If you watch "CSI" shows, you know what forensic nurses do.
In addition to dealing with the emotional trauma of patients who are crime victims, they collect evidence.
"I define forensic nursing as anything where medical and legal intersect," said forensic nurse Katie Davis, who works in the emergency room at Beth Israel Deaconess Hospital in Needham.
Nurses such as Davis are specially trained to work with crime victims, and know how to preserve evidence for crime lab testing. They are experts in working with traumatized patients — victims of gunshot or stab wounds, sexual assaults, domestic violence and elder or child abuse — and are able to put them at ease in order to take detailed statements that will be used as part of police investigations.
Davis also serves on a state panel that investigates child fatalities.
"Forensic nursing is not for everyone," Davis said. "It's a really tough job. You see the worst of the worst — rape, child sexual assaults and fatalities. You have to be able to see the silver lining in all the trauma."
Like most forensic nurses, Davis is a designated Sexual Assault Nurse Examiner, doing forensic exams and administering the state- approved evidence collection kit. These forensic nurses from around the state are on-call and respond within an hour to sexual assault cases. Examinations can take three to six hours, and the nurses often testify in court.
A sex assault nurse examiner takes a 40-hour certificate training program, although some complete master's programs in the specialty.
Liz Henderson, a clinical nurse specialist in forensics at Massachusetts General Hospital, has worked in the hospital's ER and burn unit for the past 14 years.
Henderson's interest in forensics was sparked in her previous career as a firefighter and emergency medical technician, which until recently she did part time in addition to working as a nurse.
"Working as a paramedic I saw that a lot of things were not saved and that evidence was ruined," Henderson said. "That made me want to go into forensic nursing, to teach others how to properly and objectively collect evidence while also offering compassionate care to victims."
In the MGH burn unit, Henderson has done forensic work on burns caused by arson fires as well as assaults with scalding water.
Her work in Mass General's ER has exposed her to many situations in which she had to preserve evidence of a crime, from bar fights to domestic assaults, as well as all manner of wounds.
"Forensic nurses bring a special skill set," Henderson said. "They know how to measure and document a wound before it is altered, and how to cut clothing around wounds carefully, how to preserve gunshot residue. They know what kind of body, hair and fluid samples are needed for testing by crime labs and the importance of the preservation of the chain of evidence for legal proceedings."
Forensic nursing has been recognized as a specialty by the American Nurses Association since 1995. Since then, various degree programs have sprung up.
Henderson and Davis both have master's degrees in forensic nursing from Boston College's Connell School of Nursing. The comprehensive program involves learning the science of forensics, as well as courses on victimology and the legal and court systems, and labs in evidence processing.
BC nursing school professor Ann Burgess, one of the pioneers in the teaching of forensic nursing, said forensic nurses primarily work in emergency rooms, but there are some in psychiatric hospitals, prisons, law offices and on cold case squads in police departments.
"Forensic nursing has come a long way in being recognized as an important specialty in nursing," said Burgess, who has an award by the International Association of Forensic Nurses named after her that's given annually to individuals who have made exceptional research contributions to forensic nursing. "Our goal is to have a forensic nurse in every hospital's emergency room."
Both Davis and Henderson have a new designation called "advance practice forensic nurse" from the International Association of Forensic Nurses. This designation requires an advanced forensics nursing degree and more than 2,000 hours of supervised practice.
"Forensic nurses can become like nurse practitioners and make an impact on problems like domestic violence," Davis said.
Henderson, who is now working toward a doctorate in forensic nursing, said a big part of her role is educating other nurses on the job. She has created a forensic cart for the Mass General ER that has information about safeguarding evidence as well as containers and bags to collect clothing and samples, and she produces a weekly newsletter that discusses forensic techniques and protocols.
Burgess said that the field is constantly changing due to new technology and protocols, and that forensic nurses are now called upon as expert witnesses.
"I am working on a case that links seven separate crimes to one individual through DNA," Burgess said. "With all the advanced evidence collection techniques out there and the rise in crime, the need for forensic nurses is growing."
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