The Forensic Nurse

Police in Hollywood Florida today announced that Ottis Toole who had long been the primary suspect in the murder of Adam Walsh. John Walsh the boy’s father came to nation attention back in 1981 as he pleaded and worked with police to find his son.

Fisherman discovered the decapitated head of Adam walsh in a river over 120 miles away from where the boy was abducted. The remains of his body have still not been found to this day.

Police were riduculed for their repeated bungling of the case and the case evidence. The bloodstained carpeting found in Toole’s car that would have provided DNA evidence to tie him to the case was lost.

Following his son’s death, John walsh became obsessed with finding his son’s murderer and helping to be sure that other children and families didnt have to endure what he had gone through. 

He gained national attention when he starred in the America’s Most Wanted television show in the 1980s’. After serveral years of hosting the show and testifying to congress, the Adam Walsh Child Protecion Act was passed.

When documenting a SANE case, its important to use proper terminology when charting a patient. Some of those terms used to describe a level of sexual developmental maturity can be those from the Tanner Staging System. The Tanner stages look at three key components of sexual maturity: Pubic Hair, Breast development, Male Genetalia

Tanner Staging Levels

Many people know that the color of your skin can have an effect on almost every aspect of your life. But what about being raped?

Researchers at the University of Pennsylvania School of Nursing have released a new study that shows dramatic results when it comes to identifying injuries that may have occurred during a sexual assault depending on the color of the victims skin.

The Researchers conducted a study of 120 volunteers who were predominatly white or african-american and conducted examinations after they had engaged in consentual sex. They found that 68% of the white women had incurred at least one external injury (tearing, abrasions, or swelling), but only 43% of the darker skinned women showed the same levels of injury.

Because physical injury as a result of sexual assualt is usually the exception rather than the norm, being able to clearly show an injury often has a positive effect on people “believing” the victims story.

Being a Sexual Assault Nurse Examiner or SANE, I have heard countless times from law enforcement officers, social workers, other nurses, and even the victims own family members that they dont believe the victims story.

Sexual Assualts usually happen one on one, in a private setting with no other witnesses, cameras, or other ways to try and help determine if the sex was consentual or not.

Because most of these cases come down to a he said / she said scenario the ability to produce accurate forensic evidence is critical. There may or may not be DNA evidence and if injuries are harder to detect on darker skinned victims that puts them at a distinct disadvantage both clinically and in the criminal justice system.

The Georgia Death Investigation Act (O.C.G.A. 45-16-20) requires that the coroner or county medical examiner of the county where the body is found or the death occurs be notified and that a medical examiner’s inquiry be made in all deaths that occur in this state that meet the following criteria:

1. As a result of violence;
2. By suicide or casualty;
3. Suddenly when in apparent good health;
4. When unattended by a physician; no person shall be deemed to have died unattended when the death occurred while the person was a patient of a hospice licensed under Article 9 of Chapter 7 of Title 31 of the Georgia Code.
5. In any suspicious or unusual manner, with particular attention to those persons 16 years of age and under;
6. After birth but before seven years of age if the death is unexpected or unexplained;
7. As a result of an execution carried out pursuant to the imposition of the death penalty under Article 2 of Chapter 10 of Title 17;
8. When an inmate of a state hospital or a state, county, or city penal institution; or

9. After having been admitted to a hospital in an unconscious state and without regaining consciousness within 24 hours of admission.

Often we field many requests from interested readers who are asking, “What does it take to become a forensic nurse?” or “what are the requirements to become a forensic nurse?”.

There are various designations that can also be acheived. a CFN, a  

 The problem is, there is no one right answer currently. While there is a national standard that is currently being considered, each state currently makes its own rules for its licensing. So what requirements there are in New Jersey  to become a forensic nurse are not necessarily the same as the requirements in say Georgia or Michigan.

But for the sake of conversation. In general, you must complete / possess the following requirements to become a forensic nurse:

• A valid and active nursing license (without any restrictions)
• successfully complete a formal didactic educational program in forensic nursing. This should include a minimum of 40 contact hours in the core areas of forensic nursing. These core areas include; the history of forensic nursing; the forensic nursing process; violence and victimology; injury identification, interpretation, and documentation; criminalistics and forensic science; and nursing and the interdisciplinary process with law enforcement / and legal process.