Forensic Nursing

MMC.RN · Feb 6, 2016

I am a forensic psychiatric nurse and I work at a state psychiatric hospital in maximum security admissions. Our population is adult males who have been accused of committing a crime. We typically get admissions from the jail and the majority of our patients either have a mental illness or are suspected of having a mental illness. We typically do one of two things: assess for competency to stand trial or treat to competency so that they can be competent when standing trial. We also get the occasional NGRI or patients who were considered not guilty by reason of mental disease or defect. They come to our unit and are usually quickly transferred to another long term unit.

I love my job! It's not a typical nursing job, I don't deal with complicated medical procedures on a daily basis but we do get our complicated medically unstable patients especially since a lot of them have little access to care. I am also constantly thinking on my feet with regards to safety. You never know if someone will come charging after you because they are symptomatic and experiencing hallucinations. I tend to do a lot of assessment both medical and psychiatric. We don't have a doctor on the unit at all times, state of the art medical diagnostic equipment or a 24 hour lab available and a lot of times I have relied on my assessment skills in order to make judgment calls especially since my patients like to malinger to get a trip to the hospital. As I said, it's never dull and I often have up to 24 patients at a time when I am the only nurse on the unit. I think I love my job because of the autonomy I have, I make a lot of decisions and I am constantly thinking on my feet. No patient is exactly alike and what works for some may not work for others. I have to get creative with interventions especially if they are having a psychotic episode.

As far as training goes, I have my ADN and I took psych electives while in school. I also worked with adults with mental illness in the community while I was in school. After I was hired we had about four months of special training on the job regarding mental illness and treatment as well as safety and how to handle dangerous patients.

Let me know if you have any other questions! There are so many different areas of forensic nursing you could go into. I hope I have helped and I wish you the best of luck!

nerdy student · Feb 7, 2016

Thank you for your feedback! That sounds very fast paced and unpredictable, but it sounds so interesting! I still working through some prereqs but I am always trying to keep my options open and do research on specialties that I might want to go into!

Get2theChoppa · Feb 7, 2016

I currently work as a sexual assault nurse examiner. I perform exams on adult/pediatric patients, as well as suspects. It's a 24-hour on call job. I receive calls directly from law enforcement, then meet the officers and patient/suspect at the hospital. The job consists of an interview, exam (swabbing, photos, genital exam, speculum, labs), administration of prophylactic medication, documentation from exam, and then packing up the kit. Depending on the patient, I occasionally refer pts to the ED. There's a lot of physical/psych assessment, and counseling involved. I have a lot of autonomy, and I love what I do.

I've got my BSN, and trained for a couple of months before starting on my own. You need an RN license and BSN to start.

nerdy student · Feb 7, 2016

That work sounds like it would be very emotionally charged, how do you cope with the high emotions that come with your job? I think that I would be really hard to not get invested in cases, especially for me being a woman. You have my utmost respect for choosing your job!

nerdy student · Feb 7, 2016

Do you just learn to tell when they are 'faking" or are there certain ways to tell right away? I would assume that the sort of people you deal with might be good at pulling a fast one!

nerdy student · Feb 7, 2016

I am a forensic psychiatric nurse and I work at a state psychiatric hospital in maximum security admissions. Our population is adult males who have been accused of committing a crime. We typically get admissions from the jail and the majority of our patients either have a mental illness or are suspected of having a mental illness. We typically do one of two things: assess for competency to stand trial or treat to competency so that they can be competent when standing trial. We also get the occasional NGRI or patients who were considered not guilty by reason of mental disease or defect. They come to our unit and are usually quickly transferred to another long term unit.
I love my job! It's not a typical nursing job, I don't deal with complicated medical procedures on a daily basis but we do get our complicated medically unstable patients especially since a lot of them have little access to care. I am also constantly thinking on my feet with regards to safety. You never know if someone will come charging after you because they are symptomatic and experiencing hallucinations. I tend to do a lot of assessment both medical and psychiatric. We don't have a doctor on the unit at all times, state of the art medical diagnostic equipment or a 24 hour lab available and a lot of times I have relied on my assessment skills in order to make judgment calls especially since my patients like to malinger to get a trip to the hospital. As I said, it's never dull and I often have up to 24 patients at a time when I am the only nurse on the unit. I think I love my job because of the autonomy I have, I make a lot of decisions and I am constantly thinking on my feet. No patient is exactly alike and what works for some may not work for others. I have to get creative with interventions especially if they are having a psychotic episode.
As far as training goes, I have my ADN and I took psych electives while in school. I also worked with adults with mental illness in the community while I was in school. After I was hired we had about four months of special training on the job regarding mental illness and treatment as well as safety and how to handle dangerous patients.
Let me know if you have any other questions! There are so many different areas of forensic nursing you could go into. I hope I have helped and I wish you the best of luck!

Do you just learn to tell when they are 'faking" or are there certain ways to tell right away? I would assume that the sort of people you deal with might be good at pulling a fast one!

MMC.RN · Feb 8, 2016

I have definitely learned when the are, "faking it," especially as I have continued to work in the field. As far as when they are faking a physical illness, a lot of times they look just fine and they are observed talking and laughing with their peers just a few minutes prior. Their vital signs tend to be normal and their symptoms are vague. In regards to if they are faking a mental illness and are trying to get an NGRI, they don't usually do their research correctly into what the symptoms of schizophrenia or whatever mental illness they are trying to fake. Again their symptoms are vague. They tend to be able to follow directions and are observed in the day room talking and interacting with their peers. They are able to play games and have a good attention span and are not disorganized unless they interact with a staff member. Those are just a few of the many things we tend to look for.

I hope this helps! It can be complicated and it be difficult to explain.

nerdy student · Feb 8, 2016

I have definitely learned when the are, "faking it," especially as I have continued to work in the field. As far as when they are faking a physical illness, a lot of times they look just fine and they are observed talking and laughing with their peers just a few minutes prior. Their vital signs tend to be normal and their symptoms are vague. In regards to if they are faking a mental illness and are trying to get an NGRI, they don't usually do their research correctly into what the symptoms of schizophrenia or whatever mental illness they are trying to fake. Again their symptoms are vague. They tend to be able to follow directions and are observed in the day room talking and interacting with their peers. They are able to play games and have a good attention span and are not disorganized unless they interact with a staff member. Those are just a few of the many things we tend to look for.
I hope this helps! It can be complicated and it be difficult to explain.

All of the input has been VERY helpful! Thank you for taking the time to respond! :geek:

MMC.RN · Feb 8, 2016

No problem! I'm always glad to help a fellow RN! Good luck to you!