N475: Forensic and Correctional Nursing

correctional nursing

uA specialized subset of forensic nursing in which clients are inmates uPrimary goal is to maintain a safe, secure, and humane environment for the inmates uRecognize safety and security issues for the nurse; always maintain an escape route uUnderstand the prison culture uInmates manipulate nurses. uEnvironment is highly isolated.

tertiary level

address rehabilitation or identify factors that have put individuals at risk

subspecialties

uSexual Assault Nurse Examiner uMedicolegal Death Investigation uForensic nurse investigator uLegal Nurse Consultants and Nurse Attorney uClinical Forensic Nurse Examiner uForensic Psychiatric Nurse uCorrectional Nurse uForensic Nursing Educator/Consultant

mental health issues in correctional setting

uAdjustment to incarceration is extremely difficult for many mentally ill individuals. uDeinstitutionalization led to what amounts to the "criminalization of the mentally ill." uAccess to mental health treatment and medication is a right for prison inmates. uNurses must always be aware of the vulnerabilities of people with mental illness who are incarcerated.

Sexual Assault Nurse Examiner (SANE)

uCollects forensic evidence related to a reported crime and frequently testifies as a witness at subsequent trials uConducts a thorough examination and history uCrisis intervention referral uEvaluation of the victim for STIs uPregnancy risk assessment and care uClient referral for additional support uSANE is certified through IAFN

forensic psychiatric nurse

uConnects the gap between the criminal justice, legal, and mental health systems uApplies nursing process to clients pending a criminal hearing or trail uDetermines the intent or diminished capacity in the patient's thinking at the time of the incident uMay be called on in court to testify as an expert witness in mental health cases uSanity or competency evaluation (for legal purposes) uAssessment of violence potential uAssessment of capacity to formulate intent uParole and probation considerations uAssessment of racial or cultural factors in crime uAssistance in jury selection uSexual predator screening uProvision of expert witness testimony

health issues in prison populations

uDaily operations of a correctional clinic include management of acute and chronic illness. uHIV, hepatitis, and tuberculosis uHealth care issues are recognized during screening process. uScreen each inmate upon entry into the facility uHealth care triage process includes physical and mental health history. uEducation on chronic health needs uWomen in prison oImpact of drug use and victimization oStress associated with separation from children uAdolescents in prison oOften incarcerated in adult facilities that are ill equipped to deal with the challenges of adolescent development oMust be aware of their individual vulnerability

nurse attorney

uEducated in both the law and in nursing uOften involved in malpractice cases uMay be involved in licensure disciplinary action or agency oversight uServes as legal consultant uHelps hold accountable poor practitioners who are unsafe to public uMeticulous practitioners who are wrongfully accused of negligence will be defended

Clinical Forensic Nurse Examiner

uEmergency and critical care uDelivers care to living patients who are involved with legal system, and their services may include several subspecialties uLiving forensics—individuals who are subject to forensic investigation such as: uPhysical and mental trauma uToxicology emergencies uInterpersonal violence uTransportation crashes uPolice detention

Role of a Forensic Nurse Death Investigator

uEmployed by medicolegal death investigator or public health setting uHave knowledge of anatomy physiology, pharmacology, growth and development, physical examination, and health history interviewing techniques uEvaluates death scene from a holistic nursing perspective

current perspectives

uEvidence-based practice and research uScientific research in forensic nursing is in its infancy. uCertification uCertification examination for the pediatric, adolescent, and adult sexual assault nurse examiners (SANE A and SANE P) is available through the Forensic Nurse Certification Board. uCertification for legal nurse consultant, corrections nurse, death investigators, and forensic examiners uAmerican Nurses Credential Center; advanced forensic nurse (AFN)

medicolegal death investigator

uFour types of death investigation 1.Medicolegal 2.Institution-based 3.Private 4.Public health u Medicolegal death investigators responsibilities: oIssue death certificates that state cause and manner of death

Clinical Forensic Nurse Examiner

uNurse ensures that abuse and neglect are swiftly identified and reported to the proper authorities. uChild abuse—act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk or serious harm —CAPTA Reauthorization Act (2010) uNeglect—failure to provide basic needs uElder abuse—may be physical, psychological or emotional, financial, neglect, and/or sexual abuse Well documented that children and elderly with disabilities are more likely to be mistreated. Across the lifespan, the risk for one or more forms of mistreatment triples compared with the risk for individuals without disabilities.

organ and tissue donation and transportation (Clinical Forensic Nurse Examiner)

uPhysical examination of patients who may be organ and tissue donors oCollects any evidence that may be required oHas excellent communication skills oAbility to relate empathetically with grieving families

leagal nurse consultant and nurse attorney

uProvides assistance within the legal system using specialized nursing knowledge and expertise uEvaluates, analyzes, and renders informed opinions on the delivery of care and its outcomes uReviews and interprets medical records/charts uProvides objective opinions based on standards of care uTestifies in court if needed as an expert witness uIdentify, organize, and analyze medical records and related materials uPrepare chronologies or timelines of health care events uIdentify applicable standards of care uEvaluate causation and damage issues uConduct literature research and summarize medical literature uEvaluate case strengths and weaknesses uServe as an expert witness uIdentify plaintiff's future medical needs and associated costs

role of nurse coroner

uResponsible for ensuring that appropriate measures were taken to perform death investigations and certify death certificates uPerform death investigations to certify death certificates uTherapeutic communication to communicate with grieving families uMay apply to become board certified as a death investigator through the American Board of Medicolegal Death Investigators (ABMDI)

forensic nursing responsibilities

uScreening uAssessment and documentation of injuries, and collection of evidence uExpert witness testimony from victims and perpetrators across a variety of settings such as hospitals, community clinics, or death scenes uInvolvement in paternity disputes uCases involving workplace injuries, malpractice, transportation crashes, food or drug tampering, and medical equipment defects

forensic nurses

ucare for victims of injuries, from intentional violence or unintentional accidents uThey are involved with treatment and prevention of injury u mostly occurs in collaboration with other professionals both in and out of the role of nursing (law enforcement, corrections officer, emergency departments, psychiatric practitioners, public health uWork with public health in prevention measures expertly care for victims of injuries, largely as a community-based specialty, from a medical as well as a legal perspective.

secondary level

udirect care to both victims and perpetrators; collection of evidence for the legal justice system

primary level

uprojects that aim to prevent domestic violence, sexual assault, child abuse, and accidental injuries before they occur

Living Forensics

—individuals who are subject to forensic investigation such as: uPhysical and mental trauma uToxicology emergencies uInterpersonal violence uTransportation crashes uPolice detention