The Implementation of a Forensic Program in Southern West Virginia
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Publication Date
2023-11-21
Abstract
The Implementation of a Forensic Program in Rural Southern West Virginia
More hospital-based forensic nursing programs are needed, notably in rural areas. Rural seclusion and longstanding cultural norms often prevent victims from receiving post-assault care. This project proposes a Forensic Nurse Hospitalist (FNH) program in rural, underserved southern West Virginia (WV). An FNH program has an on-site forensic nurse 24 hours a day. No forensic services are available in the southern WV region, an area below the federal poverty line with increasing violent crime rates. Prompt access to treatment is proposed to increase victims' health and forensic needs. Inclusion criteria for receiving a forensic exam include patients with complaints of intimate partner violence (IPV) with or without strangulation, sexual assault, felony assault, elder abuse, and human trafficking. Discussions will address medicolegal challenges related to the scarcity of forensic nurses, and a plan to train and decrease the attrition rate of skilled forensic nurses. Review of the literature has shown only one in ten registered nurses (RNs) who begin forensic training will eventually conduct forensic exams without preceptor oversight. Additionally, after completing orientation, forensic nurses often work in the field for only 12 to 18 months due to burnout, lack of proficiency in skills, random presentation of forensic cases, and work-life imbalance. Therefore, the proposed project will focus on combating nurse retention, burnout, and moral distress. All new nurses will be asked to complete a baseline survey online to obtain data and insight on potential topics for focus group discussions. Survey topics will include barriers, challenges, and coping skills related to the workload of a forensic nurse. The data collected will guide focus groups on debriefing, resiliency, and providing a support network for forensic nurses. Research has also shown that access to a skilled forensic nurse has increased consults for sexual assault, IPV, strangulation, child abuse, and elder abuse after the implementation of an FNH program. Thus, rates of unplanned pregnancies, sexually transmitted infections (STIs), and other psychological impacts related to violent crimes have been shown to decrease, deeming the FNH program a practical approach to combat the lack of forensic services in underserved areas.
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