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Forensic Nursing Introduction Forensic nursing is a developing and innovative nursing specialty, which is founded at the crossroads of healthcare, forensic sciences and criminal justice. As crime and violence bring together healthcare and justice, cooperation of physicians, nurses, lawyers and sociologists becomes more and more important and calling forth the need for integration of medical and legal knowledge, as well as knowledge of forensic sciences. (Lynch V., 1995) Introduction and development of forensic nursing evolved in response to the strong necessity to ensure qualitative clinical forensic intervention, preservation of evidence, effective examinations of sexual assault victims, identification and reporting the abuse (especially against women, children and elderly people, especially those, who tend to underreport violence), exerted evidence by skilled specialist. To be more general, introduction of this discipline is called forth by societys wish to combat interpersonal violence and criminal behavior. History and development Modern concept of forensic nursing is considered to be derivative from the practice of clinical forensic medicine. According to W. 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 were usually called police surgeons or forensic medical officers. The role of forensic medical specialist is considered to be the model for forensic nursing specialization development. Nonetheless before 1980s cooperation of medicine and criminal justice was not considered an important issue. The strong bond between treatment of victims of homicide and ensuring justice was emphasized in Smialeks (1983) article Forensic medicine in the emergency department. Further researchers by Mittleman, Goldberg, Waksman and Koop also paid attention to the strong need of evidence preservation and effective mutual response to victims

of violence both by healthcare and legal systems. According to the information, provided by 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 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 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. forensic 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 suspect and victim, conducting forensic photography, providing expert court testimony, and serving as a bridge between healthcare and legal systems. To be more general, nurses provide nursing and forensic types of service. Taking into account variety of cases 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 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 the survivors of crimerelated injuries and deaths, which take place within medical institutions. Collecting evidence is an important aspect of professional duties, exercised by this type of forensic nurses. By comparison, Forensic Nurse Investigator deals with scientific investigation of scene and circumstances of injury and/or death. The subspecialty of Nurse Coroner is similar to the one of Forensic Nurse Investigator. 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. 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 recommendations on victims continued care. Moreover, Sexual Assault Nurse Examiner helps the victim to avoid anxiety related to testifying in court, being his/her official representative and offering expert testimony. The aim of 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 the 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 two aforementioned types of nurses and psychiatrist consists in the fact that both mental health and correctional nurses offer a more holistic evaluation of patients background, taking into consideration the persons family, culture, emotional wellness, physiology and spiritual values. (Coram J.,1993,5) In a nutshell, 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, International Association of Forensic Nurses has promoted professional training of forensic nurses and implementation of forensic nursing itself worldwide. The organization includes more than 2000 members from 11 countries and territories. According to IAFN official website, the mission of the organization is to provide leadership in forensic nursing practice by developing, promoting, and disseminating information internationally about forensic nursing science. (International Association of Forensic Nursing Website Homepage) Among its incorporation of preventive strategies into forensic nursing at all levels, establishing and improving standards of evidence-based forensic nursing practice, promoting and encouraging exchange of ideas among members of IAFN and related disciplines, establishment of ethical conduct standards for forensic nurses and creation and facilitation of educational opportunities for forensic nurses and related disciplines. IAFN Strategic Plan 2010-2014 includes four main pillars, which are forensic nursing practice, financial perspective, leadership development and value for members. Development of educational foundation for forensic nursing practice, which is one of the most important strategic objectives of forensic nursing practice pillar, includes such aims as developing forensic nursing core curriculum, market definition and curriculum and market current specialty guidelines. In order to provide methodological basis for implementing aforementioned objectives, promotion and encouragement of research in the clinical practice of forensic nursing is included as a critical point in the Strategic plan. Moreover, some points, mentioned in Value for Members section are aimed at promoting education of forensic nurses. There are web-based educational opportunities provision, offering of diverse topics on multiple learner levels and assisting chapters in providing local education, increase awareness and participation in certification. The organization is going to continue holding

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, many can argue that functions, performed by forensic nurses, often overlap with professional duties of the representatives of other specialties either within healthcare of justice system and, therefore, it is not worth implementing such a specialty. So, in this section we would like to address the benefits of implementing forensic nursing subspecialties into practice of healthcare and justice institutions, First of all, 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. A strong emphasis on cultural peculiarities of different societies, human rights and international law is possible in forensic nursing practice, as these issues from an important part of their education. Furthermore, implementation of Sexual Assault Nurse Examiner position is valuable in context of HIV and sexually transmitted diseases prevention. Moral dimensions of consequences of being a victim of interpersonal violence, abuse and neglect are also successfully addressed by forensic nurses. One-to-one counseling, provided by forensic nurse, has a potential to help a victim of whatever type of humiliating behavior to cope with both medical and moral aftermath of the situation. (Home Office, 2004) Except cultural competence and victim care, we cannot help mentioning such benefits of forensic nursing as the chance 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, worked out by results of examination of evidence,

should be presented in court by skilled forensic specialists, so that the court gets a clear notion about all the issues, which can influence its decision. To sum up, a number of important benefits are to ground the necessity for implementing forensic nursing into practice of healthcare and justice institutions worldwide. Modern trends of forensic nursing development Among the trends, which influence forensic nursing field development, it is worth mentioning is increasing use of holistic approach towards patients needs, provision of new services for specific groups and services, which are culturally or gender sensitive, new or extended roles of forensic nurses (e.g. related to influencing relevant governmental policy), constant search for a 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 the strong need to observe human rights in forensic practice made forensic nursing one of major areas of nursing development in XXI century. Forensic nursing addresses not only taking care of health either of a victim or a perpetrator, but takes into account peculiarities of culture, legal and court system of the country. Implementation of forensic nursing also helps to reduce waiting time for victims, preserve and analyze evidence more efficiently and present related medical issues in court. International Association of Forensic Nursing is an organization, whose work is aimed at disseminating information about forensic nursing science worldwide and implementation of forensic practice in hospitals and justice system institutions worldwide. Modern trends in forensic nursing development include holistic approach to various needs of the patient, working out culturally and gender sensitive services and ever extending role of forensic nurses.

References American Academy of Forensic Sciences (2010) Website home page. Retrieved September 6 2012, from http://www.aafs.org Coram J. (1993) Forensic Nurse Specialists: Working with Perpetrators. Journal of Psychological Nursing and Mental Health Services, 31, 11 International Association of Forensic Nurses Website Homepage. Retrieved September 6 2012, from www.forensicnurse.org 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 Home Office (2004) Forensic Nursing: an option for improving responses to reported rape and sexual assault. London: Regan L., Lovett J. and Kelly L. The National Forensic Nurses Research and Development Group (2008) Forensic Mental Health Nursing . Capabilities, Roles and Responsibilities. London: Kettles A., Woods P. and The National Forensic Nurses Research and Development Group (2007) Mental Health Nursing: Forensic Aspects of Acute Care London: Byrts R. &Hardie T.