Forensic Clinical Nurses in Emergency Departments: An Emerging need for New Zealand.

Abstract Aim: This article reports on a systematic review of the literature, which was undertaken to gather evidence to support the establishment of clinical forensic nurse specialist roles within New Zealand Emergency departments. Background: Within New Zealand, violence is a significant health problem that is increasing. One result of this growing problem is the need for New Zealand nurses to recognise forensic situations and apply clinical forensic principles and practices within the Emergency Department practice settings. Method: A systematic review of the literature was undertaken using the Medline, Ovid, EBSCOHost and Proquest data bases to synthesise the findings of 23 internationally published articles on the role and function and purpose of the clinical forensic nurse in the emergency department. A thematic approach was used to analyse the information presented in the articles. Findings: The themes that emerged focused on the qualities and skills forensic nurses possess, and the level of specialist knowledge required to ensure patients receive the best medicolegal care. Key qualities and skills clinical forensic nurses possess include effectively identifying, collecting, documenting and preserving evidence from patients who are victims of violence, as well as educating and mentoring nursing colleagues and other health professionals about forensic evidence. These skills require specialist knowledge to enable clinical forensic nurses to care for some of the most challenging patients with complex psychosocial, psychological and physical health care needs all while upholding ethical and legal principles. Conclusion: A role for clinical forensic nurse specialists in our Emergency departments is clearly indicated. In addition, New Zealand emergency departments lack protocols to support nurses to care for and treat the victims of violence or unexplained death. Furthermore, the review identifies that nurses lack confidence, skills and education to be able to meet medico-legal obligations of our patients and fulfil their duty to “do no harm”