Enough Rhetoric...Time for Action

By Courtney Stephenson, BSN (pictured with Michael Baden, MD)

Imagine this article will strike a similar cord among forensic nurses because I am putting into words what I have felt for a long time about the progress of the education and training of forensic nurses.

My start in forensic nursing was in my “Introduction to Nursing” course in college. Our assignment was to do a research paper on a subject of our choice. I used my favorite topics to do a search on the Internet. I entered some key words such as “forensic” and “autopsy” to see what kind of hits I would receive. When I put “forensic” and “nursing” together, the International Association of Forensic Nursing appeared. Of course, I was ecstatic to find there was such an organization. Upon entering the site, I found the regional representatives. I contacted the IAFN to get the name of my regional representative; at the time it happened to be Georgia Pasqualone. I contacted Georgia and we set up a time to meet. She was going to be in New Hampshire soon for a sexual assault nurse examiner course. I met her in Concord and was instantly infected by the “Georgia bug.” We communicated a few times via email and telephone until my paper was complete. Georgia was, of course, very contagious and my aspiration to become a forensic nurse was set in motion.

When discussing forensic nursing I hear the same things wherever I go: “What is forensic nursing?” “What do I need to do to become a forensic nurse?” And “How do I find a job as a forensic nurse?” Honestly, I am tired of hearing about how to find a job because of the answers that are regurgitated. Some of these answers include: there are no standard routes of education; there is no standard of training; there is no set path to landing a job; or it’s who you know. Yes, it’s true you can go any number of routes to obtain the education and training (e.g., seminars, online education or on the job) but when you are faced with little income, the inability to travel or move to another place, and the lack of job opportunities, how are you expected to get your foot in the door?

Many of us say that we are not in nursing for the money. A salary is not my primary focus; however, I do have to make a living. At the same time I am not willing to do anything just for the money. I prefer the non-clinical setting vs. the inpatient setting; I’ve done that and it’s not for me.

I’ve not been able to pursue forensic nursing full-time due to my active-duty service commitment but I still talk to people at any opportunity — whether it be coworkers or friends — about forensic nursing, trying to do what I can do to promote the concept. After all, we may not be called forensic nurses, “But forensic nursing isn’t necessarily one hat you put on continuously; it’s a role you fall into when the moment presents itself,” as stated by Georgia Pasqualone in a forensic nurse article.¹

One of my former coworkers instructs at an LPN school and asked if I would do a presentation on forensic nursing to her students. I already had an in-service that I had created for the nursing staff when I was deployed to Asia last year so I just revised it to target the student audience. I brought all of my books, videos and anything else I had that related to forensic science and forensic nursing. I presented it to the students who were basically big sponges. Because of their attentiveness and questions I knew they had soaked up all of the information.

Nevertheless, it has been my experience that the credibility and/or quality of some of the forensic nursing courses offered is questionable at best. Mostly what I have done this far in my career as a forensic nurse has been self taught, whether it was from reading articles, taking CEUs, attending conferences and short courses, or watching documentaries. Donna Garbacz Bader said it well in a forensic nurse article: “It should be the nurse’s professional responsibility to seek out or recommend programs and continuing education that perfect skills in identifying, those occurrences of medico-legal significance.”²

There should be some way to inform nurses of reputable offerings through the IAFN Web site in addition to those found in forensic nurse magazine. Still, we often hear that in order to have more forensic nurses we need education. Likewise, we need forensic nurses so the number of educational opportunities can increase.

When talking about hiring forensic nurses, Patti Hancock said, “Nobody will hire them because they don’t have experience; they are not experienced because no one will hire them.” When referring to training she says, “If we are going to encourage nurses and really believe nurses are great in this role (death investigators/ coroners), which we do, then somebody has to train them.”³

Also, if Dr. Michael Baden, famed forensic pathologist, can say with certainty that more nurses are needed in the area of forensic science, you would think others in the community would follow suit.

Even though the majority of forensic nurses welcome discussion, some communities are reluctant to relinquish control of having this knowledge and what can be done to help promote the field.⁴ The “area of forensic science does not belong to a certain group of individuals.”⁵ I know there are individuals out there who have the time, position, power, money, contacts, or network that can help develop some sort of standard and can mentor those of us who are still “green” (we need more Bobbi Jo O’Neals). Patti Hancock said in the January/February issue of forensic nurse that (nurses) “can’t get into the system for hands-on training because no one will let” us in.⁶

I think it would be easy to develop a general knowledge exam; at least you could see where you stood. There are general knowledge exams for death investigation and sexual assault, so why can’t we have one for forensic nursing? Moreover, why can’t an information page be added to the IAFN Web site vs. people leaving messages on the bulletin board and being told to read past newsletters? Forensic nursing depends on “the development of a strong core curriculum and the continued nurturing of future forensic nurses,” as stated by Janet Barber.⁷

We have come a long way; we have the IAFN, forensic nurse magazine, and more and more nurses filling forensic roles, but still more is needed. In short, I propose to any of those individuals who may have the means to clear the path to please make it happen. Florence Nightingale didn’t have much experience before she did her historymaking tour in Scutari but look what she accomplished (she had the money). I do not feel that I am in the position to make things happen. I try not to be disheartend and hope that after I separate from the military in a few weeks, I will be able to pursue forensic nursing full time, specifically death investigation. I have spent just about every dollar that I could afford to take courses whenever and wherever I could as recommended by Mary Dudley, MD in forensic nurse magazine,⁸ so I could be ready when the opportunity presents itself, however, it has all been theory, little if any has been hands-on. Moreover, wouldn’t it be better to train someone with the education to do the job rather hiring someone who may have picked up bad habits? Mary Dudley also said very eloquently that nurses “have the science background. They just need to be cross-trained in criminalistics and legal issues” to do the job.”⁹

I have said my peace and maybe this article will incite fervor for some to take action instead of just talking about it. My final plea would be that if there’s any job opportunities for a forensic nurse, then get your advertisements out there. By the way, I’m looking for a job in the St. Louis area …any takers?

Courtney Stephenson, BSN, is currently employed at the VA in St. Louis. This year she completed the forensic nurse specialist course through the Florida Risk Management Institute and the Medicolegal Death Investigator Course at St. Louis University.

References:

1. Pyrek KM. Championing the medicolegal process. Forensic Nurse. March/April , p. 19.

2. Garbacz-Bader D. Forensic nursing: it takes education. Forensic Nurse. May/June , pp. 32-34.

3. Pyrek, KM. As death investigators, nurses pick up on crime-scene subtleties. Forensic Nurse. January/February , p. 27. 18- 20.

4. Pyrek, KM. Forensic nursing’s past, present and future: a conversation with visionary Janet M. Barber. Forensic Nurse. May/June , p. 16.

5. Garbacz-Bader D. Forensic nursing: it takes education. Forensic Nurse. May/June , pp. 34.

6. Pyrek KM. Nurse coroners slowly gain ground. Forensic Nurse. January/February , pp. 24-27.

7. Pyrek KM. Forensic nursing’s past, present and future. Forensic Nurse. May/June , pp.14-16.

8. Pyrek, KM. Opportunities abound for nurses, medical examiner says. Forensic Nurse. January/February , p. 20.

9. Ibid.

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