Differentiating the Nuances of Crime Scene Definitions

To the editor:

Thanks to Collista Zook for her enthusiastic response to forensic nurse and her letter to the editor commenting on Mary Sullivan's article, "Clinical Forensic Nursing: A Higher Standard of Care." (forensic nurse premiere issue August ) Ms. Zook was correct in noting that the Texas woman's body was a crime scene upon her discovery at the side of the road. Ms. Sullivan is equally correct in stating that the body was deemed to be a crime scene when the medical team first discovered the bizarre and extensive perineal and perianal trauma. Crime scenes become established and the investigations begin upon the reasonable expectation that foul play has occurred. Kudos to that OR nurse who noted important physical evidence in the midst of routine surgical preparation and took the time to preserve and document it. Ms. Sullivan's article emphasizes that clinical forensic nursing does not occur in a vacuum ... it is an integral part of nursing acumen.

Dr. Henry Lee's Crime Scene Handbook is a great resource for differentiating the nuances of crime scene definitions and classifications. He states on page 5, "A body should be considered a crime scene unto itself..." Up to the time in the operating room when the team discovered the associated genital injuries, the woman had been viewed a victim of violent trauma who had life-threatening injuries requiring emergency surgery. In such dire circumstances, it is understandable that EMS personnel and emergency staff members would not have been "tuned in" to the potential for associated sexual assault.

I believe that we are all in agreement that there is significant value for hospitals to ensure that their personnel are able to identify potential forensic cases and to participate in evidence collection and reporting/referral processes. However, I suspect that even the most zealous forensic nurse or patient advocate would concede that "life and limb salvage" must continue to be the top priority in the emergency care arena. I believe to suggest otherwise, would surely endanger the acceptability and credibility of forensic nursing within the clinical setting.

Janet Barber, MSN, RN
Greensburg, Ind.

Add Forensics to Nursing Curriculum

To the editor:

I've been an RN for almost 18 years and I want out for the same reasons so many are leaving. I've been interested in the forensic arena for a while, but had no idea as to how to get into the field; the local university has been no help at all. When I approached the faculty of the nursing department (I was there inquiring about their RN-to-BSN bridge program) and showed them a newsletter from the IAFN, they looked at me as if I'd just stepped off of the dark side of the moon, as they'd never heard of forensic nursing. Finally one said that such a program could only be offered on the master's level and they don't have a master's degree program. When I asked why, their response was, "Nurses don't normally come in contact with forensic situations." That's when I took it upon myself to educate others. These nurses will work in nursing homes, home health and community health where the nurse is the first one to come in contact victims of abuse. These nurses will work in emergency rooms, clinics and trauma centers where they will be the first professionals to come in contact with victims of sexual assault, suicide attempts and motor vehicle accidents, as well as with individuals injured while in law enforcement custody. These nurses will work in county jails and the state prison system. If that's not forensics, I don't know what is! This individual didn't know that if the victim of a crime dies in the ER, the body itself is evidence. And who's doing most of the documentation? I'm preaching to the choir, but I feel strongly that forensics, as it applies to nursing, should be as much a part of the nursing curriculum as nursing research and community health nursing. Aside from the aforementioned reasons, it also opens up an entirely new career field and could keep nurses from leaving the profession.

Jacqueline Grice, RN
Pensacola, Fla.

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