Forensic nurses combine clinical nursing practice in conjunction with knowledge of law enforcement. They provide care to victims and are involved in the investigation of sexual assault, elder and spousal abuse, and unexplained or accidental death. Forensic nursing is high stress because of the nature of the work, and it requires a broad understanding of social, environmental, and psychological influences on behavior. The environments in which forensic nurses work are varied. They work in such settings as correctional institutions, psychiatric facilities, acute care settings, coroner and medical examiners’ offices, and for insurance companies.
EDUCATIONAL REQUIREMENTS
Registered nurse preparation and Bachelor of Science in Nursing are required; often, graduate preparation is required. Certification from Sexual Assault Nurse Examiner (SANE) may also be needed for some practice settings.
CORE COMPETENCIES/SKILLS NEEDED
■ Ability to work in diverse conditions and deal with emotionally charged issues
■ Ability to combine nursing knowledge with investigative and counseling skills
■ Ability to collaborate with experts in other disciplines
■ Be an advocate for victims
■ Coordinate programs in collaboration with medical and law enforcement
■ Be able to deal with death and dying
RELATED WEB SITE AND PROFESSIONAL ORGANIZATION
In the world of nursing, certifications and their corresponding designations carry with them the concepts of excellence, professionalism, and focused dedication to career growth. Not all nurses pursue certification during their years of service in healthcare, but many hear the call and take inspired action to achieve such a goal.
Making an effort to become certified in your nursing specialty is like doubling down on your skills and knowledge. Doing this takes discipline and forward-thinking, demonstrating that you care enough to show the world that nursing excellence and professional mastery matter.
Every year on March 19th, we celebrate National Certified Nurses Day to honor the nurses who take their careers to the next level by becoming certified. This celebration encourages us to take a moment to acknowledge the role that certification plays in strengthening the nursing profession while improving care and patient outcomes. Being certified is meaningful, and we make meaning by pausing for the cause of reflection and recognition of the nurses who choose this path.
Nursing Certification 101
According to the American Association of Critical Care Nurses (AACN), the first nursing certification was issued in 1945 to recognize nurse anesthetists. Certification boards began to be created in the 1960s, and the number of available nursing certifications continues to grow to this day.
Many nurses choose to pursue certification of their own volition, while some employers may encourage or even require nurses in specific specialty areas to become certified. Having your employer pay for and support your certification goals can be a desirable benefit, especially if your certification process has a financial cost you’d rather not bear yourself.
A 2021 Journal of Nursing Administration study states, “Nurse specialty certification is ’a mechanism for validation or formal recognition by documenting individual nurses’ knowledge, skills, and abilities specific to their specialty’. It is a form of individual credentialing above and beyond entry-level education and licensing. By pursuing specialty certification, nurses exhibit a commitment to professional growth and lifelong learning while establishing competency in a specialized area of care such as oncology or medical-surgical nursing. The intended outcome of certification in nursing is to improve safety, quality of care, and health outcomes for those using healthcare services.”
No matter what certification you choose to pursue, rest assured that being certified is something to be proud of and to clearly and proudly document on your resume as a mark of nursing distinction and professional mastery.
Why Should You Consider Becoming a Certified Nurse
As mentioned above, certification is a demonstration of dedication to your area of specialty nursing practice. Being certified can serve many purposes and brings with it a variety of benefits, including:
Marketability: Being certified can make you a stronger candidate in the job market, especially if it sets you apart from non-certified applicants for the same positions.
Career mobility: Some employers may value nursing certifications very highly, with certified nurses more likely to advance on the organization’s clinical ladder or into positions of greater responsibility, including nursing leadership.
Respect and recognition: Certification can elicit in others a sense of respect for and recognition of your professionalism, expert knowledge, and skill.
Personal/professional pride: Certification may elicit pride in your expertise, mastery, and accomplishments as a dedicated nurse.
Certification is a feather in your nurse’s cap. It marks you as a nurse focused on career growth and expert skill and knowledge. By being certified, you benefit not only your career but also inspire others to follow in your footsteps and contribute to the improved quality of patient care, not to mention strengthen your employer’s organizational profile.
Certification Speaks Volumes
Having one or more nursing certifications speaks volumes about your professionalism and desire to develop yourself as a nurse of integrity and mastery. Being certified says a great deal about you, and your certifications can enhance your ability to advance your career in any direction you’d like to go.
Some nurses may sit on their laurels and do the bare minimum, while others may seize the day and take every opportunity to develop themselves professionally. Only you can decide if the path to certification is right for you based on your perception of the benefits of certification and the value of that process to your career.
In recognition of Certified Nurses Day, let’s acknowledge those nurses who’ve stepped up to the plate and taken on certification as a prospect worthy of their attention and hard work. And if you’re already certified, give yourself a pat on the back for going the extra mile and showing the world that you’re a nurse who wants to be the best you can be.
If you’ve reached the point in your nursing career where you feel like you can’t go on and might need to abandon nursing and never look back, you’re considering “the nuclear option,” which means leaving the profession for good. While this is always a possible course of action, it’s not the only one. So, before you pull that lever and exit stage left, consider the many avenues you might still wander while remaining an active registered nurse.
Burnout and Compassion Fatigue Are Real
Before we go any further, we must first establish that nurse burnout, and compassion fatigue are real. Whether related to the COVID-19 pandemic or not, nurses experience tremendous amounts of work-related stress. This has led to increasing public knowledge and media attention to the fact that nurses are leaving, or contemplating leaving, their jobs — or even the profession itself — in large numbers.
The underlying causes of nurse attrition, burnout, and compassion fatigue are numerous. However, nurses experiencing these phenomena should know they are not alone, and there is no shame in reaching out for help.
“What? No Hospital?” Alternate Career Pathways
Contrary to what many nurses might believe, there’s more to nursing than working in acute care. According to the American Association of Colleges of Nursing (AACN) Nursing Fact Sheet (updated September 2022), 55 percent of registered nurses work in general medical and surgical hospitals. While acute care is where the majority of nurses are steered right out of nursing school, the fact remains that a considerable proportion finds happy career homes outside of the hospital environment.
In the non-acute nursing world, numerous opportunities exist for nurses seeking an alternative career pathway. The COVID-19 pandemic has created a surging market of remote nursing positions in care management, quality, and chart review, among many others. Further areas of interest for those seeking non-hospital positions include:
Nursing on the sets of film and television productions
Nurse life care planner
Nurse journalist/writer
Genetics
Legal nurse consulting
Addictions
Medical claims analysis
Cannabis nursing
Nurse recruiter
Advanced practice (CRNA, APRN, clinical nurse specialist, etc.)
There are countless alternatives for nurses who feel that the hospital environment is no longer a good fit or never was in the first place.
Being Circumspect About the “Nuclear Option”
The nuclear option of leaving the profession altogether is undoubtedly a choice — albeit a radical one. If retirement is possible, this is a route to a new life beyond one’s previous career path. If not, there may be a new avenue that’s calling.
Some nurses find that psychology, social work, or careers still connected to human services and the caring professions are viable and attractive. Still, others seek to take their enormous nursing skill set (e.g., critical thinking, crisis management, leadership, problem-solving, communication, and multidisciplinary collaboration) and seek an industry where those skills are highly valued.
The choice to leave the nursing profession is serious, especially when you have devoted many years — or even decades — to your nursing career. What is often advised is that you retain your nursing license for several reasons:
Leaving the nursing career door open
Picking up per diem shifts for extra money
Keeping skills up to date
Maintaining your hard-earned nurse identity
In the end, nurses are highly valued members of society who are deemed the most trusted professionals in the U.S. year after year in the Gallup poll. With a broad and deep set of soft and hard skills, an individual with a history as a nurse brings a great deal to the table.
If you’re leaning towards the nuclear option, the best advice is to be cautious and thoughtful in making that choice. Burnout can understandably drive you to make hasty or regrettable decisions, so taking your time is paramount. Seek the counsel of those you trust who has your best interests in mind. Think long and hard, and consider staying if you can.
However, if you pull that lever and seek new professional pastures, may you do so with no blame, no shame, and your head held high with the knowledge of the enormous service you’ve done to society as a registered nurse. And finally, know that you’ll be welcomed back to the profession with open arms if you ever choose to return.
Daily Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.
During her last rotation as a nursing student at an outpatient program for severely mentally ill patients, Dawn Bounds found her calling as a psychiatric nurse.
“I loved it – to sit and talk with my patients and try to understand the context of their lives and how to support them,” recalls the Chicago native. “It was such an enjoyable experience that I knew specialize in psychiatry from that moment on.”
Pivoting to Psychiatry
Bounds, who planned to go into medical-surgical nursing, took a position in an inpatient child and adolescent psychiatry unit right after graduation.
Being in such a challenging environment came naturally to her – so much so that she used to joke she’d return after she retired. Bounds worked there while earning a master’s degree to become a family psychiatric-mental health nurse practitioner and a Ph.D. in nursing science at Rush University.
As a nurse practitioner, Bounds served in high schools and the county juvenile detention center on Chicago’s West Side. There, she helped at-risk female youths caught in a cycle of running away and getting locked up.
“I had two questions: Who are you running away from – what’s happening in the household that keeps you running? And who are you running to?” she recalls.
“Years ago, I attended a forensic nursing conference. They were talking about sex trafficking and sexual exploitation and all the red flags. I couldn’t help but think, ‘These are the girls I’m already taking care of,’” Bounds says.
“But nobody’s calling it sex trafficking or sexual exploitation. They’re just criminalizing these girls’ behaviors. They had these histories of being traumatized, and then on the other end, I was seeing them in juvenile detention, and I thought, ‘Something needs to change.’”
Supporting the Family Unit
Her research and day-to-day treatment took a fresh focus. Child welfare services often remove youngsters from abusive homes. But teens are more likely to remain in tenuous situations until they flee on their own.
Supporting young people, Bounds realized, meant supporting their entire families, especially those with minimal resources.
“These amazing kids were still going to school despite living in neighborhoods with shootings, violence, and substance use,” she says.
“I was just looking for ways to be of assistance and help them solidify some support networks so that they could not just survive but thrive amid many things beyond our control.”
Psychiatric DNP program
At UCI, where she joined the faculty this summer, Bounds will help establish a psychiatric-mental health nurse practitioner specialization in the Doctor of Nursing Practice program.
But the campus is not the only community that will benefit from her expertise and compassion. She plans to partner with primary care providers across Orange County to create an intervention that supports at-risk youths and their caregivers.
She wants to offer support beyond identifying trauma and suggesting emotional regulation techniques like exercise, yoga, and mindfulness.
“I feel like there’s this healthcare gap in how to make that happen. I think nurses and other health workers can become health coaches in the community,” Bounds says.
“Supporting teens chronically exposed to adversity could also mean connecting them to positive environments.”
This includes school-, faith- or sports-based youth programming, mental health care, housing, and support groups.
Technology’s Role in Helping Vulnerable
Her courses in the Sue & Bill Gross School of Nursing are delivered through Zoom, a tool she thinks could also serve a purpose in treating vulnerable patients. Still, Bounds misses the human connection and hopes her students can feel her warmth and sincerity through the screen.
“Being a psychiatric nurse practitioner, I know that those relationships you build are so important,” she says. “Even when they’re not my patients, students, and colleagues, I want that connection to be there.”
When asked about her proudest accomplishment, Bounds cites her mentoring ability.
“I come from a community that could be considered under-resourced, so I’m proud to be a role model for those I work with. A single mom raised me. I’m a first-gen college student. And now I have a Ph.D. and am working at the University of California,” she says.
“To me, I’m an example of that young person who might have limited resources and support right now. Examples like mine that demonstrate possibilities for young people are so important.”
From stroke codes and triage to behavioral care and transgender patients, the ENA conference highlights key health care issues.
Attendees have access to hands-on clinical simulations and more than 100 presentations and can network with emergency department peers from around the world.
See the complete list of Emergency Nursing 2022 sessions here.
ENA is ready to reconnect and recharge with you Sept. 30-Oct. 3 during the world’s largest gathering of emergency nursing professionals at Emergency Nursing 2022 in Denver
ENA’s Emergency Nursing 2022 Highlights
Unintentional Cannabinoid Ingestion in Children
With the continued legalization of marijuana, unintentional ingestion of cannabinoids by young children is on the rise. These edibles often come in attractive forms to children that can easily be mistaken for candy as they are brightly colored and something they may typically eat, for example, gummies. Because of this, children are likely to take a much higher dose than recommended, leading to vomiting, dizziness, tachycardia, difficulty breathing, drowsiness, and confusion.
According to presenter Justin Milici, the best thing to prevent this at home is to keep edibles out of reach or locked away.
Should I Call a Stroke Code for This? Subtle but Devastating Stroke Symptoms
Only some strokes present with one-sided weakness. Some devastating strokes only garner a 1-2 on the NIH Stroke Scale. Over 80 percent of strokes are clot strokes and can be fixed if caught in time. Remember, BE FAST to help identify a stroke – Balance, Eyesight, Face, Arm/Hand, Speech, and Time.
Presenter Joan Somes takes emergency nurses through real-life scenarios to raise awareness of the subtle stroke symptoms she has picked up on during her 46-year nursing and nurse educator career.
Guiding Emergency Room Nurses Through Sexual Assault Exams Using Telehealth
Many emergency departments, especially rural areas, do not have Sexual Assault Nurse Examiners available at all times to conduct Medical Forensic Exams when a victim of sexual assault comes into an emergency department. As a result, often, the patients are transferred to other hospitals, which can add to the trauma and delay time-sensitive treatment and evidence collection.
Kimberly Zemanek and Kayce Ward aim to change that with the Texas Teleforensic Remote Assistance Center, Tex-TRAC, which connects hospitals with expert SANEs virtually and joins with communities as part of their community launch with each ED partner.
Supporting Transgender Patients in Healthcare
For some going to the ED can be a scary experience. For transgender patients, that feeling is magnified because they’re afraid of being misgendered, further stigmatized, or not receiving appropriate treatment.
Presenter Connor Wesley shares the language used to talk about the transgender community, discuss health disparities and provide tools to help ED nurses better support transgender patients. Connor created this presentation after not getting much transgender education in nursing school. He’s now been giving it for more than ten years.
Critical Topics in Behavioral Care for Nursing
A Journal of Emergency Nursing study showed that 60 percent of ED nurses have no specific training in assessing behavioral health patients. As a result, some nurses believe that EDs are not the right place for psychiatric emergencies, but there is nowhere else for them to go in many cases.
The six presenters on the Coalition of Psychiatric Emergencies have a wealth of knowledge and experience they’ll share with emergency nurses to better equip them to handle behavioral health patients in the ED, including de-escalating agitated patients and approaches to self-harm. But, of course, nurses are not immune to behavioral health issues, so the coalition will also go over how to prevent burnout so nurses can be at their best.
Ah Ha Ha Ha Staying Alive … Triage Education that Makes a Difference in Our New World
We must keep trying to improve until there are zero errors in health care, says presenter Deena Brecher. By analyzing over a million triage records, common acuity assignment errors emerge that significantly affect patient outcomes. For example, the average ED nurse was only 60 percent accurate in their triage assessment.
Deena shares how to use your EDs data to improve triage assessment by focusing on presenting symptoms and recognizing a high-risk patient instead of trying to diagnose immediately.
Disaster Nursing – What You Need to Know: The Good, The Bad, and The Ugly
Nurses are among the first to step up and assist those in need when disaster strikes. As Kathy Van Dusen recounts one of her deployments, the whole town was evacuating, trying to get out, and we were going in.
Disaster nurses provide high-quality rapid-response medical care when public health, natural disasters, and medical emergencies overwhelm state, local, tribal, or international resources. This presentation will cover how to become a disaster nurse and the types of deployments to the various injuries seen.
Register for the ENA’s Emergency Nursing 2022 here.
