Posts Tagged ‘Forensic Nursing Violence Against Women’

Death and birth control

December 4, 2011

Forensic nurses are regularly involved with examining the dead and helping to determine the cause of death. It can be important in the case of a deceased female to have a record of contraceptive use and past abortions. These birth control measures can affect the body system by causing hypertension, thromboembolic disorders, glucose intolerance, or hormone changes. In abuse cases it is helpful to know if the woman was on her menstrual period to help identify bleeding as natural or a result of trauma.

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Are Staff Nurses Prepared to Care for Domestic Violence Victims?

December 25, 2008

As nurses, we advocate for our patients and we attempt to provide them with the best care possible based on theory, evidence-based practice, and research. Nurses advocate for women who are abused and attempt to counsel them on their value and who they are as a person. Nurses attempt to help heal victim’s wounds and find resources for them to continue on with life, preferably a healthy, happy, and safe life. The problem comes in when nurses are unprepared to collect evidence in the ER or office when a domestic violence victim seeks our help. The victim does not often get a second chance and so as nurses we can’t afford to miss anything, and we need to get everything right the first time for these women. How many times have we seen the perpetrator get off free because of lack of evidence? In many large city hospitals forensic nurses are trained and on staff 24/7 to provide care and collect evidence when domestic violence victims are brought in. My question is what happens to the victims that seek care in a small town hospital? Many of these hospitals see domestic violence victims infrequantly and don’t have adequately trained staff to care for them when they do seek help. As a former ER nurse I have been in situations caring for rape victims. We had a kit available but read through it step by step and prayed we performed the exam correctly. I believe a nurse with knowledge of an advanced health assessment can be a great help to victims in being able to detect abnormal findings and reporting them in full detail. This is a great start, but what else can nurses in small hospitals do to make sure domestic violence victims receive care a forensic nurse can give without the forensic nurse qualifications?

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Trauma quality management process improvement

December 18, 2007

This discussion relates to trauma quality management process improvement through the incorporation of forensic nurses. For this discussion forensics will include living as well as deceased patients and events. The discussion will emphasize the value of evidence collection, documentation, mechanism of injury and complications after the primary event by all members of the health care team. Forensic trained nurses enhance the quality management process in trauma center. Forensic nurse specialist training combine’s clinical expertise, which blends nursing knowledge with the legal system. Physical, behavioral, and cognition aspects are all included during the patient assessment as they are each indicators of health. The benefits of the forensic nurse role can be seen in proper evidence collection, documentation through the chain of custody, proper terminology use, interfacing with law enforcement, and identification of unsuspected injury through application of the nursing assessment. In the trauma environment a problem-based assessment involving the history and examination is limited in scope to the specific problem that brought the patient to the emergent care setting initially. If a nurse performing this assessment identifies physical signs of past trauma or identifies subtle signs of abuse in the initial assessment she would be lead to a comprehensive assessment and involvement with other members in the trauma team. The comprehensive assessment will encompass current health problems, health promotion, disease prevention and assessment for problems associated with known risk factors. The knowledge base of a trained forensic nurse specialist allows correct terminology use during the documentation process, which allows for a smoother interface with the law enforcement. A forensically educated nurse will identify exigent evidence and work to preserve it through collection and photography so it can be utilized for future law enforcement needs. The documentation completed serves as a legal document of the evaluation and provides a baseline for subsequent evaluations. The accurate nonbiased health assessment can be used for future encounters and trend identification for recurrent injuries. Collaboration with a team promotes accurate management of trauma patients. Raising the index of suspicion and recognizing the patient’s problem is critical to opening the issues of abuse or other crimes against patients who present to trauma centers for care. The forensic nursing assessment of the patient and situation may lead to closing a circle of violence. Management of clinical forensics is important in the trauma care centers. The forensic nurse specialist has an important role in drafting policies and guidelines for the areas of: evidence identification, collection and documentation. The forensic nurse specialist provides an emergent role in developing ongoing Trauma Quality Management.


Sexual Assault: Forensic Nursing in the ER, comment

November 15, 2007

RE: The post from August 9, 2005 and titled:
Sexual Assault: Forensic Nursing in the ER, in Forensic Nursing Chronicles

Fortunately in this case, the nurse (and /or physician) had the insight to do a rape kit and take the child seriously. All too frequently we hear about children who have been repeatedly sexually abused by a relative or a family friend, only to find out that their parent or caretaker didn’t take them seriously. These sexual acts, from molestation to penetration can have serious consequences to the child later in life.
I believe events such as the one in this case occur more frequently than most people think.
The program Dateline: To Catch a Predator, has multiple stories of men showing up at the home of a young teenage girl that they were in contact with on the Internet, only to find Dateline there instead. These men are from all walks of life. Previous sex offenders, people on Parole, religious leaders, just to name a few.
This is a widespread problem, not just an isolated case here and there. I’m glad there is a push in the medical community to be more aware of and recognize child abuse, but this is just a small part of it.


Forensics and the nursing process

October 16, 2007

Forensics is an integral part of the nursing process. Through forensics, a focused assessment can evolve into a comprehensive assessment. Part of the nursing assessment process is being open to clues given by what is not being said, marks on the body, and a partner who answers questions for the client. A busy practioner in an acute care setting can find that her focused assessment can quickly become a comprehensive, even life saving assessment. To illustrate this point I will pull from a case during my experience in Women’s Health. A client comes into the acute care area of a Women’s Hospital. Her complaint is menstrual cramping with severe pain unrelieved by Ibuprophen. During the interview process, collecting subjective data, the practioner notices that the client’s partner answers the questions for her, and that he does not leave the client’s side. Collecting objective data, the nurse notices unusual bruising along the client’s inner thighs, and upper arms. When the practioner says that she is going to do a pelvic exam and do screening for STDs, the client refuses. This could be a client who is very private with a very protective partner, or the victim of abuse. It is part of the skills gained through learning the nursing process, enhanced by the forensic ability gleaned through years of experience which will guide the practioner to giving her client optimal care.


Sexual Assault Nurse Examiners

September 17, 2007

From the statistics I read about, the majority of sexual assaults are perpetrated by males upon females, and unfortunately many go unreported. I have never understood the reasons how or why this violent part of humanity takes place or other forms of violence for that matter, but that’s how my mind works – I guess its part of my utopian brain. In any event, as a male nursing student I wonder how and if I would be able to help a female sexual assault patient since the likelihood of a male perpetrating her crime is very high. Would I be permitted to help, or would the female patient’s condition be compromised since I am a man? Are most SANEs female for this very reason? Just some questions from a guy nursing student that would like to help these patients if it’s possible.


Rape Victim Examination

May 23, 2007

Forensic Nursing and Assessment of Female Genitalia and Reproductive System

Forensic Nursing when doing a rape case will be using all of her assessment skills during an extensive yet gentle pelvic exam.

Having a calming yet professional attitude would be a must for these nurses when performing this exam. The attention to detail must be such to be able to collect all the data and incorporate it in such a way to help the victim build her case.

Along with this embarrassing exam during a very traumatic time in this person’s life, time must to taken to provide for the client’s emotional needs as well.

Again, forensic nursing, utilizes a nurse’s assessment skills in such a way as not only to retrieve necessary data but also help to piece together a crime scene in such a way that it can hold up in court if necessary and hopefully get a person off the street that could be capable of committing such a terrible crime.


Assessment of a Rape Victim

March 16, 2007

Forensic Nursing provides a continuity of care from the emergency department and/or crime scene to courts of law.
This is another area where nursing assessment and forensic nursing overlap.

In cases of rape the forensic nurse will do initial examination and continue with the nursing care for the patient accordingly. The involvement of male police officers is limited which works to the advantage of the victim as well.

There is nothing so hurting than having to tell your story to a male when you were raped by another man. You even feel the police officer will be taking sides.


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