Education
Forensic nursing gives RNs more tools to assist victims of violence
Forensic nursing is a demanding field like no other.
Sara Jennings was an emergency room nurse at a trauma center when she saw a necessity for higher look after victims of violence. Sexual assault patients went to hospital, but there was nobody there to offer them with the specialized care they needed to process the trauma, provide additional help, or gather evidence. Sara Jennings, RN Jennings saw a flyer within the break room for a sexual assault nurse training course for adults and youths and signed up. “I attended 40 hours of adult and youth training,” said Jennings, DNP, RN, SANE-A, SANE-P, AFN-BC. “I paid for it myself because I really wanted to make a difference and help these patients.” Fundamentally, Jennings said, the legal and medical systems need to return together to offer higher look after patients who’ve experienced violence. Today, Jennings is a full-time forensic nurse and director of education on the hospital International Association of Forensic Nurses, a global membership organization of forensic nurses working all over the world and other professionals who support and complement the work of forensic nursing. Forensic nurses within the US work in lots of kinds of facilities. Often, emergency department nurses seek training and supply care on their units. These nurses also work in child advocacy organizations and other health care settings.
They work with patients individually, in line with Nicole Stahlmann, MN, RN, SANE-A, AFN-BC, a forensic specialist at IAFN who also transitioned from ER nursing. These nurses provide holistic care, making an allowance for not only patients’ evidence needs and traumatic events, but in addition whether patients produce other health or mental health issues that have to be addressed through further counseling and referrals. According to Jennings, forensic nursing as a specialty is commonly a great fit for emergency room nurses because they possess skills necessary to forensic nursing, including the flexibility to speak with quite a lot of people, think critically, solve problems and multitask. “It is a combination of psychosocial and spiritual nursing education and using our trauma-informed experience to provide a holistic approach to treating patients and maintaining their health, well-being and safety,” Stahlmann said. Forensic nursing is exclusive in that it intersects with the legal system. According to Stahlmann, nurses who do not know in regards to the legal system shouldn’t draw back from this specialization.The each day demands of forensic nursing
In forensic nursing, no two patients or cases are the identical. “We definitely base our care on the patient’s needs,” Stahlmann said. Stahlmann also works as a forensic nurse on the hospital District of Columbia Forensic Nurses. Admits patients within the hospital after they’ve been triaged within the emergency department and cleared by a physician. “Once we get a positive medical report, we come in and do the forensics portion of the exam, which is identifying the patient as being there or requesting our services and getting their consent to complete the exam,” she said. “I would say their agreement continues throughout the entire portion of the exam because that is what empowers them or gives them back their voice.” Stahlmann explained that they review background information, obtain demographic information, medical history, health history, medication and allergy information, etc. Then they move on to the narrative, which is probably the most difficult a part of the exam. Stahlmann then examines the patient from head to toe, identifying and documenting injuries. It uses a kit to gather evidence from consenting patients.
“It’s incredibly difficult for a patient to come in and get through this examination,” she said. “This examination may take two to four hours, or maybe longer. However, it is also difficult for the doctor. This is an accumulation of trauma in hearing patients. Vicarious trauma increases. But I will say that it is absolutely satisfying. you are with this patient. You are alone with him on one of the worst days of his life, but you see this transformation and strengthening.”
The forensic nurse provides the patient with the medications he needs. In the District of Columbia’s case, a patient advocate follows the patient through the complete process, but not all U.S. hospitals provide such advocates, Stahlmann said. According to Stahlmann, forensic nurses could have to seem in court if a patient decides to report the incident to law enforcement.
Need and challenges
According to data published within the United States, 1 in 5 women and 1 in 71 men can be raped, and 1 in 3 women and 1 in 6 men will experience some type of contact sexual violence in some unspecified time in the future of their lives. National Resource Center on Sexual Violence. According to Stahlmann, although sexual trauma and other types of trauma are common, nurses typically don’t receive trauma-informed education. “There certainly wasn’t a trauma-focused course when I went to nursing school,” she said. “There was nothing related to forensic nursing. I had no idea about forensic nursing until two years into my nursing career.” High burnout rates amongst forensic nurses make it difficult to satisfy demand. According to Jennings, it’s estimated that forensic nurses stay in practice for about two years.
Not only is it difficult for forensic nurses to listen to and see violence, but it surely’s not normally a 9-to-5 job. According to Jennings, court hearings normally happen on nurses’ days off. Forensic nurses have to be available to reply questions from police, social services and other agencies as needed.
Although selecting a profession is stressful, there are methods to work across the stress, says Angelita Olowu, BSN, RN, SANE-A, SANE-P, a forensic nurse specialist at IAFN.
Olowu stated that she learned coping skills in her previous profession as a trauma nurse in a busy facility and maintains these coping strategies as a forensic nurse. “My advice to forensic nurses is to always try to take positive care of yourself,” Olowu said. “And try, if at all possible, to have someone else be responsible for you. Typically, nurses work in some program or on some team where there is at least another nurse or several nurses who do the same thing. Just being responsible when someone doesn’t seem to be quite themselves, or reaching out to make sure they’re okay.” Although it is difficult work, Olowu takes comfort in knowing that he may help these patients. “I can say that I have never met a patient who looked completely different from the moment he walked in to the moment he left,” she said. “They tell me they’re grateful I’m there, when really I’m grateful they let me be there for them.”What is required?
To practice as a forensic nurse, RNs or advanced practice nurses must take a 40-hour SANE didactic training course online or in person. The course has a clinical component, during which nurses turn into higher acquainted with issues reminiscent of pelvic examination and interviewing, and in addition acquire competences for independent practice. Certificates can be found from IAFN for adults and adolescents (SANE-A) or for kids (SANE-P). “This is our national certification, which can be considered similar to the CEN certification,” Jennings said.
Nurses of any specialization may help
Patients abused and attacked in every type of healthcare facilities. The nurses caring for them must have some understanding of their needs and a plan for easy methods to look after them. These patients may not disclose an injury, quite nurses may notice something that prompts them to ask questions.
“We have a lot of nurses who have worked in labor and delivery who have had patients who have experienced sexual violence,” Olowu said. “We have nurses in outpatient surgery, where patients receive post-operative care. It doesn’t matter where you practice because you touch patients at every stage of their lives. It just has to be the right time for this patient to be ready to talk.”
Nurses of all specialties bring their perspectives to forensic nursing and will be good forensic nurses. For example, mental health nurses have a task to play on this subspecialty. “You may feel like once you do the classes and the training and see the patients, it’s a little too much for you,” Olowu said. “You can be a champion in any department you are in.” Jennings suggests that each one nurses familiarize themselves with the free resources and knowledge available on the IAFN website. This information will help guide nurses’ practice when encountering victims of violence. Knowledge helps nurses develop a plan, whether it’s transferring patients to a different hospital where a forensic nurse or SANE nurse works, or equipping those patients with useful information and resources. Nurses may help by talking to administrators and chief nursing officers in regards to the plan, Jennings said.
Take these courses to learn more about forensic nursing:
It is imperative to know that forensic work involving the gathering and preservation of patient evidence should never compromise a patient’s safety, autonomy or rights. This course provides an outline of issues related to interrogation, collection and storage of forensic evidence, toxicology and documentation. Nurses working in schools, communities, emergency departments and mental health facilities can play a key role in stopping violence by understanding the dynamics and profiles behind these kinds of homicides. The FBI indicates that 89,098 rapes were reported to law enforcement in 2015, a 6.3% increase from 2014. People who’re raped or sexually assaulted enter the health care system through many routes. Nurses and first responders may encounter them in the sphere, within the emergency room, in maternity or primary care facilities. These patients will also be seen in pain clinics; in specialized centers for research on the gastrointestinal tract, genitourinary system or neurological system; or in gynecological or urological settings as you progress from specialty to specialty searching for a medical diagnosis of your symptoms. Health care professionals from various disciplines who ask the best questions and assess and follow these patients may help tremendously.
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