The science of nursing has merged with the forensic sciences and the justice system to provide a distinctive discipline: forensic nursing science. This scientific discipline incorporates numerous applications to the major status of the registered nurse at all levels of practice, ranging from the basic or generalist role to advanced practice in forensic nursing. Advances in forensic and nursing science represent a sufficient need identified worldwide by those who understand that the long-range aims of the nursing field would be limited if this need were ignored. Forensic attorneys, nurse scientists, examiners, educators, investigators, administrators, and consultants in local, state, or federal government and nongovernment institutions and organizations fill this need. The forensic nurse is prepared for individual or group interventions and services that will provide a scientific and humanitarian image to those forgotten amid the chaos of a world in crisis. Thus, women and children, the damaged and disabled who represent the most vulnerable populations, will be offered greater protection to shield them from harm.

Forensic nursing science combines the concepts and principles of the traditional forensic sciences and those of nursing in the clinical investigation of trauma and the recovery of medical evidence; it also provides direct services to victims, suspects, perpetrators, and those who witness violence. The forensic nurse scientist identifies, assesses, intervenes, and evaluates trauma, disease, and death while documenting findings, preserves and secures evidence to determine legal outcomes and improve patient care. As interdisciplinary partners in healthcare and law-related agencies, the specialist in forensic nursing science has become a potent influence in the rule of law and provides a collective intelligence for practice and research.

Violence and its associated trauma are widely recognized as critical health problems throughout the world. Among the challenges that face healthcare providers is protection of the patient’s legal, civil, and human rights (Lynch, 1995). Violence is no longer considered solely within the purview of law enforcement but rather is viewed as a mutual responsibility of healthcare and the law.

In 1979, the U.S. Surgeon General’s Report “Healthy People” outlined a strategy for addressing priority areas for improving the health of the nation, which included addressing interpersonal violence, an important contributor to morbidity and premature mortality. One expert noted that public health is in the business of continually redefining the unacceptable, which changes the social norm and eventually changes the problem. Not unlike polio, violence is also a threat to public health (Foege, 1997).

In 1989, U.S. Surgeon General C. Everett Koop challenged healthcare professionals to assume accountability, along with law enforcement, for the problems associated with violence. The surgeon general’s workshop on violence and public health addressed domestic violence, child abuse, elder abuse, rape, homicide, murder, and traumatic accidents as pervasive threats to the fundamental public health principle of population exposure. This perspective emphasized that no segment of society can be considered immune from the effects of violence. He remarked that these problems are so pervasive that they can no longer be viewed as acts of individual offenders, rather collectively, a public epidemic of violence. (Koop, 1989). In past decades, the U.S. Department of Health and Human Services has continued to recognize the inevitable outcomes of violence (injury, disability, and death) as the primary benchmarks of public health status.

With the steady increase in reporting interpersonal violence within our society, nurses are recognizing a greater number of victims of criminal acts. These victims, as well as the perpetrators of crime, are often treated in the hospital for injuries and collection of evidence. As perhaps the first point of contact in the immediate posttrauma period, the nurse is in an ideal position to gather information and physical evidence related to the crime. Forensic nurses must be able to identify injuries from weapons or human abuse and to skillfully interview patients and evaluate the nature and scope of these injuries. Nurses interface with law enforcement and the medical examiner/coroner and provide excellent resources for expert testimony when these cases are tried in a court of law. Forensic nursing demands superb assessment skills, second only to a high degree of suspiciousness.

Every injury, illness, or death can have forensic implications. Therefore, a solid forensic education for nurses provides a vital link in the development of clinical acumen required for responding to these forensic circumstances. Forensic nurses represent one significant component of a multidisciplinary team of forensic investigators addressing social injustice. Forensic nurses do not usurp, replace, or supplant any other discipline; rather, they fill a void with their unique nursing skills.

More than 4200 years ago, the Code of Hammurabi, created by the King of Babylon, established legislation governing the field of medicine and is generally regarded as the oldest known legal code. It was not until the twentieth century, however, that certain specialty disciplines emerged, including forensic science, which eventually gave rise to contemporary forensic pathology and clinical forensic medicine (Camp, 1976). Forensic nursing, as a scientific discipline, also evolved from these historic roots.

The term forensic comes from the Latin adjective forensis meaning of, or before the forum. During the time of the Romans, a criminal charge meant presenting the case before a group of public individuals in the forum in order to achieve social justice. A public debate held in the forum (court) provided for discourse between the prosecution and the defense and represents the forensic process still used today. Any subject of suspicious circumstances reported to a legal agency that requires an investigation of the actual facts and may be resolved in a court of law is considered a forensic case. Although the term forensics has previously referred specifically to the profession or study of public debates or courses in public speaking in the academic setting, this term is now so closely associated with the scientific field that many dictionaries equate the word forensics with forensic science. This new definition evolves from the application of two modern usages of the word forensic—as a form of legal evidence and as a category of public presentation. In modern use, the term forensics in place of forensic science can now be considered correct as an effective synonym for legal or related to courts. Thus, the term forensics represents an often-shortened term, referring to the application of a broad spectrum of sciences used to elucidate questions of interest to the courts in relation to a crime or to a civil action.

The forensic sciences encompass a multitude of disciplines under which the facts regarding an event or artifact are deemed to be accurate in order to dispel doubts, resolve difficult legal judgments, and determine the truth.

Until the 1990s, the American public had little or no knowledge of the disciplines or practices of the forensic sciences. However, actual footage of high-profile cases televised in court as well as popular media programming has brought recognition of forensic science to the national populous and into university curricula with an impact on career paths as never before. The results have raised awareness of the various disciplines and tools of the forensic sciences such as DNA analysis, footwear impressions, fingerprinting, and geometric interpretation of blood spatter patterns, modus operandi, and preservation or elimination of biological evidence.

As scientific and technological developments escalated in the twentieth century, the basis for forensic science and applications to medicine was firmly established. Sophisticated microscopes and other scientific instruments, advanced techniques in print analysis, radiological procedures, and computers were among the advancements that supported the rapid development and refinement of forensic practice. At the same time, groups of scientists and medical professionals were creating associations that eventually became the forums for sharing and disseminating advancements within forensic disciplines.

Now there are multiple organizations of specialists dedicated to the forensic sciences, embracing many disciplines and spanning the globe. Among these are the American Academy of Forensic Sciences (see Box 1-1), International Association of Blood Pattern Analysts, the International Association of Forensic Nurses, the National Association of Medical Examiners, the American Board of Forensic Nursing, the American College of Forensic Examiners, the International Homicide Investigators Association, the American Society for Testing and Materials, the Associations of Police Surgeons, the American Society of Criminology, and the International Association for Human Identification, among others (Lynch & Standing Bear, 2000).