Med-Surg · chapter 33 · Emergency Care
Forensic Nursing
The 13 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 3 practice questions with the reasoning.
Key points
ED protocol for violence
Violent crimes occur daily, so ED nurses must ensure that the proper protocols are followed when a patient who is a victim of violence enters the emergency department.
Legal importance of evidence
The roles and responsibilities of these nurses are crucial to preserving evidence for law enforcement and civil and criminal cases.
Forensic nursing focus
The specialty of forensic nursing trains nurses in health concerns and conditions related to acts of violence or abuse.
Forensic nurse case types
A forensic nurse can work in many fields and handle various types of cases, including child abuse, sexual assault, and maltreatment of older adults.
Care during evidence exams
They provide compassionate care to survivors of violence while performing the physical exams required to collect forensic evidence.
Court testimony role
Given this background, the forensic nurse may be called upon to provide testimonies and expert opinions for civil and criminal cases relative to their nursing practice.
Preventing evidence contamination
Forensic nurses must be able to properly preserve evidence from survivors of violence and prevent any cross-contamination.
Initial evidence documentation
They must begin by documenting and taking photographs of the patient, clothing, and injuries.
Specimen handling
They must place the trace evidence, clothing, and specimens they collect into individual envelopes or the proper collection containers.
Biological specimen collection
When collecting biological specimens, they should always use the appropriate collection tools and separate every sample to prevent contamination.
Chain of custody
Then they must complete a chain of custody form, which identifies any person who has come into contact with the evidence until it is released to law enforcement (Kleypas Badiye, 2023).
SANE evidence duties
SANE nurses abide by set protocols for collecting evidence, completing consent forms, and utilizing the Sexual Assault Evidence Collection Kit (SAECK).
SANE exam timing
An examination by a SANE nurse can take upwards of six hours, and the examination should, as a standard, be completed within 72 hours of the sexual assault (Ladd Seda, 2023).
Terms to know
- forensic nursing
- The specialty of forensic nursing trains nurses in health concerns and conditions related to acts of violence or abuse.
- chain of custody form
- Then they must complete a chain of custody form, which identifies any person who has come into contact with the evidence until it is released to law enforcement (Kleypas Badiye, 2023).
- sexual assault nurse examiners (SANE)
- A sexual assault nurse examiners (SANE) is a forensic nurse specifically trained in evidence collection and examination of victims of sexual assault.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
At 19:15, a forensic nurse begins collecting evidence from a patient treated after an assault. The patient's clothing and injuries are available for assessment. Which documentation approach follows the section's required starting step?
- Photograph the injuries and describe the patient and clothing in writing without photographing them.
- Record the assault history and defer photographs until the chain of custody form is complete.
- Document and photograph the patient, clothing, and injuries as evidence collection begins.
- Collect and seal the evidence first, then document and photograph the patient, clothing, and injuries.
Answer: Document and photograph the patient, clothing, and injuries as evidence collection begins.
The section requires documentation and photographs of the patient, clothing, and injuries at the beginning of evidence collection. Sealing evidence or completing the chain of custody form first delays this required starting step. Photographing only injuries leaves out the required photographs of the patient and clothing.
At 20:40, a forensic nurse has sealed the collected clothing and specimens in individual evidence envelopes. Before proceeding to the chain of custody form, which labeling actions should the nurse complete? Select all that apply.
- Use the chain of custody form as the only location for the nurse's signature.
- Place the patient's information on each envelope.
- Place the patient's information only on the clothing envelope because all specimens came from the same patient.
- Sign each envelope.
- Date and time each envelope.
Answer: Place the patient's information on each envelope., Sign each envelope., Date and time each envelope.
Each sealed item needs the patient's information, and each envelope must be signed, dated, and timed. Signing only another form or labeling only the clothing envelope does not meet these item-by-item requirements.
At 22:00, a nurse reviews the chain of custody form before releasing evidence to law enforcement. The collecting nurse is listed, but a second nurse who handled the sealed envelopes is missing. Which revision is appropriate?
- Replace the collecting nurse's name with the second nurse's name to identify the most recent handler.
- Add the second nurse only if that nurse opened an envelope or collected another specimen.
- Keep only the collecting nurse's name because the envelopes remained sealed.
- Add the second nurse and ensure the form identifies everyone who contacted the evidence until its release.
Answer: Add the second nurse and ensure the form identifies everyone who contacted the evidence until its release.
The chain of custody form identifies every person who has come into contact with the evidence until release to law enforcement. The section does not limit this to people who open envelopes or collect specimens, so omitting the second nurse or replacing the collector would leave the record incomplete.
Where every quote comes from
Section 33.4 Forensic Nursing of Medical-Surgical Nursing by Christy Bowen, Bridget Carey, Jessica Palozie, Maren Reinholdt, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.