6. What is Forensic Nursing?
The application of forensic science, combined with clinical nursing practice as they are applied to public or legal proceedings in the law enforcement arena.
It is the application of forensic aspects of health care combined with biopsychosocialeducation of the registered nurse in the scientific investigation and treatment of trauma, death, violent or criminal activity, and traumatic accidents within the clinical or community institution (Lynch, 1991).
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7. Forensic Nurses
Trauma/ER
SANE/FNE/SART
Nurse Coroners/Forensic Nurse Death Investigators
Nurse Attorneys/Legal Nurse Consultants
Psychiatric & Mental Health
Correctional Health
Domestic Violence
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9. ER/Trauma
Why are they needed
Identification
Care for the Survivor
Care for the Perpetrator
Identification & Collection of evidence
Clothes
Injury and patterns of injury
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10. ER/Trauma
Documentation
What we do v. the crime committed
Chain of custody
Measurements in centimeters
Location
Description
Photography
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12. SANE
A registered nursewho has been specially trained to provide comprehensive careto sexual assault patients, who demonstrates competency in conducting a forensic exam and the ability to be an expert witness.
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13. Benefits of a SANE TEAM
Willingness
Specialty training
Comprehensive care
Fact based documentation (drop all opinions)
Forensic issue
evidence collection
chain of custody
courtroom testimony
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15. Together Everyone Accomplishes More
Don’t tell other members of the TEAM how to do their jobs.
Together we can make offenders want to relocate.
16. SART
Provide victim centered services
Provide compassionate care
Provide community awareness
Where to come
How we will treat you
Encourage reporting of Sexual Assaults
Encourage successful apprehension and prosecution of guilty offenders
Aid in the identifying of false reporting
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17. Sexual Assault
Every 45 seconds a women is Sexual Assaulted.
1:5 Women
1:10-20 Men
Screen ALL Trauma Patients (LOC, clothing)
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18. Sexual Assault Exam
Sexual Assault is rarely suspected unless an outcry is made.
History from Patient (to diagnosis & treat)
Head-to-toe Assessment
Detailed Genital Exam
Collection of forensic evidence
Treatment for injuries, STD’s & pregnancy
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25. Nurse Coroner/Death Investigation
The coroner is a public official who is primarily charged with the duty of determining how and why people under the coroner’s jurisdiction die (these jurisdictions vary form state to state, but typically include sudden, unexpected, unexplained, or traumatic death).
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26. Nurse Coroner/Death Investigation
A licensed nurse who carries out the duties of a death investigator in accordance with the performance standards and procedures established under the medical examiner or coroner’s system of death investigating and the jurisdictional standards of practice.
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27. Nurse Coroner/Death Investigation
Nurses have the educational background to understand exactly what causes death and what happens to a body after death occurs. Death may be a criminal event, but it is always a medical event. Unlike law enforcement who look at the deceased and want to know, “Who killed you?” nurses look at a dead body and ask, “Why are you dead?” If it is determined that the death was due to criminal cause then it is law enforcement’s job to determine who. Who better to determine the manner of death than medical personnel?
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28. Nurse Coroner/Death Investigation
Manner of death is the circumstances in which the cause of death arose, i.e. natural, accident, homicide, suicide, and undetermined. In some cases manner of death may be difficult to determine and may appear accidental (i.e. in a suicide without a note). Forensic nurses possess the skills necessary to complete a psychological autopsy and interpret the subtle nuances of medications, health history and circumstances surrounding suspicious deaths.
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29. Nurse Coroner/Death Investigation
Mechanism of death is the physiologic derangement or biochemical disturbance incompatible with life, which is initiated by the cause of death, e.g. cardiac arrest. Forensic nurses are well educated in physiology and are therefore prepared to accurately distinguish between the cause and the physiologic mechanism of death.
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31. Goals
To establish a leadership role in health care policy making.
To influence health care social policy, health care legislation and nursing practice acts.
To educate the public about health law issues.
To educate the public about nurse attorneys.
To educate nurses about the legal system.
To represent the public; client advocate.
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32. Nurse Attorneys/Legal Nurse Consultants
Nurses want to make fundamental change in the way healthcare is delivered, and recognizing that it needs to occur through legislation and political process is a big piece of it.
Like nurses, attorneys must interact with people who are vulnerable, who have been injured or traumatized, and who need assistance to regain their wholeness.
Client advocacy is the skill nurses bring to the profession.
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34. Issues and Goals
The enhancement of appropriate care for the severe and persistently mentally ill.
The integration of psychiatric and addictions treatment.
Strategies for promotion of mental health and prevention of psychiatric disorders.
The provision of appropriate care within the criminal justice system.
The equitable provision of care for children and adolescents.
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35. Issues and Goals
Ensuring access to care for older adults and members of minority groups.
Advocacy for access to psychiatric-mental health services as readily as access to medical services.
The development of an evidence-based approach to teaching nursing students about psychiatric-mental health nursing, at both the undergraduate and the graduate levels of education.
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37. Correctional Health Nurses
Correctional healthcare is a unique specialty area.
Goals:
Facilitate an improved working relationship between the private sector and the correctional staff in jails, adult and juvenile detention centers, prisons to meet the needs of the inmate patient.
Promote correctional healthcare as part of the public health continuum.
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40. The Surgeon General of the United States recently declared:
“Domestic Violenceis the number one health issue facing the country today”
41. Domestic Violence
DV is the leading cause of injury to women in the world.
DV is the leading nonobstetric cause of death to pregnant women.
Every 9 seconds a women is battered.
1:3 women are a victim of domestic violence
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43. Eva’s Top 5 Domestic Violence Myths/Facts
MYTHS
Poor/unemployed
The victim spends a lot of time running to the doctor
He would never hurt the children
He only does this when he drinks
He wouldn’t kill her
FACTS
<15% unemployed
Only 2/3 will seek medical assistance
There is an increased incidence of child abuse
67% report alcohol abuse only 1/5 drinking at the time of abuse
2 women die each week at the hands of their husbands/Texas
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44. 3-10 Million Children Witness DV Violence in Their Homes Each Year9/15/201444www.drjayeshpatidar.blogspot.com
45. 63% of Young Men Ages 11 to 20 Who
Are Serving Time for Homicide Have
Killed Their Mothers’ Abusers
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46. The Leading Cause of Injury to 14 Year Old Boys9/15/201446
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47. More Facts..
DV kills as many women every 5 years as the total number of Americans killed in the Vietnam War…54,000
Approximately 50% of all homeless women and children in the U.S. are fleeing DV.
There are 7 animal shelters for every 1 DV shelter.
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48. DV & Healthcare Costs
3-5 billion dollars in health care claims
100 million dollars in absenteeism, high turnover and lost productivity
Employee’s miss 1,175,000 days of work per year because of DV alone
DV in the US costs an estimated $67 billion/year
13,000 acts of DV against women occur in the workplace every year
Up to 52% of victims of DV have lost their jobs because batterers typically engage in behavior that makes it difficult to work
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49. Types of Abuse
Physical
Hitting, kicking, strangulation, weapons
Emotional/psychological
Threats, destruction of self worth, isolation
Financial
Work, advancement, access to finances, credit,
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