Forensic Nurse Career Overview

What is a Forensic Nurse?

A forensic nurse specializes in caring for patients who have experienced violence, abuse, sexual assault, human trafficking, and other crimes. As registered nurses (RNs), forensic nurses use evidence-based practice and trauma-informed communication to assess and care for their patients. Trauma-informed care recognizes that a patient’s symptoms and behaviors may be the result of trauma(s) they experienced. Forensic nurses make patients feel safe, in control, and validated.

The patient assessment a forensic nurse completes may become evidence in court, and this includes the nurse’s notes, photographs taken, samples collected, and information provided by the victim. Forensic nurses may be asked to appear in court to present their findings and answer questions, and others pursue a career as legal consultants and often appear as expert witnesses. Forensic nursing professionals can pursue certification and graduate education to increase their career options and pay.

What Does a Forensic Nurse Do?

Forensic nurses primarily work one-on-one with patients to assess and recommend treatment. A forensic nurse can work in a variety of positions, such as forensic nurse investigator, sexual assault nurse examiner, forensic clinical nurse specialist, legal nurse consultant, forensic psychiatric nurse, or nurse coroner. Nurses with an interest in helping victims of crime and with great attention to detail can pursue a wide range of forensic careers.

Common daily tasks in many forensic nursing careers include:

• Interviewing patients to obtain medical and forensic histories
• Conducting head-to-toe physical assessments, including internal exams
• Photographing findings
• Collecting evidence such as clothes, as well as swabbing for body fluids
• Collecting patient samples such as blood and urine
• Cleaning and treating minor wounds
• Collaborating with other providers for prescriptions to prevent pregnancy or sexually transmitted infections
• Referring patients to community resources or other ongoing support
• Provide information to law enforcement as a mandatory reporter
• Testifying in court proceedings

Forensic nurse educators are responsible for communicating in a compassionate way with their patients, regardless of the patient’s history. It is crucial that a forensic nurse overcomes any personal bias to truly support the patient and to report details objectively. Additionally, RNs must complete ongoing training as required by their employer and state.

How Much Does a Forensic Nurse Make Per Year?

As RNs, forensic nurses in the U.S. make around $70,000 a year. In 2020, the median pay for RNs was $75,330 or $36.22 per hour. The median pay represents the middle: half of nurses earned more than that amount, and half earned less. The U.S. Bureau of Labor Statistics does not differentiate the types of RNs in its compensation reports.

Forensic nurses are RNs with years of experience and usually additional certifications. These qualifications can increase annual pay, but ultimately a forensic nurse’s salary depends on employer, location, and job title.

Citation: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses, at https://www.bls.gov/oes/current/oes291141.htm#st (visited January 23, 2022).

Where and When Do Forensic Nurses Work?

Forensic nurses can work with different patient populations in a variety of settings. All forensic nurses are skilled in formal documentation and evidence collection and are patient advocates. Employers that use forensic nursing experts include:

• Hospital systems, including emergency departments and women’s health services
• Community programs that provide services to vulnerable populations
• Correctional facilities helping victims of violence and assisting law enforcement
• Medical examiner’s or coroner’s offices to assess deceased patients
• Psychiatric institutions to assist victims who have a mental health diagnosis
• Legal offices as nurse consultants or testifying experts
• Colleges or universities as forensic nurse educators

Forensic nurses’ schedules depend on their place of employment. Forensic nurses working in hospitals that are always open may work nights, weekends, or holidays. Nurses that report to clinics or community programs may work traditional business hours during the week. Some forensic nursing roles blend scheduled hours with on-call shifts. Additionally, registered nurses with SANE (Sexual Assault Nurse Examiners) certification may have a bedside nursing contract and work on-call as a “SANE nurse” for their hospital, city, or region.

How Do I Become A Forensic Nurse?

A forensic nurse is an RN with an associate’s or bachelor’s degree in nursing. A Bachelor of Science in Nursing (BSN) is preferred by many employers. After graduating from nursing school, the next step is to take the national NCLEX-RN examination. Upon passing the NCLEX, an individual becomes an RN and applies to the state board of nursing where they plan to work.

After two years of nursing experience, an RN may start the SANE (Sexual Assault Nurse Examiners) certification process. The SANE exam is held twice a year by the International Association of Forensic Nurses. Eligibility requirements include completing 40 hours of SANE coursework, a SANE clinical preceptorship, and 300 hours of SANE-related patient care. SANE courses can be completed online or in person and are offered throughout the U.S. Students can register for SANE-A (adult) or SANE-P (pediatric) coursework. Becoming SANE certified is not the only path for forensic nursing, but it provides a foundation for many career options.

Forensic nurses wishing to further their education, increase their responsibilities, and earn a higher salary can pursue a master’s degree or graduate certificate in forensic nursing. Though not as common as other graduate nurse paths, some schools offer a forensic nursing specialty for Master of Science in Nursing students. Please note, this is not equivalent to becoming an advanced practice nurse.

Interestingly, forensic nurses are one of the few RNs who work with deceased patients. They may work as forensic nurse death investigators and/or representatives for a medical examiner or coroner. Each state handles death cases differently, so it is crucial to learn if your state utilizes forensic RNs for these roles before pursuing this option. The International Association of Forensic Nurses recommends considerable experience in emergency or critical care nursing before pursuing a death investigator role. This time allows nurses to develop excellent assessment skills and learn how to handle unexpected death. The American Board of Medicolegal Death Investigators offers certification to nurses and others who work in this field.

While frequent encounters with traumatic events certainly makes the job challenging, working as a forensic nurse can be very rewarding. Forensic nurses help victims by utilizing trauma-informed care and by developing evidence and documentation that will empower victims in the criminal justice process. This specialized nursing care enables patients in crisis to receive the help they need in a compassionate and safe way.