INTRODUCTION:

Forensic science represents an emerging worldview for the future of forensic science, because crime and violence connect two of the most powerful systems that affect people's lives around the world - health and justice. The need for policymakers to address critical issues related to violence and related trauma is a multidisciplinary issue.

These concerns require the collective efforts of doctors, nurses, police officers, lawyers, judges, sociologists, psychologists, social workers, forensic and political scientists, lawyers and activists, and other criminal justice practitioners to reduce and prevent social injustice. Effective forensic case management is an area that lacks adequate policies and legislation to ensure the legal, civil and human rights of both victims and accused.¹ The lack of qualified forensics has resulted in a severe lack of quality forensic services. Recent strategies to raise and improve global standards of care for victims of crime, the falsely accused, and the wrongfully convicted require the application of forensic science to nursing.

Significance of Forensic Nursing:

Forensic nursing represents a new perspective on the holistic approach to legal issues surrounding patient care in clinical or community-based settings. Nurses are the first persons in a medical team to see the victims or suspects, to contact their family or relatives, to handle their items and belongings during examination, and to collect laboratory samples. The integration of forensic nursing in the existing forensic medical science might be more gainful to improve professionalism. Forensic nursing allows nursing professionals to play a wider role in the clinical investigation of crime and the legal process that contributes to public health and safety (Lynch, 1995). Forensic nurses play a crucial role in fighting against violence among women, children, elderly and other vulnerable population. Forensic Nurses improve coordination and cooperation, exchange medical/forensic expertise, improve the treatment of crime victims. Forensic Nurses function as a bridge between healthcare institutions and law enforcement authorities in applicable responsibilities. Early recognition of injuries and documentation of injuries by forensic nurses will lead to effective and timely management of MLC cases.Forensic nursing is an emerging sub-specialty in India Forensic nursing is an innovative and evolving nursing specialty that seeks to address healthcare issues that have a medico legal component, While there is rampant increase in crime rates in India, forensic nursing is a new holistic approach to legal issues surrounding patient care in the hospital and community setting. Cases of child physical and sexual abuse are still underreported in our country due to social stigma etc., particularly when the offender is known to the victims. Having knowledge in forensic nursing helps nurses in identification of such cases in routine clinical examination as children also are more comfortable in revealing their traumatic experiences to the nursing professionals However, Forensic nursing is in rudimentary stage in India The Indian Nursing Council (INC) has included Forensic Nursing as a subject in the revised syllabus of the B.Sc Nursing Programme in the VI semester.

Definition:

Forensic nursing is defined as the application of the nursing process to public or legal proceedings, and the application of forensic health care in the scientific investigation of trauma and/or death related to abuse, violence, criminal activity, liability, and accidents.

(Lynch, 2004)

Principles of Forensic Nursing:

· Skills and Competencies required for Forensic Nurses

· The forensic nurse needs to have:

· Specialized knowledge of the legal system.

· Skills in the identification, evaluation and documentations of injuries.

· Victim and family centered skills and competencies.

· Containment of emotions of the victim.

· Justice for victim through accurate documentation and collection of evidence.

Forensic and Technical Skills and Competencies

Adequate knowledge specific to the forensic nursing

Technical expertise i.e., recognition and management of traumatic injuries

Basic and primary health care nursing skills and competencies

Violence prevention skills

Screening, early identification and crisis intervention of violence against children, women, elderly and other victims

Legal practice skills

legal documentation, expert witnessing in the court of law

Knowledge and application of the national laws and protocols in management of victims of crime and violence.

Forensic and technical skills and competencies

Management and organizational skills and competencies

Personal development skills and competencies

Conducting research

Desirable personal attributes

Passion for working with the victims

Empathy

Good listening skills and Non-judgmental attitude

Formal and informal recognition of clinical forensic nurses

Professional (accredited by statutory bodies such as indian nursing council)

Public

Financial (salaries) recognition

Strategies to influence the future of forensic nursing and global violence

Historical perspective: Historically, the forensic aspects of nursing have long existed.

Framework for practice: Framework for practice: This emergent nursing specialty provides a framework for health promotion and violence prevention in an effective collaboration with the disciplines of health care, criminal justice, and the forensic sciences.

Forensic Nurse Liaison

This emergent nursing specialty provides a framework for health promotion and violence prevention in an effective collaboration with the disciplines of health care, criminal justice, and the forensic sciences. Forensic nurses serve as a clinical liaison to medical and legal agencies supplementing the need for vital forensic services to provide fair and equal justice as questions of innocence or criminality arise. It must be emphasized that the practice of forensic nursing is not limited to victims, but includes court ordered evidence recovery from the voluntary suspect or the accused in custody. The forensic nurse, as the first point of contact in the immediate post-trauma period, is in an ideal position to gather information, trace and physical evidence related to a crime. Sexual Assault Nurse Examiners are Registered Nurse (SANE).

Leadership Strategy

To provide leadership in forensic nursing practice by developing, promoting, and disseminating information globally about forensic nursing science and practice.

Strategy of Access to forensic nursing

Need to provide Universal access to forensic nursing care through a marketing of their specialty. Need to provide access to Forensic nurses to provide expert and compassionate care in every community.

Identify and support diversifying the forensic nursing workforce into roles beyond SANE practice through implementation of the strategies below.

Quantify/identify the unique role of forensic nurses in specific clinical practice areas.

In the United States Trauma Centres are having 24/7- access to a sexual assault nurse examiner (SANE).

Education and Training Strategy

Forensic nurses are needed to provide with innovative, evidence-based forensic nursing education and valid, reliable, and legally defensible professional certification opportunities.

Competencies necessary for nurses to provide highly skilled and quality care of victims of violence include the science of forensic nursing.

For nurses who want an advanced professional degree representing the highest level of competency. Progressive academic institutions are currently providing the opportunity for innovative programs of study for nurses, who wish to attain a bachelors, masters or doctorate degree in forensic nursing science. The education and experience of the forensic nurse specialist provide a distinctive knowledge base and clinical skills appropriate for an advanced role in sexual assault examination, death investigation and other clinical forensic services. The most common model for the existing forensic nurse seeking a formal degree is the post-licensure education. Nurses, who hold a registered nursing license and later become involved in the forensic aspects of patient care, often return to college or university programs to advance their skills and gain credentials as forensic nurse examiners.

Strategies to improve the education and training

Increase engagement with clinically practicing nurses who serve forensic patient populations.

Increase engagement with educators across the spectrum of nursing education.

Increase engagement with hospital administrators to support forensic nursing education, clinical practice, and certification.

Demonstrate the value of forensic nursing knowledge and expertise to healthcare systems and networks globally.

Increase the consistency and quality of forensic nursing education offered through the Association.

Develop and execute the curriculum to gain the qualification and proficiency in forensic nursing.

Continue to be a sole source provider of forensic nursing education.

Provide online education and training faculty development program.

Provide the annual International Conference on Forensic Nursing Science and Practice.

Provide onsite education and training.

Influence our nurses and nursing professional about this new profession and future opportunity in academic and clinical settings.

Develop and conduct a needs assessment of schools of nursing at the baccalaureate and graduate levels relative to forensic nursing.

Consult with educational programs to introduce concepts of forensic nursing into all basic nursing curricula.

Implementing the curriculum in a phased manner

Before implementing the curriculum, identify the resources needed like faculty, administrative provision, supporting staff, learners, patients, services like space, equipment, clinical areas, financial assistance by government, professional societies, etc. If all resources are made ready, the curriculum will be introduced in a phased manner.

Forensic Nursing Science Curriculum

Courses are designed to provide participants with a detailed understanding of the role and impact of forensic nursing practice. Many universities offer a variety courses for the forensic nursing degree or certificate programs in the online format.

Curricular Aspects

Practice Paradigms in Forensic Nursing

Scientific Investigation of Trauma and Death

Forensic Markers of Child Maltreatment

Sexual Assault, Abuse and Exploitation

Violence and Human Rights

Investigation of Trauma throughout the Lifespan

Advanced Forensic Nursing

Forensic Health Policy, Ethics/Legal Aspects

Mental Health in Correctional Institutions

Correctional Healthcare Ethics and Law

Substance Abuse: Forensic Implications.

Introduction to Correctional Healthcare Injury.

Correctional Healthcare of the Older Adult

Public Health/Infectious Disease in Corrections

Scope of Forensic Nursing

Forensic nurse examiners practice in a variety of professional roles, in which they may further specialize in a variety of specific subspecialties.

Forensic Clinical Nurse Specialist/Practitioner

Forensic Correctional (US) or Custody Nurse (UK and Australia)

Forensic Nurse Coroner/Death Investigator

Tissue and Organ Donation/Recovery Specialist

Sexual Assault Nurse Examiner (Adult and/or Pediatric)

Forensic Healthcare Services Administrator

Forensic Nurse Photographer

Forensic Geriatric Nurse

Forensic Academic/Educator

Healthcare Risk Manager

Forensic Nursing Researcher

Legal Nurse Consultant

Forensic Psychiatric Nurse

Forensic Nurse Attorney/Nursing Jurisprudence

Virginia Lynch, MSN, RN, COHN-S, FAAFS, FAAN

Mother (Founder) of forensic nursing

The term forensic nursing was coined by her in 1986

She was fundamental in the creation of the forensic nursing specialty and instrumental in developing the standards for forensic nursing, which have paved the way in promoting health and justice worldwide (Maguire and Raso, 2017).

Developed the integrated practice model for forensic nursing science.

Global Strategies

Survey non-member international nursing groups to determine the extent of forensic nursing practice in their countries/communities.

Collaborate with partners (i.e., International Association and Chiefs of Police in Indian settings, Criminal lab investigators.

Agency for International Development, International Council of Nurses, Peace Corps, U.S.

Indian Health Service, etc.) to provide forensic nursing educational and technical assistance opportunities.

Public Awareness Strategies

Forensic nurses should be valued, respected, and seen as integral to health care.

Create relationships with broader local and international nursing communities.

Need to celebrate Forensic Nurses Day / Week more fully to reach a global audience.

Research Strategies

Develop or establish forensic nursing research agenda or thrust areas

Need to promote research that impacts forensic nursing practice

Support research that provides an evidence base for the practice of forensic nursing.

Research funds can be generated on forensic areas to encourage the nurses and academician to conduct the more research studies on forensic nursing.

Collaborate with academic institutions offering forensic nursing graduate programs to create partnerships in forensic nursing research with strong forensic nursing clinical programs.

Challenges

There is no specialization in UG course in nursing curriculum regarding Forensic Nursing.

There are no specific cadre/ posts for the same

There is no forensic nursing specialty in any of the hospital/ healthcare setup in our country till date.

Recognizing and establishing the role of a nursing professional in Forensic practice is an uphill task, and substantial administrative efforts will be required by DGHS, Nursing

Division, MoHFW, Government of India and other associated regulatory authorities.

Recognizing and establishing the role of a nursing professional in Forensic practice is an

uphill task, and substantial administrative efforts will be required by DGHS, Nursing

Division, MoHFW, Government of India and other associated regulatory authorities.

Opportunities

The development of a new field of practice is a challenging experience that brings together diverse professionals who recognize a mutual benefit through collaborative practice, exchange of knowledge, and shared successes in order to reach common goals. A partnership must be nurtured between forensic nurses and professionals from all disciplines with similar interests in eliminating threats to health and justice.

Future Directions for Forensic Nursing

Nurses' sensitization to forensic background

CONCLUSION:

Forensic nursing driven by our core pillars is leading the charge towards a worldwhere violence will replace the justice, healing and hope. Change is ineluctable. Professions that don't change according to the health and justice trends of our times will be lacking in essential chops and services. The scientific knowledge each nation must maintain in order to acclimatize to the conditions of the UN Millennium Development Goals by 2015, involves AIDS, poverty, hunger, malnutrition, terrorism, and violence against women and children. Yet, the improbability of meeting these pretensions poses an immense trouble with the advancing number of new wars, natural disasters and unknown conditions. The wisdom of forensic nursing can give unknown backing in combating these forces of mortal destruction through a universal presence, coinciding with forensic medical wisdom and felonious justice systems. Therefore, a new generation of forensic investigators, blending biomedical knowledge with the disquisition of injury and death, indicates new strategies in the forensic nursing for the near and distant future.

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Received on 19.10.2023 Modified on 29.11.2023

Asian J. Nursing Education and Research. 2024; 14(1):90-94.

DOI: 10.52711/2349-2996.2024.00018