1. 1 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 44 Forensic Nursing in the Community

2. 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives 1. Describe the specialized competencies and skills of the forensic nurse within the nursing process. 2. Discuss the relationship of the forensic nurse with public health professionals in addressing injury as a public health concern. 3. List the health risks that result from incidents of injury.

3. 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 4. Identify how forensic nurses deal with injuries in the three levels of prevention. 5. Discuss the health disparities that contribute to the occurrence and poor outcomes in marginalized groups that experience injury. 6. Explain the contribution of theoretical underpinnings to current models of forensic nursing practice. 7. Identify patient populations and clinical arenas in the community where forensic nurses practice.

4. 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 8. Define the key terms and concepts within forensic nursing theory. 9. Identify professionals who commonly work in collaboration with the forensic nurse in addressing injury care and prevention.

5. 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Perspectives on Forensics and Forensic Nursing  Forensic nursing synthesizes the biopsychosocial and spiritual aspects of nursing care with an expert understanding of forensic science and the criminal justice process.  Forensic nursing roles:  Sexual Assault Nurse Examiners (SANE)  Clinical forensic nurse  Forensic nurse examiner  Forensic psychiatric nurse  Forensic correctional nurse  Legal nurse consultant  Nurse attorney  Nurse coroner or death investigator

6. 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Injury Prevention  Rate of injury and crime is lower in communities that promote good health  Disparities  National Center for Injury Prevention and Control

7. 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Healthy People 2020  The proposed goals that deal with reducing injury and violence in the United States reflect the breadth of concerns and problems that result in injury, both intentional and unintentional, in communities.

8. 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Forensic Nursing as a Specialty that Promotes Care in the Community History of Forensic Nursing Educational Preparation Theoretical Foundations of Forensic Nursing Key Concepts Scope and Standards of Practice

9. 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. History of Forensic Nursing  Largely propelled by early efforts to identify and prevent child abuse and neglect and sexual assault of women  Indicators of “battered child syndrome”  “Rape” kit collection  Rape Trauma Syndrome (Burgess, 1973)  First nurse run sexual assault clinics opened in Memphis and Minneapolis in 1974  Protocols for sexual assault care  1986: U.S. Surgeon General identified violence as a health care issue  Integrated model of forensic nursing

10. 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Educational Preparation  Continuing education courses  Certificate programs  Graduate nursing academic programs

11. 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Theoretical Foundations of Forensic Nursing  Maslow hierarchy of needs and desires  Haddon’s risk of injury matrix  National violent death reporting system  Rape trauma syndrome  Lynch’s Integrated Model of Forensic Nursing

12. 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Key Concepts  Safety  Injury  Presence  Perceptivity  Victimization  Truth  Justice

13. 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Scope and Standards  Scope and Standards of Practice for Forensic Nursing (1995)  Scientific process  Quality of practice  Education  Professional practiced evaluation  Collaboration  Ethics  Research  Resource utilization  Leadership

14. 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Current Perspectives  Evidence-based practice and research  Scientific research in forensic nursing is in its infancy  Certification  Certification examination for the pediatric, adolescent, and adult sexual assault nurse examiners (SANE A and SANE P) is available through the Forensic Nurse Certification Board  Certification for legal nurse consultant, corrections nurse, death investigators, and forensic examiner  American Nurses Credential Commission; advanced forensic nurse (AFN) (2009)

15. 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Ethical Issues  Unique in forensic nursing because of the implications to not only a patient’s health, but in some cases, his freedom  Respect for person, beneficence, distributive justice, respect for community, and contextual caring  Forensic environments

16. 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Future Perspectives  Patients routinely enter hospitals with conditions that have overlying legal implications.  Forensic nurses use their expert understanding of cause and effects of trauma and are in a position to investigate the circumstances to design a plan of care for individual as well as special groups of patients.  Forensic nurses serve as a liaison between the hospital and the medical-legal community to reduce the effects of trauma.