We need member input. the ethics committee is also looking for members. please email Ecoee if you are interested.
D R A F T
Ethical Standards of Forensic Nursing Statement
Academy of Forensic Nurses (AFN)
Ethics Committee Chair - Ecoee Rooney, DNP, NPD-BC, SANE-A
In 2018, a group of dedicated forensic nurses united to form the Academy of Forensic Nurses, a professional organization dedicated to the elevation of our forensic nursing practice, to model and further define standards of our specialty by linking research to practice through scholarship, education, and service to all who are impacted by and who respond to people experiencing of who have experienced trauma. We recognize that we are called upon to care for society’s most vulnerable people, often at times of extreme crisis. As such, we hold our ethical standards as a core foundational element of our practice at the bedside, during interaction with others, and through the education of current and future forensic nurses. Guided by The Code of Ethics for Nurses with Interpretive Statements by the American Nurses Association (2015), we developed this Ethical standard of Forensic Nursing Statement as a framework to guide our professional practice in all settings.
1. Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person (ANA, 2015, p. 8).
Nurses are often one of the first care providers of those who have experienced trauma. Those first interactions with the healthcare system create an opportunity to establish a healing, trauma-informed environment through demonstrating compassion, unconditional positive regard, and caring to those individuals, families, groups, or populations and offer non-judgmental and equitable care. As forensic nurses, we provide care that reflects the intrinsic worth of all human beings and recognizes that each patient brings unique characteristics to each nursing encounter. We commit to honor differences while supporting wholeness in all our clients, reinforcing that all human life has value and should be protected and cared for in all nursing practice.
2. Provision 2: The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population (ANA, 2015, p. 8).
Opportunities for forensic nursing practice, range broadly from individual, acute, and chronic traumatic circumstances to local, regional, national, and international conditions involving trauma. Forensic nurses are trained and prepared to respond and support individuals who have experienced trauma. The AFN represents forensic nurses who provide services across the lifespan, across the micro to macro spectrum, from an individual traumatic event to a population that has been negatively impacted by mass disaster. Our ethical obligation in each of these situations is to provide care rooted in science, evidence, and therapeutic communication, seeking all opportunities to promote the autonomy and personhood of the people we serve for the best outcomes.
3. Provision 3: The nurse promotes, advocates for, and protects the rights, health, and safety of the patient (ANA, 2015, p. 8).
As forensic nurses, we recognize the acute and/or chronic vulnerability of the people we serve, understanding that trauma has impacted their perceptions of safety, personhood, autonomy, and agency. Through the experiences that create the need for forensic nursing care, we recognize that our patients require support in restoring a sense of autonomy and safety, personhood, and agency. The forensic nurse provides for establishing a caring environment that creates the environment whereby patients can express their wishes, establish their autonomy, express their concerns, and understand their rights in the context of their circumstances. Among the ways in which forensic nurses are prepared to understand and support the needs of people we serve, are advocacy for safety including safe housing, freedom from abuse and neglect, clean air and water; providing information for patients to receive legal representation, health promotion, and anticipated preventive care.
4. Provision 4: The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and acts consistent with the obligation to promote health and to provide optimal care (ANA, 2015, p. 8).
Forensic nurses employ the nursing process to ensure that the people and communities we serve receive holistic nursing care. We assess, diagnose, plan care, intervene, and evaluate our interventions to ensure the best possible outcomes for those in our care. We are accountable to our patients, the communities where we practice, and to drive evidence-based practice to promote the body of knowledge for our community of forensic nurses. The AFN supports this accountability through the promotion of best practices and research to advance the practice of forensic nursing. Through regular meetings, educational opportunities, committee work, and scholarly practice, we may grow to improve practice and therefore offer the informed and individualized care to those we serve. Our accountability and action to this principle are realized through virtual and in-person learning and collaborative events promoting current and optimal practice. AFN’s Interprofessional Collaboration committee promotes the ongoing development and collegiality of the AFN and facilitates collaboration among forensic nurses as well as other professionals and other organizations supporting forensic nursing.
5. Provision 5: The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth (ANA, 2015, p.8).
As forensic nursing, we recognize the importance of caring for ourselves and colleagues. recognize that to help others, we must maintain our own health and safety, preserve our character and integrity, maintain competence in professional practice, and continue personal and professional growth. As a community, AFN offers continuing education to our members in various areas of forensic nursing practice, bringing together subject experts from around the United States and the international community to promote learning and dialogue regarding forensic nursing best practices. The AFN offers members the opportunity to choose Special Interest Groups (SIG) where support and collaboration may occur virtually and in-person, concurrently or asynchronously.
6. Provision 6: The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care (ANA, 2015, p. 8).
Forensic nurses must seek to ensure the quality of our professional work setting by continually advocating to improve conditions for assessment and treatment of our patients, seeking to put patients and their needs first and foremost in all areas of clinical practice. AFN offers a Podcast Committee that features specialists to share the latest research findings with the general membership with the goal to improve work settings and conditions in a uniform manner. Recognizing intrinsic and extrinsic threats to our wellbeing and our profession, we acknowledge unmitigated lateral violence and a lack of self-care as core factors that weaken our relationships, our teams, our ability to be generative, and our profession. We must commit to eradicate lateral violence in our profession and create positive and strong mentoring relationships with our current and future colleagues.
7. Provision 7: The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy (ANA, 2015, p. 8).
Forensic nurses recognize that the foundation of optimal nursing practice requires the promotion of rigorous research and scholarly inquiry and an environment that promotes inquiry, the identification of significant findings should then be applied to professional standards and lead to the generation of best nursing and health policy. The AFN Research Committee is responsible for facilitating the advancement of forensic nursing practice through science, facilitating the generation of evidence upon which quality forensic nursing practice is founded. The Podcast Committee and the Journal Committee both seek to disseminate current research findings to our forensic nursing community to promote practice rooted in evidence. The Education Committee works to integrate current research findings into the educational offerings to members of our organization. Our goal of conducting ethical forensic nursing research is to disseminate findings and improve forensic nursing practice and the practice of associated professionals on a continual basis.
8. Provision 8: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities (ANA, 2015, p. 8).
Forensic nurses recognize the impact of health disparities in the United States on local, regional, and national levels and acknowledge similar health disparities internationally. AFN leadership and members are committed to protecting human rights in all settings, promoting health equity for all (individuals, families, groups, and populations) in all aspects of our practice. Promoting health equity includes education, advocacy, and interaction with all who seek our assistance is endemic to our purpose and profession.
9. Provision 9: The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy (ANA, 2015, p.8).
It is our professional obligation to maintain professional integrity and we must work together to integrate social justice into nursing and health policy. We serve as advocates for our patients and our profession both in the work/clinical setting, where health policy is written and in the public’s perception of our practice. The public must know how forensic nursing serves the public, the ways in which we provide support, and how we promote health, and safety, and equity in all settings.
REFERENCES
American Nurses Association. (2015). Code of ethics with interpretative statements. Silver Spring, MD: Author. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html
I have made some simple changes in wording. I also suggest the change from "making decisions" to "participates in shared medical decision making" in Provision 4 as this may align with the multiple roles of forensic nurses more accurately. Just a thought.