30 Years of Forensic Nurse Influence and Impact on Justice

Source: Patricia M. Speck, DNSc, and Stacey A. Mitchell, DNP, Forensic Nursing Science Section

During National Forensic Nurses Week, (November 6–12), the Forensic Nursing Science Section of the Academy joins with members of other nursing and forensic organizations throughout the world to celebrate the mission, the work, and outstanding accomplishments of forensic nurses. Thousands of nurses in more than 30 countries endeavor to change the lives of patients who experience impact from violence and to advocate for policy change in health care, law enforcement, and legal systems, which interface with victims and perpetrators of violent behavior. Real progress in curtailing these incidents requires a broad, multidisciplinary coalition of dedicated professionals that includes forensic nurses. 

Through multiple millennials, nurses are present in the forefront of efforts to respond to human suffering. Only in the past 30 years has the term forensic nurse described a specialty that continues to impact communities globally. Virginia Lynch provided a name to distinguish and a framework to study the work of many nurses over thousands of years. The roles were grounded in nursing first, expressed by the Catholic Church and the work of Sisters who nursed in the community. Careful Nursing is an early term adopted by Florence Nightingale and her colleague Sr. Mary Clair in their notes and publications. Other Sisters were serving communities that included psych-mental health, rape, unintended pregnancy, prisons, poorhouses, and epidemics. They lived and died serving the most vulnerable in their communities since the earliest recorded history. In the United States, Catholic and Protestant nurses worked in impoverished communities of lepers (Hanson's Disease), disenfranchised migrants (tenants in New York City), widows and orphans, former slaves, and persons suffering religious persecution. By providing a name (forensic nurse) and a framework, the forensic nurse role spread worldwide, encompassing serving populations of migrants, refugees, homeless, trafficked, imprisoned, persons with mental health challenges and disease, and war survivors — all persons equally disenfranchised by society. Research emerges daily as to the value of the forensic nurse in interprofessional teams and to patients intersecting with legal systems.

Like many service vocations and professions, the foundations are often not recorded, and that is true with the forensic nurse. However, today scholars who are educators and practitioners are able to align the science and practice with nursing, define the core competencies, list key content necessary in programs of study, and create a solid curriculum for the forensic nurse in accredited schools of nursing. Academia is complex, requiring full understanding of the defined levels of nursing practice, as defined by the American Association of Colleges of Nursing. The Forensic Nursing Certification Board built on the early work of former Presidents of the International Association of Forensic Nursing (authors) and updated the interprofessional evidence base to bring consensus for the unique core competencies of a forensic nurse and, along the way, qualitatively defined various descriptions of the practice, context for practice, the competency for Levels 1 and 2, as well as the content necessary for curriculum globally. Today, the comprehensive efforts to formalize the foundations envisioned by Virginia Lynch have a researched Delphi consensus for over 126 forensic nurse educators and practitioners in a 20-year effort to establish the necessary foundation to sustain the specialty role from here forward.

Since being named 30 years ago, the growing impact of the forensic nurse is seen in criminal and civil courts as an advocate for truth and justice. As part of the most trusted profession (nursing), the work of the forensic nurse is useful to the courts, not only as an educator teaching about the medical legal evaluations of patients, but as an expert with clinical experience and expertise in a forensic nurse specialty. Key to the relevance of the forensic nurse role in the collaborations among interprofessionals are descriptions about medical-legal health care processes, aligned with nursing process, from assessment to descriptions of what is heard, seen, evaluated, and treated, including the characteristics of superficial and more serious biological, psychological, social, and spiritual injury as well as the interventions necessary for recovery. With knowledge about the other two pillars in the forensic nurse role — legal systems and forensic science — naming of the complex preparation of the forensic nurse created an ally for justice globally.


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