTER
All nurses are forensic nurses.
The nurse generalist should become familiar with forensic procedures that can help provide the best care for patient cases that have legal implications.
There are many roles that a forensic nurse can perform.
Collaboration among professionals in a forensic case is key to good care.
Every nurse should consider lifelong learning as a part of practice.
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Forensic nursing is an evolving nursing specialty that focuses on healthcare when legal issues are involved. Forensic practice in nursing is now recognized as its own practice area, whereas in the past it had only been practiced informally, because there were no standards of education relating to forensic science for nurses.
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The role of the forensic nurse evolved out of the practice of clinical forensic medicine, a subspecialty of forensic medicine defined as the application of forensic medical knowledge and techniques to living patients. This role has been evident in the United Kingdom and many other countries for over two centuries. However, as the role emerged in healthcare in the United States as a medical specialty, forensic medicine was considered to be the domain of physicians alone. It was not until the 1980s that the need for expansion of the role was identified. In a 1983 article, Smialek highlighted the need for knowledgeable clinicians in the emergency departments regarding forensic cases, because evidence was being lost by commission or omission during trauma treatment. For this reason, it became apparent that all nurses working throughout the healthcare system, and specifically in settings where trauma patients present, must have some baseline knowledge of how to assess patients, preserve evidence, and interface with the legal system in order to mitigate negative consequences for both the patient and the system.
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While practicing as a death investigator and as one of the first nurses to become a member of the American Academy of Forensic Sciences, Lynch advocated for the value of forensic education in nursing schools and for the role of nurses in forensic practice. She proposed the development of forensic nursing as a specialty in 1986 (Lynch, 2013). And although her early vision of forensic nursing focused on the role of the death investigator, she quickly saw the need for an expanded role that encompassed a broader clinical forensic nursing practice.
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The earliest example of forensic nursing practice involved sexual assault nurse examiners (SANEs). In the early 1990s, a group of nurses recognized the lack of appropriate care for victims of sexual assault and developed training for nurses to prepare them to properly assess patients, collect evidence, document findings, and interface with the legal system in caring for victims of sexual assault. This same group of nurse clinicians established the International Association of Forensic Nurses (IAFN) in 1995 (Sekula & Burgess, 2006). Over the years, the practice of ...