The badly beaten and bruised 74-year-old woman presented to the emergency room via ambulance after experiencing a violent physical attack perpetrated by her 45-year-old son. At the request of law enforcement, a forensic examiner conducted an exam, took a medical history, obtained a statement from the patient, and documented and photographed all injuries. Several weeks later, the forensic clinic received a call from the patient, requesting the nurse examiner who conducted the examination to delete the photographs and abuse report findings because, “the injuries looked bad in the photos, and I don’t want my son to go to jail when he didn’t really mean to hurt me.” Like many victims of abuse, this vulnerable population is at risk of recanting their statements and declining to participate in investigations because they do not want their loved ones to face criminal charges and prosecution. The forensic team explained that they could not delete photographs and any report, as they were evidence.
Forensic examiners receive specialized education and clinical training in screening, examining, and assessing elder victims of abuse, neglect, and exploitation.
Comprehensive physical examinations are meticulously documented using body charts. Evidence is collected, analyzed, and preserved. Injuries, such as markers of strangulation and suffocation, are forensically photographed. Examiners are trained to detect injuries that may be overlooked by law enforcement and other first responders who may lack specialized knowledge, proper equipment, and space to conduct a comprehensive assessment.
Exams often occur in emergency or critical care settings, in the immediate aftermath of abuse. Nurse examiners are versed in the multitude of abuse – physical, emotional, neglect and financial – and the concerns of victims reluctant to disclose harms or seek help. Besides documenting physical injury, they assess the psychological effects of abuse. With unique insight, forensic examiners conduct exams of elder victims with empathy and understanding, tailored to the individual’s medical, emotional, cognitive, and contextual concerns.
In addition to collaborating with multidisciplinary professionals, including health care providers and social workers, to ensure victim safety and recovery, forensic examiners work with law enforcement and prosecutors to facilitate justice. Their findings are part of the investigation and criminal record. They may offer testimony in criminal proceedings regarding their observations, assessment of victim vulnerability, the results of diagnostic tests, and findings. Among their many roles, forensic examiners may serve as educators, consultants, and researchers.
As part of a multidisciplinary team, examinations conducted by a qualified examiner can enhance the investigative process and facilitate case resolution. With expertise, experience, and empathy, the forensic nurse addressed the concerns of the reluctant 74-year-old victim, while helping to mitigate harms, prevent abuse recurrence, and optimize her safety and goals. The forensic nurse was able to ensure that the elder victim had the proper support and resources necessary to proceed to the next step in the journey of the investigative process with law enforcement.
For more information about forensic nurses, reach out to the Emergency Nurses Association (www.ena.org).
