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Forensic nursing

Forensic nursing is the application of the forensic aspects of healthcare combined with the bio/psycho/social/spiritual education of the registered nurse in the scientific investigation and treatment of trauma and/or death of victims and perpetrators of violence, criminal activity, and traumatic accidents (Lynch, 1991. p.3) In short, forensic nursing is the care of patients intersecting with the legal system (Speck & Peters et al, 1999). Sexual assault perpetrated against girls and women is a pervasive problem globally and has been associated with a range of adverse mental and physical health outcomes for survivors. This includes post-traumatic stress disorder (PTSD), depression, substance use, anxiety, suicidality, and negative reproductive health outcomes. (Padmanabhanunni & Gqomfa, 2022). Survivors of SA bear the burden of both acute and long-lasting sequelae, including injuries, sexually transmitted diseases, and an increased risk of chronic physical and mental health problems.


Lynch used the clinical forensic medicine (CFM) role as a template for the forensic nurse role. The CFM describes the use of clinical practices to support judicial proceedings to protect a victim, usually after death has occurred. A strong advocate for the forensic nursing specialty in the United States, Virginia Lynch pushed to have the specialty recognized. She was successful in the American Academy of Forensic Science recognition of the forensic nurse in 1989, and she completed her thesis on the conceptual framework for forensic nursing, graduating from arguably the first U.S. forensic nurse master's program. The early publications about the plight of victims spawned nursing programs throughout the United States. In 1992, the term forensic nursing was adopted by nurses gathered at the University of Minnesota who elected Virginia Lynch the first president of the International Association of Forensic Nurses.

The nursing paradigm includes person, health, nursing, and environment. The metaparadigm emphasizes holistic care as it highlights humanistic aspects woven with scientific knowledge. The practice of forensic nursing borrows from all sciences, including legal principles, forensic science, and the bio-psycho-social-spiritual sciences that support the forensic nurse's role in all environments (Volz et al, 2022). The specialty is now recognized worldwide, helping to promote an international focus on violence.

Forensic nursing in the United States developed in response to concerns in the 1970s regarding the treatment of patients with crime-related injuries and the proper handling of evidence. Globally, the development of general clinical forensic medicine and forensic nursing have progressed at different speeds, with one preceding the other on a country-by-country basis. Founded in 1992, the International Association of Forensic Nurses is the first professional association for forensic nurses. Other organizations support forensic nurses globally, including End Violence Against Women, International, the American Academy of Forensic Sciences - Forensic Nursing Science Section (2023), and the Academy of Forensic Nursing (2018).

Although forensic nursing can be traced back thousands of years, for recent history, the role in the United States is traceable to the 1970s (Liu, 2024). Medical professionals were involved in court cases that involved crimes, e.g., rape. Medical professionals highlighted the medical issues, moving science from the criminalistic view to a health concern.

Forensic nursing combines nursing practice and forensics in the scientific investigation of death and injury resulting from criminal activity and accidents. In addition to providing care, forensic nurses act as multidisciplinary team members with and consultants to other nursing and medical professionals and law enforcement. They receive advanced training in collecting and preserving evidence, treatment protocols, and legal proceedings and testimony.

The specialized training that forensic nurses receive related to both the medical and legal needs of these patients drives demand for the specialty. Crime victims face a higher risk of post-traumatic stress disorder, depression, suicide, and medical complications than other patients; forensic nurses improve both legal outcomes and quality of life for these patients relative to standard Emergency Department care. Forensic nurses also assist in providing professional insight to potential causes of patient injuries in situations in which witnesses are unavailable.

Prior to beginning an exam, forensic nurses must receive consent from the patient. In addition to documenting obvious injuries, forensic nurses specialize in looking for subtle signs of assault, such as petechiae, voice changes, and loss of bowel or bladder function. Forensic nurses document patient injuries through tools including cameras, measuring tapes, fluid swabs, rape kits, and a high-powered light that can reveal hard-to-see bruises and fluids like semen, urine, or saliva. They document every injury for potential use as evidence in a later court case, where they may be called as an expert witness to testify to the injuries.

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