I would like to see the development of forensic courses locally. There is one coming to Syracuse, this month, for the first time. I am anxious to see what the turn-out will be like. Unfortunately, the ED MDs that I have worked with, do not adhere to the preservation of evidence. Many do not even want to play into suspecting as some injuries as possible forensic cases. Oh well, maybe I’ll learn something very useful, or else I’ll just become a bigger thorn in their side. Rock on, patient advocacy!
Archive for October, 2008
As an ED nurse, I take great pride in my profession. I have always strived to educate myself and maintain my CEUs. I have been a long-time CEN and have encouraged my fellow co-workers to also sit for the credentialing. I am also TNCC, EPNC, RRT and TNCC certified. I look forward to the challenge of learning about forensic nursing and the preservation of evidence. I have no problem caring for these individuals, as I believe I have achieved the empathy aspect. I just need to learn how to protect their best interests. I contacted the local State Troopers before I learned about the existence of this program for some pointers, but they were not at all helpful. I would think that legal and medical should have a close working relationship. HIPPA regulations have put up a big barrier, I think, in that many people are afraid to give out any sort of information for fear of being cited. Case in point, one night, the SPs came into the ED, searching for someone, and threatened to arrest the MD and charge nurse on duty since they would not give out any information. I wish there was a resolution to this problem.
I always become so frustrated with CPS in our state. We see so much abuse and neglect that we report and continuously receive back reports as unfounded. A few weeks ago, I had a particularly aggravating case. A child was brought in by his mother. He was 10 years old, withdrawn and did not make eye contact. He was barely able to move his dominant R arm and had poor neuros. As I triaged him, I finally, confronted the mother, gently, and asked her bluntly if she had a safe place to go home to. She started to cry. Then the whole story came out how the significant other often became drunk and beat up on the children and her. I brought her back to the ED and persuaded her to file charges, which she did, and obtained all the CPS info. After calling it in, I looked up the family info on the computer, just out of curiosity. There were 8 children in the family and all of them had been seen MANY times over the past 3 years with injuries that were beyond the usual childhood variety, except for 2 visits – a sore throat and bronchiolitis. The most serious was listed as syncope (on a 5 year old) and you know that just doesn’t ordinarily happen. For some reason, CPS called me back later that night for clarification on my report, and I casually mentioned to her that many of the other children had also been seen over the past few years for injuries. I did not mention names, nature of visits or anything else. I was afraid of HIPPA violation, and later contacted by QA dept to run it by them. I also checked the HIPPA regs, and found I was within their regulations, so I was clear. Anyway, in the end, I finally received notification that the case was unfounded. I just could not believe it! How can we make a better case to protect these kids?
Physicians are obligated to relieve chronic pain. What should the professional do when chronic pain is present, but substance abuse is a concealed co-occurring disorder? When addicted patients experience any type of pain, the goal is to treat the pain; the addiction treatment in not the priority while patient is in pain. If drug abuse is unknown in the patient it’s the nurse’s job to suspect abuse when normal doses of analgesics do not relive the patient’s pain. If the nurse can determine the drug that is being abused and the amount being used, it is best to avoid exposing that drug to the patient and have an alternative drug.
Having worked in the ED for many years, I have had the opportunity to witness the inhumanity of acts of random violence to our fellow neighbors. Some of it is abhorrent, some I will never forget. I left the ED for 7 years and went into Case Mgmt because of it, but the lure of clinical nursing was too much to resist. I see forensic nursing as a great learning opportunity. I can see where we may have “messed up” on some potential cases. For example, I have personally taken care of many date-rape victims, truly suspecting Rohypnol as the culprit just by the way these poor girls were acting. Back then, of course, we automatically called the police agencies and advocacy groups in right away because HIPPA was not an issue. Now however, I need to learn the fine lines of not only HIPPA, but also how to truly preserve the evidence and advocate for the patient.
Since beginning my studies in Forensic Nursing, I have been amazed by the questions repeatedly asked by my fellow ER colleagues, family, and friends: “A Forensic Nurse? Where are you going to get a job dealing with dead people? Do you watch CSI and Forensic Files?” That’s when I eagerly engage them in an educational monologue on what they all know has been a true passion of mine for years. They seem somewhat perplexed to learn that in Forensic Nursing, the focus is on the living patient. Most think that the term “forensic” solely applies to crime scenes and death. I explain that the concept of forensic nursing encompasses so much more. It’s ultimate nursing with a legal edge. Proper assessment, investigation, documentation, evidence collection, and intervention for patients with suspected violence, abuse, neglect, or liability-related issues are the key elements in achieving successful clinical forensic practice. With each chapter I study, my role as a health-care provider, patient advocate, and future forensic nurse becomes more clearly defined. It also helps me delineate fact from fiction for my “not-so-forensically-inclined” audience!
While working in the ER of a local hospital, I witnessed a case where detailed documentation by an experienced physician helped save a 5 yr old Somali girl from ongoing psychological and sexual abuse. This little girl had been brought to the ER several times over the course of 3 months. She was brought in by her mother with several physical complaints that included lack of appetite, constipation, frequent crying and painful urination. Initial physical exams and lab tests were essentially normal. During the 4th visit, the physician decided to do a more in-depth physical assessment and full evaluation of the situation which included a psycho-social assessment of the family. The results revealed ongoing sexual and psychological abuse by a family member. The physician’s reporting and her detailed documentation of the findings help remove the perpetrator of this crime from the victim’s home and later assisted in his conviction.
Our Massage Pathology course MT114 provides 45 hours of Pathology, which is more than what is required by the The National Certification Board for Therapeutic Massage & Bodywork.
October 8, 2008
Does your course provide 40 hours of Pathology as required by the The National Certification Board for Therapeutic Massage & Bodywork?
September 16, 2008
You may find the tuition and fee information by going the right side of this website. Go to the section “Forensic Nursing Resources.” Click on “Online Forensic Nursing Certificate Program at Canyon College.” Click on “Admission Policies” at the very top of the page. Click on “Tuition” and “Fees.”
Next, go to the “Online Education” section on the right side of this Forensic Nursing Chronicles site. Click on “Massage Pathology Course, Undergraduate & Graduate.” Click on “Fees.”
For both Massage Pathology and Forensic Nursing Courses, you will find the information you seek.
September 9, 2008
What is the cost of the Forensic Nursing and Massage Pathology Courses?
September 3, 2008
Forensic Nursing courses are not required to prepare for the NCETMB, NCETM, or MBLEx. However, Forensic Nursing students say they see Massage Pathology in a new light. They are able to remember Massage Pathology facts and concepts better and do better on Massage Pathology exams. One does not have to be a nurse to take our Forensic Nursing course. We have one course open to nursing students and non-nursing students. We have another course open to only nurses.
Of course Massage Pathology is required to sit for the NCETMB, NCETM, and MBLEx. A Massage Pathology course can be used along or with a Forensic Nursing course. Our Massage Pathology class does fulfill the requirements of the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) for a student to take (1) the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) and (2) the National Certification Examination for Therapeutic Massage (NCETM). Our Massage Pathology class also allows students to take the Massage & Bodywork Licensing Examination (MBLEx) according to the requirements of the Federation of State Massage Therapy Boards.
August 27, 2008
Does your Massage Pathology course fulfill the requirements of the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) to take the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) and the National Certification Examination for Therapeutic Massage (NCETM)?
Does your Massage Pathology course fulfill the requirements of the Federation of State Massage Therapy Boards to take the Massage & Bodywork Licensing Examination (MBLEx)?
Will your Forensic Nursing course assist me in preparing for and taking the exams listed above?
forensic nursing chronicles
Forensic Nursing Education
National Certification Board for Therapeutic Massage & Bodywork
National Certification Examination for Therapeutic Massage and Bodywork
Federation of State Massage Therapy Boards
Massage & Bodywork Licensing Examination
Forensic nurses work with mental ill patients, many with a criminal background. As nurses work with patients who have a high probability of displaying violent behavior, the need for a risk assessment increases. Risk assessment is the process of assessing the individual patient against his or her specific risk factors as well as against other general risk factors, such as substance abuse. The Royal College of Nursing (1998) suggests that the aims of risk assessment are to: identify the hazards, identify who is at risk, evaluate the risks, make a record of the findings, and review and revise the assessment. A thorough mental health and mental status assessment is also key. As a nurse we need to be aware of the many factors that influence mental health, which can aid in our risk assessment skills. Individuals have different stress management abilities, spiritual and belief systems, genetic factors and interpersonal relationships. Assessment and management of risk are necessary in mental health nursing; they protect the welfare of consumers of mental health services and the community, and also play a role in protecting nurses against potential litigation. – Health Assessment for Nursing Practice, 3rd edition, Wilson-Giddens -Violence Risk.com
I progressed in the program Community and Public Health Nursing, I could understand the significance of relating the total package including forensic nursing. Each and every component is vital to the Community Health Nurse. During the last module I was able to finally connect it altogether. From patient education to physical assessment I am now prepared to use the tools and relate them in the CPHN perspective. This course has been challenging to complete when you work full time and are not in a structured environment, however I am extremely proud to be nearing the finish line and am competent to now work as a Community Health Nurse.