TMC PULSE

t m c » p u l s e | a u g u s t 2 0 1 4 26 t m c » p u l s e | a u g u s t 2 0 1 4 T he overlap between nursing and forensic science is more prominent than one might think. Equipped with cameras and tripods, ultraviolet lights to identify specific places to swab for biological evidence, and even special- ized cameras that allow the user to see bruising beneath the skin when no visi- ble marks are apparent, forensic nurses provide high quality care for crime victims, suspects and perpetrators. Within the Harris Health System, the community-owned health care system for the nation's third most populous county, the forensic nursing program allows nurses to treat patients, interface with law enforcement officials, and pave the way to accommodate legal needs through the collection and preservation of evidence. "Our program was established in 2008," explained Stacey Mitchell, DNP, director of the forensic nursing program for Harris Health. "There was a community need that was identified to address sexual assault patients, but after looking, learning and identify- ing gaps, we realized that there were other victims of crime, violence and injury that we could focus on as well. Caring for Justice beyond gathering evidence and testifying in court, forensic nurses strive to deliver objective care to patients, suspects and perpetrators B y A l e x O r l a n d o We expanded rapidly and extensively to include various types of patient populations." Mitchell was instrumen- tal in establishing the department and expanding its range of treatment— Harris Health's forensic nursing pro- gram now sees patients who have been victims of adult sexual assault, child sexual assault, elder abuse, domestic violence, physical injury, human traf- ficking and even occupational injuries. Sitting at the intersection between health care and the legal system, foren- sic nursing is one of the fastest growing nursing specialties in the world, gener- ating interest among both practicing and prospective nurses. Blending biomedical knowledge and critical thinking skills with an understand- ing of both the principles of law and human behavior, forensic nurses are poised to address physiological needs, acknowledge psychological trauma and prioritize legal concerns. "Our focus is on that intersection," said Mitchell. "We have the responsi- bility to not only look at the medical needs of the patient, but any potential legal needs and responsibilities, as well. That's where forensic science and the legal system interact with health care. If a forensic nurse can collect evidence and clothing and preserve them, so that down the road they can be pro- cessed in a potential case, and maybe have a positive outcome or some sense of justice for that patient, then we've done our job." "It's kind of a neat collaboration— we do everything that we can to stay oriented towards not re-victimizing the patients," added Khara Breeden, M.S., BSN, one of the nine forensic nurses at Harris Health System. "It's really a multi-pronged partnership between us, the physicians, who we work with to guide the patient's care, and law enforcement officials, as well as different partners and advocates from our community." Trained to collect medical evidence in instances where a crime may have occurred and communicate those findings to law enforcement officials, when necessary, forensic nurses begin their work in the examination room. "The first thing we do is to interview our patients, and write down whatever they say, word for word," said Breeden. "As we go through that process, I'm making a mental checklist of all the places that I need to look for evidence— it helps guide my physical exam. After the interview, I might look at particular body parts for bruising, abrasions or visible trauma, using my camera or any other necessary equipment. By the time we collect swabs of specimens for evidence, we've established a real relationship with our patients." The personalized care that forensic nurses can provide, and the ability to devote hours to patients, differentiates them from other nursing specialties. "Our forensic nurses are taking care of only one patient at a time for as long as they need our help," said Mitchell. "An emergency room nurse may have five, ten or fifteen patients depending on the size of the emergency room and how busy they are. We're solely focused on that one person, which allows us to take the time to identify the things that they might need and help coordinate those resources." An invaluable aspect of the care they offer, forensic nurses are able to provide resources that can help patients even after leaving the hospital, from a phone number for a women's shelter to the location of support groups for sexual assault survivors. "Coordinated care allows us to understand the role of everyone else in that investigation who's going to intersect with that patient," said Mitchell. "We have a great advantage because we're right in the middle of everything—we know where everyone is and what they're doing." This past year, Harris Health's forensic nursing program consulted on over 778 criminal cases. Although they

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