Risk Assessment In Forensic Nursing

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

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
forensic nursing mental assessment
forensic nursing mental health assessment

Forensic Nursing with Community and Public Health Nursing

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.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
Public Health Nursing

Massage Pathology and Forensic Nursing Courses, comment

Does your course provide 40 hours of Pathology as required by the The National Certification Board for Therapeutic Massage & Bodywork?

Original Post:
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.




Original Post:
September 9, 2008
What is the cost of the Forensic Nursing and Massage Pathology Courses?




Original Post:
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.



Original Post:
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?

tags
forensic nursing chronicles
forensic nursing
Forensic Nursing Education
Massage Pathology
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

Occupational Health Nurse

The role of the Occupational Health Nurse is key in any working environment. Why is this so important? In order to provide a safe environment for our staff and in the case of a medical facility, our patients. I believe it is important for a qualified Nurse to be trained in the role of Occupational Health. I am speaking from first hand experience as a year ago I was asked to take on the role of safety officer for our clinic. Although not in the same capacity of an Occupational health nurse I was fortunate enough to be sent on some training courses in order to facilitate the role, much of the same dynamics were applied. I learned valuable information to assess workplace hazards and to identify potential problems. I think it is important to have specifically trained staff i.e. the forensic nurse to be able to thoroughly investigate environmental issues when they occur.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing assessment
Forensic Nursing Process
Forensic Nursing Education
Forensic Nursing Employment

Successful Collaboration Equals Successful Forensic Nursing Process

In order for successful forensic nursing interventions to occur in the healthcare setting, there must be a successful collaboration between law enforcement, judicial systems, social support systems, and healthcare providers. Each form vital links to the chain of justice that must be afforded to every individual impacted by trauma directly or indirectly related to violence, abuse, neglect, maltreatment, or exploitation.

tags
Forensic Nursing Process
forensic nursing, forensic nursing chronicles, forensic nursing theories

Pediatric medication errors

In regard to Medical neglect on April 30, 2008: I perceive weight miscalculations recognized as a frequent problem in medication dosaging. I would encourage nurses to have the child's weight double checked by the parent and another nurse.



Original Post:
April 30, 2008
The reading I would like to comment on is Compliance and Noncompliance. This is an issue for many different reasons in any healthcare setting. In the setting that I work (the pediatric outpatient clinic serving mainly low socioeconomic families) noncompliance usually goes hand and hand with medical neglect. A large percentage of our population is of African American decent. I do know that there are some culture beliefs on medical care. The idea of preventive care, for example with well child visits is not seen as a necessity. Taking the time to educate on why preventive care is necessary and can help avoid medical problems is the only way to decrease the noncompliance rate. However a large part of my job is to also monitor appropriate follow up for medical concerns. The compliance rate goes down when people feel that their child is better from their illness. Asthma is chronic diseases where I see parents bring their child to the ER in an asthma exacerbation only to not show for their pulmonary follow up because the child was not wheezing anymore. It is our responsibility to take these opportunities and teach why it is so important to follow up with pulmonary care. The education to the parent that you may not hear anymore wheezing does not mean that the child is not still having problems. Proactive patient education can help with compliance and noncompliance rates.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
forensic nursing emergency room
Forensic nursing culture
Forensic nursing ethnicity
patient education
Health Promotion
Disease Prevention
Pediatric Nursing
Child Abuse
Child Neglect
medication errors

Determination of decisional capacity in patients exhibiting psychiatric symptoms

I currently work as a psychiatric liaison for a large general hospital. I am responsible for conducting psych-social evaluations on patients who, while on the medical floors, exhibit psychiatric symptoms. I am also an active member of the hospital’s Bioethics Committee. As part of my job, I receive requests for evaluations to determine a patient’s decisional capacity. During the past few months I have seen an increase in requests to determine a patients capacity to provide informed consent for medical procedures. I decided to discuss this issue because it has great ethical and legal implications for all involved. In the hospital, primary physicians order evaluations to determine whether their patient has lost capacity to make their own decisions. The implications of the results of these evaluations are very serious, often controversial and could mean that a patient may end up having a procedure they did not want. These evaluations often raise ethical questions regarding a patient’s right to choose. These evaluations can also lead to disagreements and discord among the healthcare professionals involved in the care of the patient. I have noticed that physicians and other medical professionals are often quick to judge patients as lacking capacity to make decisions. Physicians sometimes assume that psychiatric symptoms equate with limited decisional capacity. I have found, while interviewing patients, that they may lack a basic understanding of the risks, benefits and alternatives of a procedure even after their doctor has explained the procedure to them. I also find that patients are often afraid to ask their doctor questions or seek clarification. In closing, I feel that the issue of decisional capacity could provide a great opportunity for healthcare professionals with expertise in this field to educate staff and patients and to offer clarification when questions arise regarding a patient’s decisional capacity.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
Forensic Nursing Human Rights
patient education
Forensic Nursing Education

Medication errors

The nurse ”is the last line of defense” in preventing medication errors. One must read and reread and recheck all labels. In light of many errors in dosing recently in relation to the medication Heparin, one must read and reread and recheck all labels. The vials of Heparin state 1 unit dose. A nurse you must check and recheck the orders, the dose, the patient, on all medications, If medication is prepared by the pharmacy, we must not take it for granted the mixture of medications is correct. We must be careful in rushing to give medication, must check and recheck everything, before administering any medication, Errors, do happen as nurses we are the last line of defense to catch these errors.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
medication errors

Violence and Abuse

I have just completed the chapter on Violence and Abuse from Stanhope: Community and Public Health Nursing, 6th Edition. I am reminded once again of the importance of evidence collection and verbal or behavioral cues. We as Nurses must be constantly alert to the whole environment when we are caring for our clients especially when it comes to children. I will once again admit, working in a fast paced clinic for several years and dealing with 60-80 patients per shift I would tend to over look some of the signs of emotional or physical abuse that were listed in this chapter. This chapter was another excellent reminder.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
Forensic Nursing Violence Against Women
Child Abuse
Forensic Nursing Violence Against Men
Public Health Nursing

Female circumcision, comment

Female circumcision posted Tuesday Dec 4 2007

I knew about female circumcision for a few years but I never had the opportunity to evaluate a case. I recently had a woman from Africa who came to my clinic because she was having bleeding every time she had sex. She had been in the country for about two months and stated to me that she was married, but stated she was single to the intake person. A very interested male translator was with this woman and I asked if he was her husband or just a friend. He stated he was her friend so I excused him. People in America do not know that in Africa if a man can afford more wife he may be married to several women depending upon where they are from and what tribe. The man was nervous but left. (Bigamy is a crime in the USA in case you forgot.)
I had to have a telephone translator to ask questions and give this patient information.
I found out this woman did have female circumcision. The bleeding was only after sex.
The pelvic examination revealed both labias including the mons pubis was removed. The genital was only a smooth area where the skin of the mons pubis sewn together. A small speculum fit snuggly into her vaginal hole to evaluate the cervix and the vaginal walls.
Clearly the problem was the small entrance into the vagina.
After the woman was dressed I allowed the male companion back in the room (I suspected he was her husband). I showed them a picture of an uncircumcised vulva and explained to them that the tissue was necessary to stretch to deliver a baby. The patient already knew she would have to be cut open to deliver a baby.
My suggestion was to use K-Y jelly and proceed careful when having sexual encounters. There is a possibility that the vaginal hole could open a little more. If she continued to have bleeding, she would need altering the vaginal orifice with surgery.
The reason for the circumcision is religious and to try and convince women and men not to do this is to bleak.
There are women in Africa that are refusing to have this done. They are getting into groups but are usually osterized by their tribes. Sometimes these circumcisions are done when the female is a child but usually around menarche.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
Female Genital Mutilation
Female Circumcision

Pandemic influenza (H5N1)

I work in Alaska on the Aleutian island occasionally.
Recently a village had a 'dry run' to practice giving immunizations incase the pandemic flu strikes here. Alaska is a threat because of migration of birds. It is felt that Alaska will be one of the first hit with the avian flu.
This small village was able to immunize 68 people in 4 hours.
The staff was eight people but they probably could have done it with six because they used two people to evaluate and work on spousal and child abuse issues with the 'dry run'
One person was an intake at the door of the community center to guide the people through and help fill out forms.
Two people took vital signs and screened to make sure the person receiving the immunization had never been allergic to other flu shots or allergic to eggs.
Two people gave the vaccines; one person helped the person go out of the clinic and answered any other questions.
The village thought this 'dry run ' was a success.

Original Post:
November 29, 2007
If/when a pandemic takes place, clinical nurses will need to use advanced assessment skills to recognize those who have been infected as well as those at risk. The symptoms of H5N1 have been shown to mimic the pandemic flu of 1918. Early symptoms of H5N1 mimic that of regular seasonal flu. However, the disease process of the H5N1 appears to be more inflammatory in nature leading to a mortality rate >50% affecting those with healthy immune systems. There is no rapid method to test for H5N1 and no vaccine. A person with seasonal flu or a regular cold has upper respiratory symptoms and an increased WBC count. A person with H5N1 has upper respiratory symptoms and a low WBC count. Could these clinical markers be used as an effective screening tool to triage and disperse available treatments (anti-virals, ventilators, etc.) in the throws of a full blown pandemic? If/When H5N1 mutates to develop human-to-human transmission initiating the pandemic, could the virulence decrease?

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
forensic nursing assessment
Forensic Nursing Process
Healthcare Security
Health Promotion
Disease Prevention
Syndromic Surveillance
infectious disease control
Public Health Nursing
nursing health assessment

Idenification of an Individual

Identification of an Individual;
Forensic Medicine www.forensic online.com Aurthor ; Joseph I. Cohn M.D. Pathologist. General Information for Individuals.
Posted: Dec. 22 2007,15:43

This information was informative and possibly all of us have seen forms of this identification on movies and television. I watched a forensic medicine show that showed how one homeless person was identified. The body was almost mummified with no identification no teeth. No one around that could identify the body. The forensic physician took one of the mummified fingertips and injected it with saline. After the tip was inflated with saline he could roll a fingerprint and found the unidentified homeless persons' name.
So many wonderful skills have been developed to help identify people. Another skill is the forensic facial reconstruction that can reconstruct a face from even broken skulls.
Many other identification methods have improved with computers. Now 2D and 3D reconstruction of the skull using computers can approximate the person found with a few facial bones and again the skull.
Forensic medicine is leaping forward to help humanity understand the past and find people who have been lost.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
forensic finger prints
corpse identification

Verbal cues for evidence collection

The process of collecting data for evidence in regards to abuse must be a daunting task. We as Nurses are well trained in assessing physical clues but what about verbal cues. As I progress through each chapter of “Forensic Nursing” by Lynch I am reminded to constantly be alert to what the client is trying to tell you. This past week I had a client in my clinic for routine immunization, I performed a TB test and 48 hrs later when she returned she was angry, became upset with me because I pronounced her name wrong. I have seen this particular client on several occasions and she is usually happy and positive and actually seems timid at times, I was quite shocked by her outburst. Without going into particulars I found out later that day after discussing the situation with one of the Drs. that this particular individual had reported domestic violence to our social worker earlier that morning. I knew her behavior was out of the ordinary so it prompted me to investigate further. We can either choose to get angry with the client ourselves or look further into the change in behavior. I am glad I chose the right way.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
forensic nursing assessment
Forensic Nursing Violence Against Women

Nursing Care For Inmates

Providing quality healthcare to patients is challenging, especially when those patients are inmates; housed in an environment completely unsuitable for healing. Nursing theorists have long taught the importance of having basic health needs met. Hygiene is one of the most significant interventions, as this begins with a person’s ability to fix oneself in a clean environment. The patients I have cared for are inmates in a jail. A facility that houses people in tight living quarters, limits the use of showers and restrooms, and generally is comprised of people with a history of poor hygiene practices. Secondary infections prevent primary wound healing; contagious diseases are rampant (especially for the immunocompromised). This is when it is important for the nursing staff to be diligent to encourage good habits, educate based on education level, and work with correctional staff for the potential of the facility to be reached. This is the kind of nursing that started to save lives in the beginning, and it is these concepts that all nurses must acknowledge from time to time. Nurses must have a strong foundation in the basics to make all interventions capable of working.

tags
forensic nursing chronicles
forensic nursing
forensic nursing theories
forensic nursing diagnosis
Correctional System Forensic Nursing
patient education
Health Promotion
Disease Prevention