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The 'Most Holistic Nursing I've Practiced'

Megan Lechner, MSN, RN, CNS. Courtesy of Megan Lechner.
Like a lot of nurses interested in this field, I found the combination of the medical and forensic worlds fascinating. Always one to try to figure out "why" or "how," this field of nursing seemed to be calling me. When I first learned about forensic nursing, I was working in the intensive care unit. Some of the things I loved about critical care nursing are the same things I love about forensic nursing today. Not that I knew that at the time! In both specialties, you are very focused on one or two patients. You get to know those patients—you learn everything about them. Forensic nursing adds a unique component, allowing you to focus not only on the short- and long-term physical and mental healthcare concerns, but also on social components, safety planning, and community partnerships to ensure care and recovery of the patients. Forensic nursing is the most holistic nursing I have ever practiced.
Training for Forensic Nursing

Megan prepares the colposcope for a sexual assault examination. Courtesy of Megan Lechner.
The typical education for a forensic nurse starts with the Sexual Assault Nurse Examiner (SANE) education. Depending on the state and program, other courses and on-the-job training and education are provided. For me, it was a little more involved. I obtained my master of nursing degree with a specialty in forensic nursing. This is not required education for most forensic nursing positions, but I feel that my education has made me a better provider.
Every Day Is Different

Tools of the trade: a sexual assault evidence collection kit. Courtesy of Megan Lechner.
I currently work as a forensic nurse examiner team manager and clinician. I am part of an in-house, hospital-based team in Colorado Springs that specializes in providing care to victims of violence across the lifespan. We take care of patients who are victims of sexual assault, intimate partner violence (domestic violence), strangulation, child abuse, elder abuse, human trafficking, and other types of violence. In 2017, we provided care to nearly 1800 patients.
There is no such thing as a typical day in forensic nursing. Sometimes I see several patients throughout my shift, or I may spend time educating other providers, students, or community partners. We also spend a lot of time on peer review, ensuring that all of our patients are receiving top-quality healthcare.
What's Unique About Forensic Nursing

Megan dries swabs taken from a patient as part of a forensic exam. Courtesy of Megan Lechner.
Among the many aspects of forensic nursing that I love, its holistic nature is at the top of the list. I also really enjoy the intersection of the medical and legal components of care, and working with members of law enforcement and other community partners. Often, such crimes as sexual assault and domestic violence are treated simply as legal problems. Of course there is a legal component, but violence, in every form, is a healthcare issue. It is responsible, both acutely and chronically, for millions of healthcare visits and treatments every year. Being a voice for this and for those patients is what I love.
Vicarious Trauma: An Occupational Hazard
The biggest challenge of being a forensic nurse is the vicarious trauma. Forensic nurses repeatedly hear stories of horrible things that have happened to people. Although these may not always, or immediately, affect us, vicarious trauma is cumulative. Nurses in general experience a high rate of vicarious trauma, and forensic nurses often experience more. This allows us to recognize and use positive coping mechanisms, and promotes bonding with our team members. No one understands the work like your colleagues. Strong and special relationships are formed in forensic nursing.
Megan Lechner has been a forensic nurse at UCHealth Memorial Hospital in Colorado Springs for the past 10 years. She began her nursing career in 1997.
Medscape Nurses © 2017 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: What's It Like to Be a Forensic Nurse? - Medscape - Aug 14, 2017.
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