violence in healthcare workplace

Forensic Nursing: Specialized Care for Victims of Violence

What do forensic nurses do?

A college student at a local university walks into an emergency department at 5 o’clock in the morning. The young woman begins crying and tells the triage nurse, “I’m not sure, but I think I was raped. All I remember was having a few drinks at a party. When I woke up my underwear was on backwards and I hurt down there.” The nurse brings the young woman into a private area and summons the sexual assault nurse examiner (SANE) on call. 

Nursing care for victims of violence 

In hospitals across the United States, stories like this are unfortunately all too common. According to the FBI, 2019 saw an estimated 1.2 million violent crimes across the country. 68.2% were aggravated assaults, 22.3% were robberies, and 8.2% were rapes. Murders accounted for 1.4%. 

Nurses care for both victims and offenders of violence, often without specialized training. When it comes to caring for victims of violence, many nursing professionals are unaware of the basics of forensic nursing practices or the specialized care that these victims require. 

Recommended course: Forensic Healthcare Bundle: Responding to Patients Impacted by Violence 

What is forensic nursing?

In 1995, the American Nurses Association (ANA) recognized the specialty of forensic nursing. Since then, forensic nursing has become an innovative and evolving nursing specialty that addresses healthcare issues with a medico-legal component. Forensic nursing programs provide nurses with the necessary skills for specialized healthcare and expertise to meet the needs of victims and offenders of violence.  

But what do forensic nurses do? Specialized forensic healthcare may include evaluation, identification and treatment of injuries, collection of biological and/or physical evidence, legal documentation of injuries, and participation in court proceedings. 

The role of Sexual Assault Nurse Examiners

The earliest and most recognized role in forensic nursing in the United States is that of the sexual assault nurse examiner (SANE). The purpose of SANE programs is to provide victims of sexual assault with healthcare, forensic assessment, evidence collection, forensic documentation, and guidelines for giving testimony in court.  

Getting SANE certified requires completion of a 40 plus hour course, precepted training, and credentialing after successful completion of the national exam. SANE programs offer an effective means of training nurses to meet the healthcare and legal needs of sexual assault victims with competence and compassion. 

Recommended course: Sexual Assault Response and Evidence Collection 

What do forensic nurses do? 

In general, forensic nurses practice in various settings and care for a diverse group of victims and offenders. Many forensic nurses work as part of interdisciplinary teams that investigate abuse or neglect situations with adults and children, as well as teams involved in prevention efforts.  

Forensic nurses in critical and emergency care and psychiatric nursing routinely interact with individuals who have experienced violence and its consequences. These nurses provide physical care while attending to the collection of evidence and documentation for legal proceedings. 

Where do forensic nurses work?

Forensic nurses may also work with individuals on the medical, psychiatric, and evaluation units in prisons and jails. Facilities that employ forensic nurses include hospitals, community healthcare sites, law enforcement officers, coroner’s offices, and the military.  

Other areas of forensic nursing practice include:  

  • Death investigation 
  • Mass disaster care/investigation 
  • Legal nurse consulting 

What kind of training do forensic nurses need? 

Several nursing schools offer graduate nursing degrees or minors in forensic nursing. Many undergraduate programs also have courses in forensic nursing. Using an interdisciplinary approach, these programs collaborate with law schools, criminal justice programs, and forensic science departments to ensure that students begin the process of team collaboration necessary for effective forensic care. Course topics in these training programs include:

  • Federal rules of evidence
  • Crime scene analysis and processing
  • Mechanisms of injury
  • Criminal and civil law
  • Expert and fact witness testimony
  • Criminal profiling

Through didactic course work and clinical experiences, nurses build skills in these areas around the central pillar of responsible nursing practice. 

About the authors

Angela F. Amar, PhD, RN, FAAN is an associate professor and assistant dean for BSN education in the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta. She is co-chair of the expert panel on violence of the American Academy of Nursing. She is also a member of the Institute of Medicine Committee on the Biological and Psychosocial Effects of Peer Victimization: Lessons for Bullying Prevention.

Kathleen Sekula, PhD, PMHCNS, FAAN is a professor at Duquesne University School of Nursing in Pittsburgh. While there, she created the HRSA-funded MSN, DNP, and PhD forensic programs. She served as president of the International Association of Forensic Nurses Certification Board and was a member of the editorial review board for the International Journal of Forensic Nursing. She is a recipient of the Virginia Lynch Pioneer in Nursing Award from the International Association of Forensic Nurses.