The Need For Forensic Nursing In The Emergency Room Setting: A Case Study

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Chapters 1-3 of Forensic Nursing by Lynch discuss the origin, dynamics, principles, and increasing importance for Forensic Nursing in a clinical setting. The realization that Emergency Room patients are not only in need of, but more importantly, are entitled to benefit from this “new” applied science is becoming more evident to me every day. Recently, I was involved in the care of an elderly female patient that had presented to the ER for evaluation and treatment of injuries she sustained in a fall. She was assessed by the triage nurse and her primary nurse. All documentation addressed the mechanism of injury as a fall. The ER physician documented that the patient indeed fell and sustained injuries, but at the hands of domestic violence by the patient’s son. After medical diagnostics and treatment were rendered, I was asked to prepare the patient for discharge. After reviewing the chart, I realized that the initial assessment and documentation by the nurses did not include the circumstances regarding her injuries, nor a body gram description. Involvement of Law Enforcement, Social Services, and Protection Resource Services also had not been discussed with the patient. I then interviewed the patient, taking a full history of the precipitating/actual events. I documented her statements, and patterned her injuries on a body diagram template. I then contacted our Psychiatric Intake Department for collaboration with DHR/Law Enforcement/Social Services. Together we proposed an emergency safety plan for the patient to go to a women’s shelter for protection from further abuse from her son. Fortunately, this patient had a favorable outcome. Without applied nursing forensic techniques and the successful collaboration with other public entities, justice for this patient would certainly have been denied.

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