Forensic nursing/ Essay / Paper by

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Forensic nursing/ Essay / Paper by Forensic nursing/ Essay / Paper by Document Transcript

  • FORENSIC NURSING 1 Forensic Nursing Introduction Forensic nursing is a developing and innovative nursing branch, which is founded at the crossroads of healthcare, forensic sciences, and criminal justice. As crime and violence bring together healthcare and justice, cooperation between physicians, nurses, lawyers, and sociologists becomes more and more important and calls forth the need for integration of medical and legal knowledge, as well as knowledge of forensic sciences (Lynch V., 1995). The introduction and development of forensic nursing was caused by a strong necessity to ensure efficient clinical forensic intervention, preservation of evidence, effective examinations of sexual assault victims, abuse identification and reporting (especially against women, children, and elderly people, as they tend to under-report violence), and skilled specialists. To be more precise, the introduction of this discipline is called forth by the need to combat interpersonal violence and criminal behavior in society. History and Development The modern concept of forensic nursing is considered to be derived from the practice of clinical forensic medicine. According to McLay, a subspecialty of forensic medicine (defined as application of forensic medical knowledge and techniques to living patients) has existed worldwide for more than two centuries (1990). Forensic medicine specialists used to be called police surgeons or forensic medical officers. The role of forensic medical specialists is considered to be the model for forensic nursing specialization development. Nonetheless, before the 1980s, cooperation between medicine and criminal justice had not been considered an important issue. A strong bond between treatment of victims of homicide and ensuring justice was emphasized in Smialek’s (1983) article “Forensic medicine in the emergency department”. Further researches by Mittleman, Goldberg, Waksman, and Koop also
  • FORENSIC NURSING 2 emphasized the strong need for evidence preservation and an effective response to victims of violence both by healthcare and legal systems. According to the information provided by the International Association of Forensic Nurses, the concept of forensic nursing itself originated in 1992 at a conference in St. Paul, Minnesota, where a group of seventy nurses met at the first national convention for sexual assault nurses (International Association of Forensic Nurses Website Homepage). As since then the forensic nursing specialty has been rapidly evolving and ramifying, including more and more fields of practice, it is worth researching into the concept of forensic nursing and its components. Definition of Forensic Nursing. Types of Forensic Nurses Forensic nursing can be considered both a branch of nursing and a judicial system (as it tackles evidence collection, which is critical to specific criminal cases) (Lynch, 2006). In order to understand the concept of forensic nursing, we need to refer to the definition of the term “forensic”. It is usually described as “pertaining to the law”, specifically issues which relate to public debate (American Academy of Forensic Sciences, 2010). Modern forensic nurses act in such areas as domestic violence, abuse or neglect of children and elderly people, psychological abuse, trafficking in human beings, religion-related violence, forensic mental and psychiatric health, nursing in correctional establishments, automobile and pedestrian accidents, suicide attempts, drug or alcohol abuse, checks for environmental hazards, suicide cases, and suspicious deaths. Professional duties which are performed by forensic nurses include provision of direct service to individual clients, consultation services to medical and legal agencies, collection of evidence from suspects and victims, conducting forensic photography, providing expert court testimony, and serving as a bridge between healthcare and legal systems. In general, nurses provide nursing and forensic services.
  • FORENSIC NURSING 3 With regard to the variety of cases that forensic nurses deal with, Virginia Lynch defines it as “application of the nursing process to public and legal proceedings, and the application of forensic healthcare in the scientific investigation of trauma and/or death related to abuse, violence, criminal activity, liability and accidents” (Lynch, 2006). Due to broadness of the forensic nursing field, a variety of subspecialties have evolved within it (Forensic Nurse Clinical Specialist, Forensic Nurse Investigator, Nurse Coroner or Death Investigator, Sexual Assault Nurse Examiner, Legal Nurse Consultant, Forensic Gerontology Specialist Forensic Psychiatric Nurse, and Correctional Nursing Specialist). Activities of clinical forensic nurses include provision of care for survivors of crimerelated injuries and deaths, which take place within medical institutions. Collecting evidence is an important aspect of professional duties performed by this type of forensic nurses. By comparison, a forensic nurse investigator deals with scientific investigation of the scene and circumstances of injury and/or death. The subspecialty of the nurse coroner is similar to the one of the forensic nurse investigator. A nurse coroner serves as an elected official who is involved in investigation and certification of questioned deaths. They help to examine the scene of crime, study the body, assist during autopsies, and collect information on the deceased in order to find out the exact cause of death. A sexual assault nurse examiner is considered to be the first type of forensic nurses, which has evolved within general nursing. This subspecialty includes examination and assessment of injuries got by the victim, collection and preservation of evidence, provision of recommendations on the victim’s continued care. Moreover, a sexual assault nurse examiner helps victims to avoid anxiety related to being testified in court, being their official representative and offering expert testimony.
  • FORENSIC NURSING 4 The duty of a legal nurse consultant lies in providing witness testimony and extra education for healthcare and legal professionals in the fields related to issues which arise at the junction of healthcare and justice. Most often, legal nurse consultants help attorneys who deal with medical malpractice, personal injury, workers’ compensation, and probate. Their help is valuable in the context of analysis of medical information related to the case. Forensic gerontology specialists help to investigate cases which include abuse, neglect or unlawful exploitation of the elderly. According to the National Forensic Nurses’ Research and Development Group, “There is an increasing need for forensic knowledge and understanding about the role of Forensic Mental Health Nurse in all settings and with all groups of patients. The majority of general mental health nurses work with histories of offending in (non-forensic) settings, including acute admission wards; services for young people and children; therapeutic communities; and facilities for treatment and recovery, as well as individuals with problematic substance use” (2008,12). Although both psychiatric and correctional forensic nurses interact with the perpetrator, the nature of the relationship and the timing differentiate their roles (Coram J., 1993). As we have mentioned above, psychiatric nurses take care of perpetrators’ mental health while incarcerated, whereas correctional nurses care for physical needs of those who are convicted. Within different types of correctional facilities, these nurses tend to the sick, perform physical examinations, and administer medication to people who suffer from chronic diseases. The main difference between the two aforementioned types of specialists consists in the fact that both mental health and correctional nurses offer a more holistic evaluation of a patient’s background, taking into consideration the person’s family, culture, emotional wellness, physiology, and spiritual values (Coram J., 1993, 5).
  • FORENSIC NURSING Therefore, modern forensic nursing is a broad concept, which includes a variety of subspecialties whose representatives perform nursing and legal functions in relation to taking care of physical or mental state either of a victim or a perpetrator and providing assistance in terms of investigation and judicial review of the case. International Association of Forensic Nurses Since its founding in 1992, the International Association of Forensic Nurses has promoted professional training of forensic nurses and the implementation of forensic nursing itself worldwide. The organization includes more than 2000 members from 11 countries and territories. According to the IAFN official website, the mission of the organization is to provide leadership in forensic nursing practice by developing, promoting, and disseminating information about forensic nursing science all over the world (International Association of Forensic Nursing Website Homepage). Among its duties are the incorporation of preventive strategies into forensic nursing at all levels, setting and improving standards of evidencebased forensic nursing practice and promoting and encouraging exchange of ideas among members of the IAFN and related disciplines, the establishment of ethical conduct standards for forensic nurses, and the creation and facilitation of educational opportunities for forensic nurses and related disciplines. The IAFN Strategic Plan 2010-2014 includes four main pillars, which are forensic nursing practice, financial perspective, leadership development, and value for members. Establishing the educational foundation for forensic nursing practice, which is one of the most important strategic objectives of forensic nursing practice, includes such objectives as developing the forensic nursing core curriculum, market definition, and current specialty guidelines. In order to provide a methodological basis for implementing the aforementioned objectives, promotion and encouragement of research in the clinical practice of forensic 5
  • FORENSIC NURSING 6 nursing is included as a critical point in the strategic plan. Moreover, some points mentioned in the “Value for Members” section are aimed at promoting education of forensic nurses. These points are the provision of web-based educational opportunities, diverse topics at various learner levels, and provision of local education, increasing awareness and participation in certification. The organization is going to continue holding the annual Scientific Assembly of Forensic Nurses, whose aim lies in disseminating knowledge related to forensic nursing among members and non-members and offering various topics for forensic nurses’ education. Benefits of Practicing Forensic Nursing After having read a variety of literature on the issue under discussion, many can argue that functions performed by forensic nurses often overlap with professional duties of other specialties either within healthcare or legal systems, and, therefore, it is not worth implementing such a specialty. Thus, in this section, we would like to address the benefits of implementing forensic nursing subspecialties into the practice of healthcare and legal institutions. First of all, the implementation of forensic nursing is a valuable tool in terms of “addressing the dynamics of archaic cultural traditions and religious practices that continue to pose threats to vulnerable subjects in each society – women, children, the disabled, the elderly and the poor”. (The source is not mentioned!) A strong emphasis on cultural peculiarities of different societies, human rights, and international law is possible in forensic nursing practice, as these issues form an important part of their education. Furthermore, the implementation of Sexual Assault Nurse Examiner position is valuable in the context of HIV and sexually transmitted diseases prevention. Moral dimensions of being a victim of interpersonal violence, abuse, and neglect are also successfully addressed by forensic nurses. One-to-one counseling provided by forensic nurses
  • FORENSIC NURSING 7 has a potential to help a victim cope with both medical and moral consequences of the situation (Home Office, 2004). Besides cultural competence and victim care, it is also important to mention such benefits of forensic nursing as the opportunity to better preserve evidence (especially in cases related to sexual assault) and ensure professional gathering, analysis, and documentation of evidence. Specialists also mention that findings made on the basis of examination of evidence should be presented in court by skilled forensic specialists, so that the court gets the correct and adequate information about all crucial issues that can influence its decision. To sum up, a number of important benefits ground the necessity for implementing forensic nursing into the practice of healthcare and legal institutions worldwide. Modern Trends in Forensic Nursing Development Among the trends which influence the development of the forensic nursing field, it is worth mentioning an increasing use of the holistic approach to patients’ needs, provision of new services for specific groups and services which are culturally or gender sensitive, new or extended roles of forensic nurses (for example, related to influencing a relevant governmental policy), and a constant search for new knowledge (The National Forensic Nurses’ Research and Development Group, 2007) (The National Forensic Nurses’ Research and Development Group, 2008). Conclusion Recent developmental trends in forensic and nursing sciences together with a strong need to observe human rights in forensic practice have made forensic nursing one of the major areas of nursing development in the 21st century. Forensic nursing addresses not only taking care of health either of a victim or a perpetrator, but it also takes into account peculiarities of cultural, legal, and court systems of the country. The implementation of
  • FORENSIC NURSING forensic nursing also helps to reduce waiting time for victims, preserve and analyze evidence more efficiently, and present related medical issues in court. The International Association of Forensic Nursing is an organization whose work is aimed at disseminating information about forensic nursing science worldwide and the implementation of forensic practice in hospitals and legal institutions worldwide. Modern trends in the development of forensic nursing include a holistic approach to various needs of patients, working out culturally and gender sensitive services, and extending the role of forensic nurses. 8
  • FORENSIC NURSING 9 References American Academy of Forensic Sciences (2010) Website home page. Retrieved September 6 2012, from Coram J. (1993) Forensic Nurse Specialists: Working with Perpetrators. Journal of Psychological Nursing and Mental Health Services, 31, 11 Home Office (2004) Forensic Nursing: an option for improving responses to reported rape and sexual assault. London: Regan L., Lovett J. and Kelly L. International Association of Forensic Nurses Website Homepage. Retrieved September 6 2012, from Lynch V. (1995) A new perspective in the management of crime victims from trauma to trial. Critical Care Nursing Clinics of North America, 7, 3 Lynch V. (2006) Forensic Nursing Science, Berlington: Jones&Bartlett Learning, LLC McLay W. (1990) Clinical Forensic Nursing, London: Printer The National Forensic Nurses’ Research and Development Group (2008) Forensic Mental Health Nursing . Capabilities, Roles and Responsibilities. London: Kettles A., Woods The National Forensic Nurses’ Research and Development Group (2007) Mental Health Nursing: Forensic Aspects of Acute Care London: Byrts R. &Hardie T.