Nurses’ Supporting Role in Law and Order

By PATRICIA R. OLSEN

WHEN it comes to solving crimes, images of detectives, police officers and scientists often come to mind. But nurses, too, play a critical role in the criminal justice system, and they can make good money doing so. 

Nurses with forensic training may gather data at accident sites and in other situations where crimes may have occurred or medical evidence needs to be collected. They may also testify in court cases and help lawyers understand medical records — often for medical malpractice cases.

Some nurses with this training start a business as legal nurse consultants, and still others become coroners, completing work like that of medical examiners, who hold doctor of medicine degrees. Some continue their regular nursing work and do forensic work part time.

Holly Bedgio has run a business as a legal nurse consultant for 10 years. In addition to her job as director of clinical operations and risk management for Matrix Home Care in West Palm Beach, Fla., she works with a dozen law firms around the country, helping lawyers decide whether to take a case, for example, or identifying who shares the blame in a wrongful death suit. 

“I love that no two cases are alike,” Ms. Bedgio said. The lawyers often don’t brief her before she reads case files so as not to influence her findings. “It’s like reading a mystery novel. You have to put the pieces of the puzzle together to solve the case,” she said.

As coroner for Charleston County in South Carolina, Rae Wooten draws on 30 years of experience and training as a nurse. Her forensics skills include how to identify evidence in a death investigation as well as how to interview witnesses and suspects.

“I’m a fact-finder. I investigate deaths, including homicides, fatalities from traffic accidents, those that are fire-related, and those that initially are unexplained, unexpected or suspicious,” Ms. Wooten said. She assesses the state of the body, takes photos, orders autopsies, and works with law enforcement to determine the cause of death. 

Nurses have long performed various forensic services, but over the years the skills have become codified under the umbrella of forensic nursing. 

“You’ll hear the title ‘forensic nurse,’ but that can be misleading, as if it covers one area,” said Julie Rosof-Williams, course coordinator for the forensic nursing program at Vanderbilt University in Nashville. “To identify someone as a forensic nurse is not comparable to saying, for example, that someone is a pediatric nurse, which indicates the person works solely with children.” 

The field has drawn interest from nurses at several levels, including licensed practical nurses, registered nurses and nurse practitioners. As a result, in the last decade or so masters and doctoral degree programs have proliferated to provide training.

For example, in 2004 the School of Nursing at Vanderbilt University began offering forensic nursing as a minor in the masters of nursing program. Several private educational providers also offer forensic nursing courses. 

Carey Goryl, executive director of the International Association of Forensic Nurses, says that it is important to research any educational provider. “Potential employers and even some state nursing licensing boards may not recognize all the forensic courses that are available,” Ms. Goryl said. “Nurses who have a particular employer in mind should contact them first and find out which educational provider is acceptable for that forensic program.” 

The salaries for nurses with this training vary widely, said Ms. Rosof-Williams, depending on specialty, local market rates, degree and experience. 

As president of the South Florida chapter of the American Association of Legal Nurse Consultants, Ms. Bedgio is familiar with salaries in her specialty. It’s not uncommon for a legal nurse consultant working full-time to make six figures, but it takes a while to get started, she said. In her experience, a legal nurse consultant can make between $100 and $150 an hour.

Certification can also be an issue. “A certificate program can give a general background, but if nurses want to practice with a specific population, such as sexual assault patients, they need specialized training, such as provided by a 40-hour sexual assault nurse examiner, or SANE, course,” Ms. Goryl said. 

The forensic nursing association offers two board certifications for sexual assault nurse examiners, for nurses who want to work either with children, or adolescents and adults. The organization has also teamed with the American Nurses Credentialing Center, a subsidiary of the American Nurses Association, to provide additional credentials. 

MS. ROSOF-WILLIAMS also works at Vanderbilt University’s School of Medicine and at Our Kids Center, a clinic of Metropolitan Nashville General Hospital. She serves as a sexual assault nurse examiner at the center, supporting and collecting evidence from children who may have been sexually assaulted. As part of her job, she has also testified in court cases involving those children. 

Ms. Rosof-Williams describes her specialty with enthusiasm. “As a sexual assault nurse examiner, I have the opportunity to get involved in direct patient care and help people heal from some of the worst situations ever,” she said. “Not only do I get the reward of helping patients, I also get rewarded when other health care providers say: ‘Please do this. You’re the expert.’ And I get the intellectual excitement of helping people outside the health care system do their job. I like the idea of serving social justice, where the guilty go to jail and the innocent go free.”

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