Meet a Forensic Nurse

Meet a Forensic Nurse

The emerging field of forensic nursing presents a unique opportunity to engage with the convergence of medicine, law, and criminal justice. Continue reading to learn more about the intricacies of this fulfilling and demanding profession. As specialized practitioners bridging healthcare and criminal justice, forensic nurses offer care to patients dealing with the enduring health implications of victimization and violence.

Within their role, forensic nurses conduct patient assessments to identify signs of trauma, conduct investigative interviews, and collaborate with social services and law enforcement. They also actively participate in crime scene investigations and provide expert testimony in legal proceedings.

This feature on forensic nursing offers insights through a Q&A with forensic nurse examiner Laura Clary. It also provides comprehensive information about entering this evolving field, including salary projections, job prospects, and various specializations and work environments within forensic nursing.

Q&A With a Forensic Nurse

What is the role of a forensic nurse, and why is this work significant?

Foremost, a forensic nurse examiner is a registered nurse. My role centers on nursing, distinct from law enforcement or prosecution. I am here as a nurse. Forensic nurses undergo specialized training and certification to deliver trauma-informed, patient-centered care to victims of sexual assault, child abuse, intimate partner violence, non-fatal strangulation, and human trafficking.

Forensic nursing is a challenging arena with notable turnover. I am fortunate to work alongside an exceptional team of nurses who support, collaborate, and deliver compassionate, evidence-based care to violence survivors.

On challenging days, we remind ourselves, “Yes, this job is demanding, but imagine if no one were here to do it? Who would assist these patients in need?” The difficulty underscores the importance of teamwork. My colleagues are more than co-workers; they are a united, dedicated family making a difference in our patients’ lives and community.

Is becoming an RN a prerequisite for becoming an FNE?

In many states, including Maryland, being an RN is a prerequisite for pursuing forensic nursing certification. State-specific regulations vary, so individuals interested in this path should explore their state’s requirements before embarking on relevant courses.

What inspired you to help patients in this capacity?

Since high school, my desire to help people was clear. Nursing resonated with me as a potent means to do so. Simultaneously, my interest in forensics was profound. Working as an emergency room nurse in Baltimore, I encountered sexual violence victims. Given the limitations in our ability to care for them, we would transfer them to hospitals with specialized, skilled nurses.

I always wondered about their journey post my care. My exploration led me to forensic nursing, where I learned about prerequisites, pursued the necessary training, and embarked on this impactful journey since 2010.

At what point in your nursing journey did you decide to specialize in this field?

After becoming an RN in 2008, I swiftly turned my attention to forensic nursing. In Maryland, I needed 18 months of clinical experience before enrolling in the course.

I waited out the 18 months and began the course as soon as I could. Two years after nursing school, I officially entered the realm of forensic nursing.

Could you describe a typical day in your profession?

While I am fortunate to be a full-time forensic nurse manager, I previously balanced full-time emergency nursing with on-call forensic shifts. During on-call shifts, I awaited calls, ready to respond whenever help was needed. This is a common mode of operation for forensic nurses nationwide—on-call availability, waiting for the phone to ring.

As a full-time forensic nurse manager, my day involves overseeing the SAFE & Domestic Violence Program. My role ensures that our team is prepared to respond to patient needs 24/7, year-round.

Furthermore, I believe managers must maintain a bedside perspective. Therefore, I take the same number of calls as my nursing team. Patient care remains a passion, and I am committed to maintaining that connection.

Outside the hospital, I am involved in community education, shedding light on SAFE’s offerings through presentations in schools, community centers, police departments, and other relevant agencies.

How do you uniquely assist patients?

Forensic nurses possess training in forensic photography, specifically alternate light source photography—unconventional in nursing. We employ special dyes to reveal micro injuries not visible to the naked eye.

We collect and preserve biological evidence, drafting comprehensive reports with body maps. Our expertise extends to maintaining evidence chain of custody. Our care persists beyond discharge; we stand by our patients from the bedside to the courtroom. Months or years later, we may testify as expert witnesses, reflecting the care and treatment provided.

Volunteer Opportunities for Former Nurses

What are some significant challenges in this work?

As earlier mentioned, this work carries significant emotional challenges and a risk of vicarious trauma. Vicarious trauma encompasses shifts in a forensic nurse’s perspective of self, others, and the world, stemming from repeated engagement with patients’ trauma-related treatment, emotions, and accounts of suffering.

This underscores the importance of self-care. Managing stress after work and leaving work-related concerns behind isn’t always simple.

Within my team of 18 forensic nurses, we possess a strong bond. I am fortunate to have colleagues with whom I can vent or discuss difficult cases. Collaboration and camaraderie are vital, and I am grateful for the exceptional group of forensic nurses by my side.

How can someone become a forensic nurse?

The prerequisites for practicing as a forensic nurse vary by state. I suggest researching your state’s nursing board to ascertain approved courses.In most states, an accredited 40-hour didactic course is mandatory, followed by various clinical activities and preceptorship under an experienced forensic nurse examiner. The International Association of Forensic Nurses provides comprehensive information.

Any advice for nurses contemplating this path?

If you’re intrigued, I encourage you to explore this avenue. Although challenging, the rewards are immense. After each shift, you’ll have the satisfaction of knowing you made a genuine impact on your patients’ lives. The world can benefit from more forensic nurses.

Becoming a Forensic Nurse: Steps to Consider

Starting the journey toward a career in forensic nursing begins with becoming a licensed registered nurse (RN). RNs obtain associate or bachelor’s degrees in nursing and secure licensure through the National Council Licensure Examination (NCLEX-RN). Pursuing board certification or a graduate degree in forensic nursing represents the subsequent phase. Many RNs opt for training and certification as sexual assault nurse examiners (SANE), a specialized forensic nursing area focused on aiding victims. Aside from RN licensure, SANE programs often require at least two years of experience involving advanced patient assessments.

Aspirants should choose training programs aligned with the International Association of Forensic Nurses’ standards. Additional prerequisites might vary in accordance with state nursing boards.

Upon completion of both classroom and clinical training (40 hours each) and commencement of practice as SANEs, individuals can opt for either of two board certification exams: SANE-A for adult and adolescent care or SANE-P for pediatric care.

Certain jurisdictions hire forensic nurses trained as death investigators. Those interested should possess experience in emergency or intensive care nursing and consider taking an American Board of Medicolegal Death Investigators certification exam. Depending on local regulations, forensic nurses could serve as medical examiners or coroners.

Salary and Job Outlook for Forensic Nurses

Forensic nursing, an RN specialty, carries a median annual salary of $73,300, according to Bureau of Labor Statistics (BLS) data. The advanced skills inherent to forensic nursing—meticulous documentation, critical thinking, attention to detail, and effective communication—can influence earnings. As per PayScale, forensic nurses earn between $59,000 and $89,000 annually.

BLS projections indicate a 7% growth in RN employment from 2019 to 2029. This is anticipated to result in over 220,000 new positions nationwide.

Earnings and job availability can vary based on location. California leads in terms of both RN salary and employment, with an annual mean wage of $113,240, although the state’s job saturation rate is at 17.42 per 1,000 jobs.

Across the board, a scarcity of SANEs underscores the national demand for forensic nursing expertise. In Virginia, for instance, only 16 out of 122 licensed hospitals offer forensic exams, and a mere 150 out of 94,000 Virginia RNs practice forensic nursing.

Other high-paying states include Hawaii, the District of Columbia, Massachusetts, and Oregon, all of which boast RN annual mean wages exceeding $90,000.

Forensic Nurse Specializations and Work Environments

Forensic nurses can select from a range of specializations and career paths, including forensic nurse examiner (FNE), legal nurse consultant, forensic psychiatric nurse, nurse death investigator (NDI), correctional nurse consultant, and forensic nurse educator.

Forensic Nurse Examiner (FNE)

Certified FNEs examine victims of violence, often as part of criminal investigations. They also offer crisis intervention, refer patients to other programs, and utilize forensic photography to collect evidence. They often provide expert witness testimony in legal proceedings.

Legal Nurse Consultant
Legal nurse consultants collaborate with physicians and attorneys, advising on medical evidence for ongoing cases.

Forensic Psychiatric Nurse
These nurses assist patients dealing with emotional or physical trauma. Nurse death investigators (NDIs) perform post-mortem examinations and gather evidence at crime scenes.

Correctional Nurse Consultant
Correctional nurse consultants work with incarcerated patients, providing healthcare services, exams, and medication.

Forensic Nurse Educator
Forensic nurse educators teach courses in forensic nursing, covering subjects such as evidence collection, domestic violence, and elder abuse.

While general medical and surgical hospitals employ the highest number of RNs in the U.S., forensic nurses practice across diverse settings. Their presence is evident in hospital emergency rooms, urgent care centers, psychiatric facilities, prisons, community anti-violence programs, government agencies, and offices of coroners and medical examiners.