Friday, November 13, 2009

The Forensic Nurse

Today is the last day of the first "Forensic Nurse Week" ever. It will take place annually the second week of November. This is very exciting for all of us in the profession. When I began working in the field in July of 1987, we were not even officially recognized as a specialty in nursing!


Many people are completely unaware of forensic nursing. Just what is it? I will share with you this definition directly from my organization, the International Association of Forensic Nurses, of which I was a founding member ( www.iafn.org ):


"Forensic Nursing is the application of nursing science to public or legal proceedings; the application of the forensic aspects of health care combined with the bio-psycho-social education of the registered nurse in the scientific investigation and treatment of trauma and/or death of victims and perpetrators of abuse, violence, criminal activity and traumatic accidents.


The forensic nurse provides direct services to individual clients, consultation services to nursing, medical and law related agencies, and expert court testimony in areas dealing with trauma and/or questioned death investigative processes, adequacy of services delivery, and specialized diagnoses of specific conditions as related to nursing."


Also, the International Association of Forensic Nurses has listed the various areas in which forensic nurses work:


Interpersonal Violence
Forensic Mental Health
Correctional Nursing
Legal Nurse Consulting
Emergency/Trauma Services

  • Automobile and Pedestrian Accidents
  • Traumatic Injuries
  • Suicide Attempts
  • Work-Related Injuries
  • Near-Fatal Trauma
  • Disasters

Patient Care Facility Issues


  • Accidents/Injuries/Neglect
  • Inappropriate Treatments/Medication
  • Administration
Public Health and Safety


  • Environmental Hazards
  • Drug/Alcohol Abuse
  • Food and Drug Tampering
  • Illegal Abortion Practices
  • Epidemiological Issues
  • Anatomical Gifts (Tissue/Organ Donation)
Death Investigation

I came into the field as the result of an accident. I had previously worked in psychiatry, both adult and child, or the operating room, alternating between the two. After a fall in the OR, which resulted from slipping on hydraulic fluid that had leaked from an orthopedic table, which ultimately resulted in my having extensive back surgery and being disabled for a year and a half, my surgeon felt it would be unsafe for me to resume OR duties or to work in psychiatry. The Child and Adolescent Sexual Abuse Resource Center was advertising for an on call RN to cover cases and I applied. The rest is history.


When the city decided to train nurses to do adult sexual abuse exams, which was a half time position with benefits, I applied and was hired there, also retaining my on call work for CASARC. I found the work very exciting and exacting and my colleagues in the profession were always willing to help, in any way possible.


While there were programs of sexual assault nurse examiners in the U. S. since 1976, it was not until 1992 that 72 nurses met in Minneapolis, MN, called together by Linda E. Ledray, RN, Ph.D., SANE-A, FAAN, Director, SANE-SART Resource Service, MMRF, Minneapolis, Minnesota. It is the only time in my life that I was in the right place at the right time.


We spent two days, and long into the night, deciding on our name, our goals, and talked about our dreams. I recall, fondly, staying up almost until dawn, in the University of Minnesota dorm, with the pioneers in forensic nursing, such as Ann Burgess, Virginia Lynch, and Pat Speck and many more - 72 of us. We agreed to hold an annual scientific assembly and set a date for our next meeting, to be held in my own home state of California.


Just a few years later, the American Nurses Association recognized forensic nursing as an official specialty and, not long after, our newly established forensic nursing certification board offered the first specialty exam for adult sexual assault nurse examiner certification. I very anxiously sat for that exam and proudly was able to write SANE-A, after the RN following my name.


At our scientific assembly in 1996, when our founding president, Virginia Lynch, handed over the gavel, I read a poem, "The Forensic Nurse" that I had written to honor her and all of my colleagues inf our International Association of Forensic Nurses. This specialty and that membership in IAFN has been the most wonderful aspect of my nursing career. It has defined me as a nurse professional and I feel I have done the most good in this specialty for an often overlooked population. I would encourage all nurses to consider forensic nursing as their area of specialization


On this last day of our first ever Forensic Nurse Week, I want to say thank you to so many. I won't and can't name you all personally but you know who you are - my wonderful colleagues and mentors, friends and fellow forensic nurses who have been there for me, every step of the way for my entire twenty-two years in the field. I am blessed to have had you in my life. I thank God daily for putting me in the right place at the right time! May you all continue in the work with great blessings.



The Forensic Nurse


At the dawn of a new millennium, there has evolved a need,
For a new group of nurse professionals, a pioneering breed,
On the cutting edge of nursing, to fight crime's vicious curse,

Health care responds to violence, in the role of forensic nurse.

The tasks are many and varied, each sharing a common thread,
A search for truth and justice as this specialty forges ahead.
Fighting interpersonal violence, making note of multiple clues,
Learning to hear the unspoken, recognizing the tiniest bruise.


A commingling of nursing science, forensic science and the law,
From this vast wealth of knowledge, the forensic nurse must draw,
From sociology, and psychology, criminology and fields diverse,
An arsenal of such education, arms the forensic nurse.


Easing the trauma of rape, responding to a criminal scene,
Compassionate notification of kin, judging nothing as routine,
Dealing with drug and alcohol abuse, calling for a hearse,
Providing care for inmates, these are roles of the forensic nurse.


Facilitating organ donation, expert witness testimony in court,
Investigating work place injuries, writing a medicolgeal report,
Assisting in forensic research, providing specialized quality care,
Educating and consulting with colleagues, making the public aware.


From birth to death, and far beyond, there is a difference made,
By nurses who have undertaken to embrace a new crusade,
In the fight against crime and violence, helping in its reverse,
Is the commitment and dedication of the forensic nurse.


Carmen Henesy

Dedicated to founding president, Virginia Lynch, 
and my colleagues 
of the 
International Association of Forensic Nurses

Copyright (c) 1996 by Carmen Henesy
All rights reserved. 


18 comments:

  1. Thanks for sharing, Carmen. I felt a frisson, a thrill reading your post. I admire your enthusiasm for your work, your talent for putting it down in words, and your strength. Good wishes to all the people you've worked with.

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  2. fullet, that means so much to me. I am very sad
    that the SF budget cuts meant the loss of my job
    of 21-1/2 years. Of course, I will always
    remain a member of IAFN and I was so honored by
    that organization, in 1995, with an achievement
    award. I will, hopefully, be doing some
    consulting work in the future. On behalf of me
    and my colleagues, thanks for your good wishes!

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  3. I can see that working with trauma victims is a demanding profession. Best wishes on your semi-retiment.

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  4. I was going to leave a comment, but that glass of wine looks good. Think I'll tkae a break and pour me a glass of Caberbet Sauvig
    Stephen Tremp

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  5. i am so humbled to read of your work and your dedication, Carmen! thank you for sharing with us a bit of it.

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  6. COngrats on this wonderful career you had, what a blessing, I know all nurses are not appreciated enough. It takes allot of compassion, caring, PATIENCE. THANKS SO MUCH.
    Blessing on your retirment.. JOB WELL DONE

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  7. lskeviewer, demanding, yes, but very rewarding and
    my colleagues were always there for support and
    encouragement when needed!

    Stephen, you should have poured me a glass! I am
    glad you stopped by!

    Manuela, I am pleased to have people learn that
    there are forensic nurses out there. They
    are doing work with the victims in Darfur,
    Sudan at the present time and our
    organization has grown from our Canadians at
    the beginning to world-wide members. I was
    so honored by my Japanese counterparts when I
    visited there several years ago!

    Inky, it has been a wonderful career though, at
    times, when that pager went off at 3AM, I
    could have chucked it all! One of the detec-
    tives always used to tease me on New Year's
    Eve as we inevitably met in the emergency rm,
    "My wife is getting tired of this!"

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  8. This sounds like very important work. I think I might have a hard time seeing victims of crimes and things like that. It takes a special person to be able to do these things.

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  9. Ratty, sometimes it was very difficult. Having
    worked for many years,I did not have as
    hard a time dealing with the emotional
    aspects as I did with some of the physical
    brutality I saw dealt to some patients.
    It is amazing how humans treat each other.
    Sometime when an advocate would be talking
    to the the patient, I would just go outside
    and take a few breaths of fresh air!

    Hardest was when we would do videotaped
    forensic interviews of children. Then, we
    would have a special, nonleading way that
    had to be done and we could not reach out to
    comfort or console a child, in any manner
    that might be misinterpreted by the courts.

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  10. What an interesting post! There was a forensic science laboratory where I worked (police) and the work they did held a fascination for me. Emphasising 'work' as opposed to the horrors of their subjects. The police clerical staff used to give blood samples at certain times which provided me with the opportunity to stop and chat.

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  11. TY for your comments on my write Angels without wings" this post , thanks to you, made me do it.
    My mom was a nurse until she had to stop because she took on another tough yet rewarding career, having babies becoming a mommy ..lol

    I wanted to be one, but I hated the sight of blood, and Doctors, scare me lol

    I felt bad because I do love making people feel betterand I do just that every chance I can.

    Thanks goodness I have not been in the hospital that much, but, when I have been around them, it is not the doctors that comfort, ease, make them smile, feel cared about, its the nurses, not matter what type of nursing. It is always the nurses that come through,no matter what the trade
    I am glad U liked the poem, and your welcome to use it.. WOW!!! TY SO MUCH

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  12. I agree with Ratty, and that it takes a very special person with a big heart like yours to be able to do a great job.

    Thanks Carmen, for your dedication and skills.

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  13. you must have a huge heart....and blessed are those in your lives....

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  14. oops...blessed are those in your life...not lives...well, unless you've lived a few others you haven't told us about !!

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  15. Valerie, forensics is very interesting, hence the
    success of all the CSI shows and Bones, etc.

    Inky, I have to agree with you, nurses and very
    often the nurse aids, are the caregivers. In
    this era of cutbacks and RN shortages,
    staffing in often minimal and nurses are
    hard pressed to have enough 1:1 time with
    patients.

    Beth, I think I may have past lives! One thing
    that helped so much in doing this work was
    the ability to call one of my fellow nurses,
    at any time, if I needed to debrief after a
    case. We all knew we could do that. Also,
    at our weekly staff meetings, we talked
    about our cases and had a "check in" with
    our therapists, also helpful.

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  16. What a wonderful profession and you have every right to be proud of your friends and mentors as well of yourself. Our world today really need people of your calibre.....:- Hugs

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  17. I think your profession sounds fascinating. I've always had an interest in forensics. It must be very fulfilling for you.

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