33.4 Forensic Nursing

Role of the Forensic Nurse

The specialty of forensic nursing trains nurses in health concerns and conditions related to acts of violence or abuse. A forensic nurse can work in many fields and handle various types of cases, including child abuse, sexual assault, and maltreatment of older adults. Continuing education beyond the NCLEX exam is required to become a forensic nurse. These professionals receive training in evidence collection, chain of command for evidence, and emotional support for victims of violence. They provide compassionate care to survivors of violence while performing the physical exams required to collect forensic evidence. Given this background, the forensic nurse may be called upon to provide testimonies and expert opinions for civil and criminal cases relative to their nursing practice.

Methods for Evidence Preservation

Forensic nurses must be able to properly preserve evidence from survivors of violence and prevent any cross-contamination. They are trained to collect all types of evidence, such as biological specimens, and to document injuries. In addition, forensic nurses search for trace evidence, such as dirt and gravel, on clothing or the patient’s body. When collecting, preserving, and documenting evidence, forensic nurses abide by set protocols. They must begin by documenting and taking photographs of the patient, clothing, and injuries. They must place the trace evidence, clothing, and specimens they collect into individual envelopes or the proper collection containers. Forensic nurses should carefully change their gloves between collecting each specimen and avoid coughing or sneezing to prevent contamination. When collecting biological specimens, they should always use the appropriate collection tools and separate every sample to prevent contamination. Swabs should be allowed to dry completely and should not be placed in plastic to preserve the specimen as much as possible (SAFE TA, 2024).

After sealing the individual items of evidence, nurses need to label each item with the patient’s information and then sign, date, and time the envelope. Then they must complete a chain of custody form, which identifies any person who has come into contact with the evidence until it is released to law enforcement (Kleypas & Badiye, 2023).

Sexual Assault Nurse Examiner Nurse

A sexual assault nurse examiners (SANE) is a forensic nurse specifically trained in evidence collection and examination of victims of sexual assault. They typically work in emergency departments, but can also work in other facilities, like OB-GYN offices. SANE nurses abide by set protocols for collecting evidence, completing consent forms, and utilizing the Sexual Assault Evidence Collection Kit (SAECK) (Figure 33.3). They gather a detailed history from the patient about the assault and collect DNA evidence with swabs, hair combings, fingernail scrapings, etc. After examining the patient’s entire body for additional injuries or evidence, they complete the required SAECK forms and seal all evidence. An examination by a SANE nurse can take upwards of six hours, and the examination should, as a standard, be completed within 72 hours of the sexual assault (Ladd & Seda, 2023).

Figure 33.3 The SAECK kit is used by SANE nurses to collect evidence from sexual assault victims. (attribution: Copyright Rice University, OpenStax, under CC BY 4.0 license)