a forensic nurse as someone who “provides specialized care for patients who are victims and/or perpetrators of trauma (both intentional and unintentional)” and who has “a specialized knowledge of the legal system and skills in injury identification, evaluation and documentation.” Forensic nurses can be especially helpful when a victim decides to pursue criminal charges against his or her assailant, as they are able to both treat and document injuries. Documentation by a forensic nurse is often a key piece of evidence in court proceedings, especially in combination with their testimony about injuries and the condition of the victim at the time of examination. The patient’s informed consent for the forensic examination must be obtained,
as well as a release to provide any collected evidence and records to law enforcement. In some states, IPV and SA are mandatorily reportable crimes, so it is vital that the victim understands their options regarding interaction with law enforcement as well as the choice to have or to forego examination. Whether or not an examination of a victim of IPV or SA is conducted by a forensic nurse, it is vital that any relevant evidence of the assault be preserved and documented appropriately, along with a detailed account of the patient’s report of the incident—using verbatim language if possible. Box 3 offers information specific to sexual assault response teams, which may include forensic nurses.
Box 3: Sexual Assault Response Teams Given the importance of a coordinated approach to the provision of care to IPV and SA survivors, the creation of a sexual assault response team (SART) may be warranted. SARTs are one means of ensuring that all protocols are followed throughout the trajectory of care and that expectations and requirements of different agencies are met. Typically, these teams are composed of forensic nurses, law enforcement officials with experience in IPV and/or SA casework, social workers or other social service providers, community resource advocates, and prosecutors in a given locale. The team works together to ensure that victims’ needs are met, offenders are held accountable, and public safety is ensured (National Sexual Violence Resource Center, 2024) . One important advantage of establishing an SART is clarification of what jurisdiction is served by the team. This is important for prosecution of cases as well as for establishing a chain of custody for forensic evidence. Jurisdictions can be determined by law enforcement, local government, or team members themselves. Regardless of how the jurisdiction is determined, it is important to recognize the need for engagement with service providers from all the involved sectors in the service area. For example, some IPV shelters are limited in their ability to accept clients beyond certain geographic borders because of funding constraints or other regulations. A person reporting SA may live in one county but be assaulted in another. Coordination among agencies is therefore crucial to successful resolution of the case. Establishing memoranda of understanding among involved agencies may also be necessary. Basic Forensic Photo Documentation In addition to written documentation, photos of the Separate written consent from the client before taking photos is required. Before obtaining the photos, also explain to the client the procedure and its importance. In medically stable individuals, obtain the photos before other medical treatment or examination when possible. Digital photography is becoming more commonplace in the clinical setting however, maintaining the security and chain of custody of images is of utmost importance. In summary, the following principles should be followed: ● Include photographs of the face, along with the injured areas. ● Place an object of measurement (such as a high-resolution photograph ruler) next to the injury, and include it in the photo to illustrate the size of the injury. Be sure not to cover any part of the injury with this object. ● Take at least two photos of any injury: one showing measurement and one showing where on the body the injury is located. ● Keep a photo log that includes the following: ○ Victim’s name ○ Date and time photos were taken ○ Photographer’s name ● When possible, take subsequent photos to document changes in the injury over time. (Moore, 2021) Anatomical Diagrams or Body Maps Anatomical diagrams or body maps are another useful way to document injuries, especially when photo documentation is limited or not possible. This involves documenting the location and characteristics of an injury on an image/drawing of a body. In addition to the location of the injury marked on the figure, the size, shape, color, characteristics of the edges around the wound, and any foreign material present in the injury should be described. Any area not examined should be marked as such on the diagram (Day et al., 2021) . An example of a body map for documenting IPV is available from FWV (2015c) at https://www.futureswithoutviolence.org/userfiles/file/Consensus.pdf injuries may be taken for records. Photographing injuries is important because it provides a visual record of a client’s trauma and can be used as key evidence if a civil or criminal lawsuit is filed. Forensic photo documentation means that a procedure is followed to capture visual evidence of injuries as well as the healing process (Moore, 2021) . A provider’s Box 4: Photographs, Diagrams, and Body Maps Photographs agency or organization may have policies with respect to these specific procedures. At a minimum, such a policy should describe (1) the purpose of photo documentation, (2) the situations in which photos should be collected, and (3) the procedures for collecting photos, including the consent process (Moore, 2021) . Box 4 describes visual documentation methods.
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