Where do forensic nurses work?

Because forensic nursing is not a separate entity, but is integrated into the overall care needs of individual patients, forensic nurses work in many common healthcare institutions—most often in hospitals.

In hospitals or clinical settings, forensic nurses often work as part of a multidisciplinary team that includes emergency department staff, child and adult protection advocates, law enforcement and prosecutors. The amount of work depends on how much need there is. For instance, Schmitz’s team is responsible for covering 10 hospitals, which requires her team to work “on-call” to meet varied demand. A patient in need of a medical forensic exam can arrive at any time, so forensic nurses who are on call need to be prepared to arrive as soon as possible. Schmitz says she doesn’t know who she’s going to meet when her pager goes off, but she’s prepared for anything.

“It doesn’t matter if the call is in the middle of the night during a blizzard—I’m on my way,” Schmitz says.

It’s very rare that a forensic nurse works in an environment with focus on the non-sexual violence, according to the International Association of Forensic Nurses (IAFC). Nurses that do can become certified as Sexual Assault Nurse Examiners (SANES) with two years or nursing experience, training and certification. Those that don’t work in that field, might work in the following settings:

• Medical examiner’s or coroner’s office: Called forensic nurse investigators, they examine the crime scene and the body.
• Nursing homes or senior living facilities: Forensic gerontology specialists help investigate cases involving abuse or neglect of elders.
• Aftermath of mass disasters: In disaster zones, forensic nurses provide much-needed trauma and emergency nursing, mental health stress management, death investigation and management of infectious diseases.

Before getting your heart set on a particular path, it’s important to note that every state’s board of nursing has its own set of practice standards, which could impact what settings forensic nurses are allowed to practice in.

What characteristics make for a good forensic nurse?

Being a forensic nurse is immensely challenging, but those with these characteristics might find this position massively rewarding:

• Critical thinking: The victims’ problems go much deeper than just physical injury or pain. Though there may be little sign of physical injury, in some cases, forensic nurses must be able to preemptively address mental health issues as well. Jarvis notes that forensic nurses often work autonomously and must use critical thinking to decide on the next best steps in an exam.
• A strong sense of self: Many helpers who work with those affected by trauma often experience a sort of secondhand trauma themselves, also called vicarious traumatization. Characterized by a lack of personal meaning and hope, it can affect the trauma helper’s marriage, mental health, children and friendships.Having a support system, a strong belief system and effective and healthy coping strategies can help forensic nurses immensely in maintaining their ability to have empathy daily for their patients and continue to be an advocate for them.
• Individualization: Each person reacts differently to trauma and a forensic nurse has to be sensitive to each patient’s state. Schmitz loves this aspect of the job. Each patient gets her “Undivided and full attention in a way that is rare in nursing.”

Above having empathy, being detailed-oriented and skilled at multitasking, Jarvis also cites passion for this type of work is the most important.

“This work is not for everyone, and it takes a particular type of person to do it,” Jarvis says.

How do I become a forensic nurse?

First and foremost, you’ll need to become a registered nurse by earning either an Associate’s degree in Nursing or a Bachelor of Science in Nursing and passing the NCLEX-RN exam. After that, you’ll need about two years of nursing experience. Most nurses interested in forensics spend time in the emergency department, the ICU, OB/GYN or psychology and mental health units.

After two years of nursing experience, you can complete a 40-hour SANE course with an adult/adolescent or pediatric focus, or both. Those interested in becoming a forensic nurse investigator can earn a certification through the American Board of Medicolegal Death Investigators. Keep in mind that some states may require you to be an Advanced Practice RN for certain workplaces..

Why is being a forensic nurse rewarding?

Though being a forensic nurse can be emotionally challenging and can require additional training, many in the field find it extremely rewarding. Jarvis describes it as an incredible honor to work with and help individuals and often their loved ones on what may be the worst day of their lives.

It’s imperative that the patient see themselves as more than just a victim and realize that their experience does not define them. Getting to be the person who tells them that for the first time is incredible, Jarvis said. “It makes you feel as though you are truly making a difference.”