As the medical industry comprises a wide spectrum of disciplines, there are many different schools of nursing to support these fields – and to suit all specialisms and strengths.
Perhaps one of the lesser-known nursing branches, forensic nursing is a very rewarding field that requires a particular skill set. Below, we’ll take a look at forensic nursing, and outline the ‘soft skills’ required to perform well in this position.
What is forensic nursing?
The term ‘forensic’ refers to the investigation of crime, and particularly to the use of science in ‘piecing together’ details of an offense. Forensic nursing, therefore, is a practice that involves working with victims of crime, often while aiding the criminal justice system in gathering the evidence required to prosecute the perpetrator of the offense in question.
Forensic nurses treat and assess victims, sharing their findings with investigators – and they often provide mental health and emotional trauma support and evaluation.
In what circumstances would the work of a forensic nurse be required?
The majority of forensic nurses are employed in hospitals and specialist centers focusing on victims of violence and abuse. The work of a forensic nurse may be required in situations where it is suspected that a criminal offense has been committed, resulting in physical and/or emotional harm. The nurse will work with the victim to deliver a medical assessment and specialist treatment, as well as preserving evidence, conducting interviews and taking statements to pass on to law enforcement.
Not all hospitals and healthcare centers employ forensic nurses, but they are very valuable additions to the workforce and can make a significant difference to the efficacy of criminal investigations where bodily harm has been sustained.
Offenses that may be investigated with the help of a forensic nurse
Below, we explore the most common investigations that may require input from a specialist of this kind.
Assault, physical abuse and intimate partner violence
If actual bodily harm has been committed, forensic nurses may be tasked with treating the injuries, while ascertaining and assessing how they were caused, interviewing relevant parties to collect statements, and checking whether those statements correspond to the findings. The information gathered is then passed on to investigators to hold as evidence.
Sexual assault and rape can cause physical injury, and may also leave behind vital evidence. A forensic nurse may be involved in the implementation of a ‘rape kit’, as well as assessing bodily trauma and providing treatment to aid in recovery. Offenses of this kind can lead to severe mental health issues, and many forensic nurses are also skilled in the management and treatment of psychological damage of this kind.
When carers of vulnerable individuals, such as children, elderly people or those with certain disabilities, fail to provide adequate support, it may lead to physical harm and illness. Issues such as malnourishment, infections, dermatological conditions, parasites and psychological harm may then arise. Injuries can also be caused if the vulnerable individual is forced to undertake tasks that should be performed by carers on their behalf.
A forensic nurse can help to determine whether certain physical conditions are the result of neglect by parents or caregivers. They can also aid in the treatment of psychological issues resulting from this type of mistreatment.
Accident and incident investigation
From vehicular collisions to workplace injuries, forensic nurses can help to determine fault – and therefore liability – in relation to accidents and incidents. They can help to investigate whether the injuries sustained may be attributed to neglect or carelessness on the part of another individual.
Not only can this help in the collection of evidence for criminal investigations, but it may also aid victims who intend to sue – or employers or motorists striving to prove their innocence in a court of law. It is very common for victims of crime to suffer psychological trauma as well as physical injury. A forensic nurse may also be tasked with assessing and treating these issues.
In certain circumstances, the expertise of forensic nurses may be called upon to determine a cause of death for individuals who have passed away in suspicious or uncertain circumstances.
They may work alongside a coroner to explore the medical evidence present and draw a conclusion – either ruling out or supporting any allegations of foul play, neglect or negligence.
How long have forensic nurses existed?
While medical professionals have played a major part in criminal investigations and court cases since at least the 19th century, a defined idea of a forensic nurse was not introduced until 1990, when Virginia Lynch conceptualized the role as part of her master’s thesis. It was then accepted as a specialist field of nursing by the Academy of Forensic Sciences, and the International Association of Forensic Nurses (IAFN) was established the following year.
Lynch herself is a superb example of the power of nurse-led public health initiatives. As a founding figure of forensic nursing, her work has made a huge difference to the relationship between the worlds of nursing and law enforcement. Despite being a comparatively new field within the nursing umbrella, forensic nurses have been embraced as very valuable contributors both to the world of criminal investigation and policing, and to the medical industry.
What skills do you need to become a forensic nurse?
While a wide range of ‘practical’ competencies is required of those training to become a forensic nurse – many of which crossover with other fields of nursing – there are also a number of invaluable ‘soft skills’ that all specialists of this kind should strive to develop.
Below, we explore a number of these skills, and explain how they are applicable to the role.
Attention to detail
As forensic nursing crosses over with the world of criminal investigation significantly, and because the information and evidence collected as part of a nurse’s assessments and interviews with patients may be used in a court of law, excellent attention to detail is vital.
The smallest piece of information or the most obscure or subtle symptom may flip a case on its head, and could mean the difference between the victim of a crime achieving justice and a ruling being made based on inaccurate evidence. This is among the most important of a forensic nurse’s ‘soft skills’, and great effort should be made to develop and maintain strength in this area.
Good bedside manner and empathy
Victims of crime tend to be in a very vulnerable state following the incident in question, and many suffer lasting emotional and psychological damage.
While key elements of a forensic nurse’s job include clinical assessment and the collection of evidence, it’s important that these tasks are undertaken with sensitivity and care. After all, the role may also include the treatment of mental health issues arising from trauma – so forensic nurses must display excellent levels of empathy and a great bedside manner to aid patients in their recovery.
This skill also comes with a practical advantage, as individuals are more likely to be forthcoming and open in interviews if they feel that the person conducting them is caring and sympathetic. This means that the collection of evidence can be made more straightforward, making investigations significantly easier.
Strong interpersonal skills
The need for excellent interpersonal skills naturally ties in with the requirement for good bedside manners, which is mentioned above. However, these strengths and abilities should extend beyond the nurse-patient relationship.
Forensic nurses need to be able to communicate with other medical specialists, as well as with police personnel, criminal investigators and legal experts. They may also need to talk to friends, family and other individuals connected to the alleged victim undergoing treatment and assessment. As mentioned above, the ability to effectively and empathetically manage interactions of this kind can help an investigation to run as smoothly as possible.
Excellent communication abilities
Whether discussing the findings of an assessment, interpreting interview responses from victims or related individuals, recording legal testimony or explaining complex medical terminology to non-medical personnel, forensic nurses must be strong communicators.
Clarity in written or verbal communication is vital, as, again, this will make a huge difference to the processing of evidence and the ease with which all parties will be able to understand the procedures involved and all related findings.
The ability to advocate
In some cases, victims in criminal cases can be left feeling ‘out of the loop’, or do not feel that their concerns are being addressed. Part of a forensic nurse’s job is to advocate for patients, making sure that they are receiving the right treatment in relation to their physical and mental health, and pushing for their voices to be heard. Not only will this benefit the patient and potentially the ongoing criminal investigation, but it may also have a positive knock-on effect for the nurse’s employers.
According to a 2020 article by Julie L. Valentine, Kathleen Sekula and Virginia Lynch, patient rights violations are less likely to occur in hospitals that employ forensic nurses.
Unlike many nursing positions, individuals employed as forensic nurses may be required to present evidence in a court of law. For this reason, public speaking abilities will be a significant bonus for anyone working in a position of this kind.
Clarity will make evidence easier for legal professionals and jurors to understand, absorb and analyze, while poise can help to impress upon the listeners the indisputable and highly professional nature of the clinical and scientific work undertaken.
The more a forensic nurse is able to work on developing their self-confidence when speaking in public, the less stressful they are likely to find the experience – and the more effective they are likely to be in the presenting of evidence.
Vicarious trauma is a very real issue in areas of employment that focus on assessing, treating and aiding victims of crime. This is why it’s extremely important for forensic nurses to develop healthy coping skills.
While these methods can be successfully honed by the individual in part, it is extremely beneficial for professionals within this field to arrange regular sessions with a licensed therapist to ensure that the coping mechanisms they have developed are effective and benign in all ways.
While the ability to manage the emotional impact of working with victims is vital, a balance must be struck between maintaining a healthy sense of ‘distance’ and remaining empathetic and approachable to patients.
Confidentiality is a requirement for all medical professionals working in collaboration with legal and law enforcement specialists in the collection of evidence, the investigation of crime and the building of a case against an alleged perpetrator. Of course, evidence and information must be shared with others working on the same criminal case, but a clear understanding of the levels of authorization and access must be maintained at all times.
Forensic nurses must also have a strong sense of initiative when it comes to determining which information should be restricted and which may be shared. Failure to adhere to confidentiality requirements can be a very serious matter, and may lead to termination and even prosecution.
Another vital forensic nursing ‘soft skill’ is that of patience. Due to trauma, fear of self-incrimination or other issues, interviews with victims of crime can be drawn out, difficult to navigate and sometimes unfruitful. These discussions may need to be repeated at suitable times in the future, without putting too much pressure on the subject.
What’s more, due to the complex nature of some cases, legal and investigatory procedures can feel slow, and certain requests can take significant amounts of time to process. For this reason, the ability to be patient and manage one’s own expectations when it comes to timescales is key to a successful career in forensic nursing.
Good time management
While the above section emphasizes the need for patience, it is also important to maintain a professional sense of urgency when undertaking one’s own work.
A forensic nurse must be methodical and pay strong attention to detail when assessing victims of crime and collecting evidence, but it is also vital to ensure that, wherever possible, the work does not delay the wider investigation, and that all information is readily available when needed.
While little can be done to expedite test results or the receipt of certain pieces of evidence, it is important that the forensic nurse does all in their power where it is possible to have an effect on the speed of the process.
What training is required to become a forensic nurse?
When it comes to training, the basic forensic nursing requirements reflect the standard qualifications needed to enter any other nursing role. After studying a bachelor’s degree, nurses can study the online Master of Science in Nursing in Forensic Nursing offered by Cleveland State University, which provides a wide-ranging introduction to forensic nursing and forensic methodologies. It also prepares nurses for contact with the legal system, provides training in legal processes and trial preparation, so that the evidence nurses collect can be presented in a professional and confident manner.
From here, candidates must take and pass the National Council Licensure Exam (NCLEX). Once they have done this, they will be considered a qualified registered nurse (RN).
The next step is for candidates to gain relevant clinical experience that will support the development of specialist knowledge and the ‘soft skills’ mentioned above. Medical and surgical experience, along with work in psychiatric and pediatric wards, will help to prepare future forensic nurses for their future role.
Forensic nursing certification
An optional final step is to become certified as a forensic nurse, either by qualifying as an adult/adolescent sexual assault nurse examiner (SANE-A) or a pediatric sexual assault nurse examiner (SANE-P). There is also the option to specialize as a forensic nurse as part of a Master of Science in Nursing (MSN) program. Qualifications in correctional nursing and death investigation are also available from specific educational institutions.
Forensic nursing requires a set of carefully honed, highly specialist strengths, including medical and clinical skills and the ‘soft skills’ we explored in this article. It is a challenging but highly rewarding career path in which professionals can contribute not only to the health and wellbeing of victims of crime, but also to their fight for justice by way of collaboration with police and legal experts.
While some individuals have a natural proclivity toward the skills we have mentioned above, all of them can be learned and developed as part of a forensic nursing qualification, or cultivated on an individual basis as the result of focused study.
As the role was conceptualized comparatively recently in terms of the modern medical industry, it is likely that more and more hospitals, medical centers and specialist victim support organizations will require the contributions of forensic nurses as time goes on.
Forensic nurses will undoubtedly continue to be in demand across the US, making it a very sensible role for anyone pursuing a career in the field of healthcare.