Looking for a Forensic Nurse to Interview

thenewhighlandr · Aug 4, 2011

If either of you could answer the original questions and the ones I added and send them to [email protected] that would be fantastic.

thenewhighlandr · Aug 4, 2011

Thank you, both!

shoegalRN, RN · Aug 4, 2011

answers in bold.

That would help me out a lot. I don't need place of employment because we're writing a reflection on the interview so I will not be turning in the actual interview. Could you also answer:
Are there tangible goals to work for? Will I see concrete results when the job is done?
Basically for me, it's to complete the case. I get paid on each completed case. There is a report that comes out that tell you how many complete cases make it to court.
Are there clear lines of responsibility?
YES! The responsibilty of the SANE is to do evidence collection. We are also responsible for calling the police department and speaking with the sex crimes unit if the patient wants to report the crime. We are responsible for taking pictures of injuries (genital and non-genital), doing a pelvic exam, collecting blood and urine, and ordering meds for prophylaxis (sp?) STD prevention. We also can order x-ray or CT if indicated.
How flexible is this position? How structured is the environment?
I am only required to be on call 3 days a month. Our program is very structured. The ER docs pretty much let us have at it as long as the patient is medically cleared.
Are the hours regular and the duties consistent?
Depends on what hours you are on call. No one case will be the same, but you do the same duties in each case, unless the patient refuses to have a forensic case done, but wants to be "checked out" anyway.

KC4NSICRN · Aug 4, 2011

Here are the answers to the interview questions. Originally I was going to send it in a document so the previous responses are included; Those responses are in italics and mine follow in non-italic. Please note that although I no longer work in a hospital, I did for many years. I think what I do can give you a different perspective of what a Forensic Nurse does.

Interview Questions

Please tell me a little bit about your educational background and how you decided to become a forensic nurse.

I have my BSN in Nursing. I decided to become a SANE based on my love of forensic science. I wanted to combine nursing and forensics. I also wanted to be a strong voice for domestic violence victims.

KC: I have a Diploma in Nursing with 34 + years of experience. I can trace my interest in Forensic Nursing way back to my curiosity as a child. Figuring out how things work, solving puzzles, finding out what happened and how.

My career had always been in Adult Trauma and Emergency: I like not knowing what's coming in the door next and taking care of it. I was a Flight Nurse on a helicopter ambulance and worked the trauma rooms when not flying. It was Easter weekend around 1985 and we had deaths to call in to the coroner's office. I was calling them all in and the Death Investigator said we had had more deaths than a (he named) a much larger city, and complimented me on my reporting. He asked if I would be interested in attending a Death Investigation Seminar and I said yes, and from there I was hooked.

I began attending and then joined the International Association of Forensic Nurses (IAFN) and met Virginia Lynch, RN, the Pioneer of forensic Nursing. From there I've attended so many great seminars on this topic that I began to teach a forensic Nursing presentation around the country and in Canada. It's been one of the best career decisions I ever made. There so many different areas within the Forensic Nursing framework that you can go into.

I am now self employed as a Forensic and Medical Legal Nurse Consultant and Licensed Private Investigator.

Before Hurricane Katrina I was employed also at an Urban Level 1 Trauma Center as a Forensic Nurse Liaison. I created that position and it grew as the years went by. I did all forensic activity in the hospitals (we had sister facilities connected by a shuttle bus) except SANE and I would consult at both campuses. I worked all death cases, handled all terminal care activities, identified any unknown patients admitted to the hospital and searched for their families, and was Coordinator of the Organ tissue and Eye Donor program. I worked with Law Enforcement agencies from all over the USA, funeral homes from all over Louisiana and many of the alphabet agencies (DEA, ATF, FBI) as well. Hurricane Katrina closed my hospital and they did not call my job back, so I explored other areas of nursing. I miss that job a lot though and believe the need is still there.

Where are you currently employed and explain what your job entails from day to day.

I am an ER nurse employed in a level one trauma teaching facility. My job as an ER nurse changes literally from minute to minute. I can have an assault victim in one room, someone having a heart attack in another room, and someone having a miscarriage in another room. If I am assigned to do Trauma that day, and if a trauma comes in, I drop everything I'm doing and head off to the trauma bay. Pretty much the jack of all trades.

KC: My practice is in my home office and I try to stick to a schedule.

9-10: Emails and answer phone calls

10-12: Case reviews

12-2: Case reviews, client interviews, investigations

2-3: Report development

4-5: Marketing

What is one of the most exciting cases you've ever worked on?

Don't really have too many, just one high profile case that will most likely go to court where I will have to testify as an expert witness. The case made the news, the suspect was in custody, and there was lots of forensic evidence to be collected along with the incident being witnessed.

KC: I have so many! The best answer to that is: The next case! But I have worked an Eraser Killer case, much the same as Scott and Drew Peterson, where they have done away with their wives and report her missing and later it's found that she was murdered. The working theory of why they commit these crimes is they would rather not hurt their wives by divorcing them, so they do away with them instead.

In my previous job I had a patient who came in unconscious and unidentified. He was a very good looking young man, clean cut, and was hit by a car at the intersection right in front of our hospital, so naturally we thought he might be a doctor, nurse or student of one of the medical or nursing schools nearby. I ended up having to get him fingerprinted and place an article in the Associated Press in order to identify him. This happened the month after 9/11 and I even had families from New York calling. Psychics even called!

What is the most satisfying aspect of being a forensic nurse?

Knowing what I do makes a big difference.

KC: Ditto! You are a nurse, but you have skills that other nurses do not possess, so you have the honor of helping patients in ways that other nurses can't. Not everyone wants to be a Forensic Nurse, but then not everyone wants to be an ICU or ER nurse, either.

Also, in my job now, finding that one piece of evidence that solves the case or that is the clincher to obtain a guilty verdict.

Giving a voice to those who feel powerless in the face of those who have wronged them.

What is the least satisfying aspect of being a forensic nurse?

Hearing the victim's story. I try not to get so wrapped up in the story because it makes me angry at the suspect and then I can't focus on doing my evidence collecting.

KC: I can't think of one (except for developing spreadsheets for my reports).

What, if anything, do you like more about this job than being a staff nurse?

The autonomy.

KC: Ditto! Also, I like being a go-to person. When nobody knew what to do about a situation at my old job, they would call me and I would either handle it or find out how to handle it. I learned something new every day this way.

If students are interested in this position, how would they begin their journey?

You have to be a detail oriented person. Every fiber, every hair strand will count. You should start off trying to get into ER nursing, although you do not have to be an ER nurse to become a SANE (at least not in MY area). Learn the female reproduction parts like the back of your hand. You can work OB and become a SANE. Go to all forensic nursing education opportunities. Join the International Association of Forensic Nurses. Watch every reality crime show out there, Discovery ID is a favorite channel of mine!

KC: I agree with being inherently meticulous, have exceptional observational and documentation skills.

I watch all those programs too but am frequently irked by the unreality of it all. I remember the first CSI show I saw, they were walking all over the evidence and I actually picked up the phone, but who was I going to call?

Those programs are also having a deleterious effect on our judicial system, as juries now expect even the smallest law enforcement agencies to have DNA results "by the second commercial." In other words, they expect all of law enforcement to be like on TV and it's just not realistic to think so. I like the true crime shows better.

I would suggest working ER also. After you learn more about forensic nursing, you will soon see that every aspect of nursing has forensic applications.

What is the average salary for a forensic nurse?

I get paid by the case. I get a stipend for each case I do, along with an hourly rate for how long it takes me to complete the case. Each case takes an average of 4-6 hours.

KC: I also get paid by the case. I set my own fee schedule and require a retainer to cover the first several hours of work.

What are the usual hours for a forensic nurse?

I am required to be on call 3 days a month. I also get on-call pay.

I work anytime someone needs me, and I generally try to stick to M-F, 9-5, but an email can come in any time and I will respond to it.

Do you see, on average, more male or female forensic nurses?

I see more female cases on average. However, I have done a male case.

KC: I see more female Forensic Nurses but male Forensic Nurses are also a valuable part of the team.

Do you work with a team? What is everyones role?

There is a team of SANE nurses at my hospital. We also work closely with law enforcement (the sex crimes unit) and organizations that support victims of rape and domestic violence. We work closely with detectives, as well as the prosecutor's office. The SANE is repsonsible for evidence collection, completing a rape kit, doing a pelvic exam, taking pictures of injuries (genital and non-genital), collection blood and urine, and placing orders for meds, x-rays, or CT's as needed. There is a ton of paperwork, which also includes collecting the victim's statement. We also work with social workers to place victims in shelter if needed.

KC: I have a business partner who is also a nurse. We are both trained Death Investigators and he has been a Deputy Coroner in the past. He specializes in marketing and Multi Media presentations for court, so he designed all of our promotional materials. He has the computer and technical knowledge that I lack.

I love the nitty gritty, down and dirty part of the investigative work. We make a great team! Today we were studying photos of a death scene in which a potential murder was staged to look like an accident. We are both Cajun and have a strong work ethic.

Are there tangible goals to work for? Will I see concrete results when the job is done?

Basically for me, it's to complete the case. I get paid on each completed case. There is a report that comes out that tell you how many complete cases make it to court.

KC: In my old job, I reported sexual assaults that went undiscovered in the ER, for ex., when a trauma patient is so severely injured that she may go straight to the OR and upon reading the records, discover that she came in from an assault or other injury and she had no pants on. I would then report that to the SANE Director and an evidence kit would be collected.

As an ER Supervisor and later as a Forensic Nurse, I was part of the Rape Crisis Network, where we had a sort of Grand Rounds and would discuss each case. Members of this task force included the DNA testers, the police, social workers, advocates, prosecutors from our parish and surrounding parishes. We would get an update on how we were doing in our evidence collection quality, find out how many cases went to court, how many were successfully prosecuted, what was lacking on those who didn't make it, how to improve our care, and also educate there was an educational piece to it.

Using this method, especially when you have multiple jurisdictions as members, you may even be able to research trends perpetrators are starting to use, and you can even notice if more than one suspect has used the same MO, and catch a serial rapist. One that comes to mind is that in several cases, the perpetrator tied the shoe strings of the victims' shoes together.

By having these meetings, law enforcement was able to look at those cases with new information and a serial rapist was put away. It could be something as simple as the words he used to lure her into his car, or what he said during the commission of the act.

Are there clear lines of responsibility?

YES! The responsibilty of the SANE is to do evidence collection. We are also responsible for calling the police department and speaking with the sex crimes unit if the patient wants to report the crime. We are responsible for taking pictures of injuries (genital and non-genital), doing a pelvic exam, collecting blood and urine, and ordering meds for prophylaxis (sp?) STD prevention. We also can order x-ray or CT if indicated.

KC: See above for Team. So far on my team there is only my business partner and I. Since it was my company first, I'm the president. We subcontract if there is a need for an expert who is currently practicing, or if the case is out of our expertise. For example, I would sub-contract a geriatric or chemotherapy case.

How flexible is this position? How structured is the environment?

I am only required to be on call 3 days a month. Our program is very structured. The ER docs pretty much let us have at it as long as the patient is medically cleared.

Self employment offers the greatest flexibility, but it has pros and cons, like other jobs do.

Are the hours regular and the duties consistent?

Depends on what hours you are on call. No one case will be the same, but you do the same duties in each case, unless the patient refuses to have a forensic case done, but wants to be "checked out" anyway.

Even if the patient does not want to report the case to law enforcement we used to keep the kit (if allowed to collect it) for a certain amount of time and still offer pregnancy prophylaxis and STD testing.

__________________________________________________________________________________________________

In conclusion, I again apologize for not getting back to you earlier. This was an interesting thing to do! and I really enjoyed the other nurses' responses. I hope this helps your presentation. And if you or anyone else has any further questions, please do not hesitate to ask.

~KC

shoegalRN, RN · Aug 5, 2011

KC:

I agree with you on the crime shows. I meant to say the true crime stories like The First 48, Forensic Files, Crime 360, Extreme Forensics, 48 Hours, etc. I can't stand CSI, it's soooo fake! I remember at my SANE training during the photography part, the instructor says "I can't stand CSI". It takes weeks, if not months to get DNA results. Our crime lab is so back up now.

KC4NSICRN · Aug 5, 2011

ShoegalRN, for awhile there, I thought you and I had worked at the same hospital.