Forensic Nursing and Its Challenges to the Profession - Term Paper Example

Forensic Nursing and Its Challenges to the profession Nursing is a profession which works on the core concepts of empathy, communication, caring, trust, advocacy, and leadership. Every area of nursing uses these concepts and beyond to provide care to clients at times when they need it the most. Forensic nursing has addressed important concerns in nursing such as timely investigation of forensic evidence that could lead to early recovery ;however, forensic nursing is a new field that needs to overcome challenges such as recognizing its important role in healthcare institutions. The result of which is development of the profession and appropriating funds to cover the expense of hiring more forensic nurses. The Nature of Forensic Nursing According to the American Academy of Forensic sciences (AAFS) forensic nursing is “the application of forensic aspects of health care combined with the bio/psycho/social/spiritual education of the registered nurse in the scientific investigation of trauma and or death” (Hammer and Pagliario, 2006). In the past, forensic medical interventions (including lifesaving interventions) were withheld until a Forensic medical examiner (FME) has arrived at the emergency department and had collected evidence (Pyrek, 2006 ). In fact, clients were even transferred to other cities that offered forensic clinical services; moreover, there was not much intervention that could be provided in order to protect forensic evidence ( Pyrek, 2006). When a Forensic Nurse Examiner (FNE) is available at the clinical site, they are able to secure the important forensic evidence requiring timely recovery and preservation without withholding medical interventions ( Pyrek. 2006). In 1991, the American Society of Forensic Nurses was the first to recognize and accept Forensic Nursing as a specialty (Bader and Gabriel, 2009 ). The following year , 72 primary sexual assault nurse examiners formed the International Association of Forensic Nurses (IAFN) (International Association of Forensic Nurses, 2006). The aim of the IAFN promoted the education of forensic nurses; thus, the Forensic Nursing Code of Ethics and the Scope and Standards of Nursing Practice was developed in 1997(Bader and Gabriel, 2009). Forensic Nursing is a specialty that is still in its infancy, thus it needs to continuously grow to provide an appropriate response in trauma cases, provide a more holistic care to their clients, and create advocacy for their patients in an unbiased , scientific, and objective manner. In the past many of these roles have been carried out by emergency nurses who may not be aware of the legal complexities that characterize trauma cases, and who may not consult with the hospital legal team when such cases are presented, potentially resulting in loss of critical forensic evidence( Pyrek, 2006). Importance of Forensic Nurses in healthcare institutions Forensic nurses can provide appropriate health care response in the event that they are presented with either a victim or a perpetrator of a traumatic case. They are trained in identifying injuries and their patterns, documenting statements and injuries through written and photographic accounts, and collecting and preserving physical evidence. Linda McCracken in the forensic nurses states that” health care and the law often become enmeshed during critical moments when patient care supersedes the concern for social justice. ( Pyrek, 2006). Most nurses and institutions are not trained to recognize the importance of physical evidence, so in the process of providing care to the patient, key physical evidence may be lost, i.e.: through discardment of victims clothing, or cleansing of the wounds. When most trauma cases are presented to the Emergency department, the Emergency nurse is most often the first person encountered by the patient, the first to know the situation, deal with the family as well as patient property; thus, first to deal with the specimen and evidence ( Pyrek, 2006). In these situations, the evidence and the manner and the time in which they are collected, saved, and documented can have an impact on the turn out in the analysis and legal proceedings (Ledray, 2010). Forensic Nursing has a multi-disciplinary approach Forensic nurses provide a more holistic care to their clients by including the forensic aspect within their care plan (Pyrek, 2006). A forensic nurse play similar roles as any other registered nurse such as patient advocacy; however, they also work closely with the legal system, making them more active members of the investigation, liaisons for law enforcement and facility staff, as well as identify, collect, and preserve the evidence, provide accurate documentation, and act as expert witnesses in courts (Bader, D.M., Gabriel, L.S., 2009). The forensic nurse practice models include sociology, criminology, clinical and criminal investigation, and education (Hammer and Pagliaro, 2006). The forensic nurse is not just an advocate for the client but an advocate for truth and justice: in addition to this, Bader and Gabriel (2009) asserts that the first priority of a forensic nurse is to ensure the safety of the living victim and the dead victim’s body, collecting and preserving evidence from the body, performing a forensic examination with the intention of identifying and collecting evidence that may have transferred from the victim, collect evidence from without bias and without causing physical and psychological stress to the living or dead victim, and documenting all evidence . They are also responsible for conducting interviews on the victim, suspected victimizer, convicted victimizer; family, friends, and witnesses (Bader and Gabriel, 2009).They have to pay attention to collect any physical evidence ( dirt and paint chips), biological evidence ( saliva, insects) and physical material i.e. fabric (Bader and Gabriel, 2009). Lastly, the documentation which is perhaps the most important piece of evidence in an investigation should be accurate, descriptive, and without personal bias. Roles and responsibilities of Forensic nurses Forensic nurses have to be unbiased and scientifically objective. Forensic nurses don’t come only in contact with victims of violence, but also with the victimizers. While many nurses when faced with a suspect or accused of a crime may be more concentrated on finding out why the suspected or accused perpetrator may have committed the act. While the question may be important, forgetting to concentrate on the evidence can be perilous. As forensic nurses they need to concentrate on what they are seeing, and what needs to be collected for the purposes of analysis. According to Janet Baber, MSN, FN, “in the beginning forensic nursing was based on helping people in need...Now forensic nursing has evolved to where we must compartmentalize our desire to nurture, console – any nurse would do that because caring for and protecting human being is instinctive “( qtd. From Pyrek, 2006). The advocacy component is not unique to forensic nursing...the forensic nurse cannot be get overtly involved in advocacy. This nurse must stay within an objective, scientific framework, because if a nurse allows advocacy to supersede concern about the evidence, he or she will become diverted from the purpose of forensic nursing (Pyrek, p.29).” Concentrating on the evidence will help more in uncovering the truth of the crime and revering justice than being embroiled in emotions of the case and the client. This is what will help the forensic nurse when it comes time for them to provide the evidence in court, where they are going to have prove that they were objective in their evidence collection and that they were not deterred and entangled in the circumstance of the case. In the book Forensic Nurse, Sharon Crowley, RN, MN, and California forensic examiner says that, “What I do as a forensic nurse is going to be dissected in a court, or in a crime lab. Forensic nursing practice is mandated by science, and I don’t have a problem with that because I see my advocacy come through science “( qtd from Pyrek, p.30). Challenges to forensic nursing The reason behind the origin of forensic nursing was that forensic pathologists believed that pertinent legal questions were not being addressed, and inspite of resistance the specialty has grown significantly (Hammer, R.M., Pagliaro, E.M., 2006). As forensic nursing continues to grow, there will have to be increased interprofessional collaboration, communication, and sharing of information and knowledge to achieve justice. Currently, there are not many hospitals, clinics, if any, that have a forensic nurse in place, because not many institutions believe that it is necessary to have them, not to mention there is already a poor patient to nurse already. Some challenges that the specialty will face will probably include - job opportunities, funding, education and training, professional development mandates, and continuing acknowledgment of importance and respect from other health care colleagues (Pyrek, 2006). Forensic nurses have to be self-directed, and be confident in their abilities. Personal experience and self-reflection I have been interested in forensic science for a long time, and took a full year course at University of Toronto as an elective about 3 years ago. We were introduced to different areas of forensics, but forensic nursing was not one of them. It was very interesting to research this topic and learn about the roles of forensic nurses. Having had done a placement in long term care, I have heard of many of elder abuse, and realize that the issue is probably not getting the attention it deserves. I like that forensic nurses extend the roles of registered nurses to include the forensic aspect in their care. I realize that it would be very challenging to pursue a career as a forensic nurse, and hope that it will continue to grow. Conclusion The whole purpose of forensic nurses is to aid their law enforcement and forensic science colleagues in analyzing the evidence, and to do that, it must be important that they take out their emotions about the victim, victimizer, and case, to collect what they see without bias and utmost objectivity to ensure justice. Forensic nursing is a speciality that face many challenges in its growth mainly in terms of job opportunities, especially in today’s clients where institutions hardly are able to keep a good nurse to client ratio, it will probably be hard to establish the need for forensic nurses, however, until there is a high profile case that increases concentration on forensic nursing, they will just have to be more self-directed in their career ( Pyrek, 2006). Read More