August 18, 2016

Criminals Beware: Forensic Nurses Are On The Case

Criminals Beware: Forensic Nurses Are On The Case

Written By: Lee Nelson

When Vikki Vodosia met the little six-year-old boy to do his exam, she was taken back by his politeness and sweetness, especially after all the horror he had gone through in his brieflife; he had been beaten head to toe with an extension cord.

“It had been a couple weeks since the incident had happened, but there were still marks all over his body when I did the examination,” says Vodosia, a forensic nurse at the Children’s Hospital Intervention and Prevention Services (CHIPS) at Children’s of Alabama, Birmingham.

This is a place where children who have experienced suspected abuse come for healing and help from specially trained licensed professional counselors, doctors, social workers, and sexual assault nurse examiners (SANE) such as Vodosia. She provides forensic medical evaluations and comfort to victims.

Forensic nursing has become one of the newest and hottest specialties recognized by the American Nurses Association, and it’s growing rapidly in many parts of the country.

What Do Forensic Nurses Do?

According to the International Association of Forensic Nurses (IAFN), forensic nursing is the application of nursing science to public or legal proceedings.

Forensic nurses receive extra training and knowledge in injury identification, evaluation, and documentation. Many times, they first help a patient through their trauma, fears, and bodily injuries; then they collect evidence, work with legal authorities, and can testify in court when needed.

“This can be the worst day of their lives for some people; we want to ensure that they have the resources they need to move through the criminal justice system if they choose to interact it,” says Kim Day, Project Director at IAFN.

When helping a patient, these nurses collect a comprehensive medical history, including health and sexual history, as well as information about the things that have happened to them in the past.

“We use these varied pieces of information in order to apply forensic science and figure out what samples to take. If someone has been drugged or ingested a lot of alcohol, we need to work through that, too. We have to figure out how to identify samples that might be helpful to the investigative process,” she adds.

What Qualities Do You Need To Be A Forensic Nurse?

Entering this highly specialized form of nursing requires a candidate who likes being a nurse, not someone that wants to be a law enforcement officer.

“That’s not what this is all about; it is taking care of people that are trauma victims. It’s being able to give them the resources they need and reassurance that they are physically OK,” said Day, “Most of these cases never make it to the courtroom; the focus can never be on what the criminal justice system will do with this. “

Although positive outcomes can result from working with such patients, they may come to the forensic nurse feeling extremely overwhelmed, and the nurse must tailor the exam to the patient's comfort level.

Vodosia feels that the job takes someone highly compassionate.

“I never wanted to be a nurse, but I was 28 when I went back to school and now nursing is my passion. I get to see victims heal from this,” she explains. “This fell right into my plan in life, and it is what God chose for me.”

Vodosia says that many children she treats have misconceptions about what has happened to their bodies; when they have been abused, they feel that they are no longer a virgin. Some think that what happened to them makes them walk differently, and everyone will know what happened to them. She helps them understand and process the fact that their genitals are healthy and that the body can heal quickly.

Related: 7 Habits All Nurses Should Pick Up

Where Do Forensic Nurses Work?

Forensic nurses can be involved in death investigations, and they can also work with coroners. They can take part in the investigation of domestic violence cases, and some forensic nurses work in prisons to help care for prisoners who have been abused by other prisoners.

“There is a huge arena we can practice in, and it’s growing,” Vodosia claims.

Day said that the majority of SANE-trained forensic nurses are in hospitals; twenty five percent, however, are working in community settings.

One community center utilizing forensic nurses is the Philadelphia Sexual Assault Response Center located next to the Philadelphia Police Special Victims Unit; this is a free-standing center open 24 hours a day. The forensic nurses are on call 24 hours a day in a private setting specially created to reduce anxiety or further trauma for the wounded and weary. The nurses perform rape exams, collect evidence, and provide advice and counseling referrals to victims of rape and sexual violence.

Other forensic nurses can work with coroner and medical examiner’s offices, as well as in psychiatric hospitals. Forensic nurses also are called to participate during mass disasters or community crisis situations.

How Much Do Forensic Nurses Make?

According to, the average salary of a forensic nurse is $54,000. Alaska was the lowest paying at $42,000; Washington, D.C. topped out at $71,000 with job openings available in county governments and large medical centers. Just like any nursing job, the pay depends on experience, region, and the employer's budget. The IAFN states that forensic nursing is the fastest growing nursing subspecialty.

Related: Nursing Is In A Transition, And That's A Good Thing For Nurses

What Schooling/Certifications Are Needed To Become A Forensic Nurse?

IAFN offers two certifications for the Sexual Assault Nurse Examiner (SANE). The SANE-A is specialized for adults and adolescents, and the SANE-P is specialized for pediatrics. To earn certification, registered nurses must pass an examinationl; the exams are offered twice a year during the months of May and October, and may be taken at testing sites across the US and internationally.

To actually sit for the exam, applicants must meet the eligibility criteria determined by the Forensic Nursing Certification Board. Board certification is not a requirement to practice forensic nursing; however, in most cases, that certification assures employers that the nurse has the knowledge, experience, and professionalism to do the job well.

Studies from the Institute of Medicine reveal specialty-certified nurses receive better marks of satisfaction from patients, have lower rates of errors in patient care, and sometimes earn bigger salaries or stipends for keeping that certification.

In the course of their studies, future forensic nurses will participate in online or in-person academic classes, as well as a required internship.

Branching Out In The Forensic Nurse Field

Susan Smith has been a nurse since 1989, mostly employed in the emergency room. She stopped working temporarily in order to earn her BSN, and then continued on to receive her master’s degree. During the course of her education, she discovered the specialty of forensic nursing.

“This is such an up and coming branch of nursing; I latched onto it,” she says. She just recently moved to Wichita, Kansas from Lincoln, Nebraska.

Smith is taking the online portion of a course from Dr. Bill Smock, a police surgeon who directs the Clinical Forensic Medicine Program for the Louisville Metro Police Department. She eventually will spend time in Louisville in order to take the hands-on portion of the course.

“This course teaches you clinical forensic evaluation of gunshot wounds; Smock teaches the mechanism of gunshots,” she explains. “The human body is the portable crime scene; as an ER nurse, I wasn’t really trained in the collection of evidence or how to document it.”

With a recent rise in police-involved shootings, forensic science and medicne have become hot topics across the country.

“If an officer is involved in a shooting, the officer says one thing happened, and the victim has a totally different story,” she says. “It’s one word against the other. My perspective is that if you have the training and knowledge, you can look at the victim and figure out who is telling the right story.”

For those considering forensic nursing as an area of nursing specialization, there will be days of heartbreak, days of discovery, and days of feeling like you did some good for someone who went through something bad, reflects Smith.

“I have never looked back; it;s been the best thing I've ever done in nursing,” Smith concludes.

Next Up: How Nurses Cope With Mass Shootings And Attacks

Lee Nelson lives in the Chicago area and writes for national and regional magazines, websites, and business journals. Her work has recently appeared in,, Yahoo! Homes, ChicagoStyle Weddings, and a bi-weekly blog in

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