Forensic Nursing Career: An Interview with Dr. Carter-Snell

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Some people who enter a career in forensic nursing might never feel the need to extend their impact beyond work in clinics, hospitals and labs, but Dr. Cathy Carter-Snell of Alberta, Canada believes teaching at the university level is another way to have an effect. In fact, she’s been a professor at Mount Royal University in Alberta for 17 years, and had a significant role in 1997 in helping launch the school’s online forensic certificate program. She wrote, or over the years has revamped, much of the curriculum for the six classes that comprise the program and has also taught several of the classes, including its Victims of Violence course. Students in the certificate program come from a mixed professional background, but many of them are first-responder types: about 30 percent are nurses; another 30 percent are police officers; and the remainder are a mix of undergraduate and graduate students taking coursework for electives, and social workers.

The coursework is extensive in scope and can help students to learn more about what to look for when working with patients to ascertain if a crime has occurred. Those in in the Forensic Science Lab class, for example, might study gas chromatography, blood spatter patterns, and even blood-typing. Nurses taking classes might learn to become more adept in the emergency room at accessing injuries that could be a result of violence or sexual assault. They should also become more knowledgeable about how to document a patient’s injuries through note-taking or photographs.

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Nurses and other students can also learn how to better treat victims of violence, for example, so as not to victimize them a second time by making them feel guilty or responsible about what happened. “As well, some 30 percent of victims of sexual assault never show any injuries,” Dr. Carter-Snell said, and that is why knowing what forensic clues to look for when a patient comes in for emergency care is important.

        “If you consider the emergency care patient, the crime scene is the patient.”

The first thing that medical staff and the nursing staff do is try to clean them up. “Women, in particular, can suffer from PTSD and anxiety as a result of violence,” says Dr. Carter-Snell, “and could turn to substance abuse to cope.” Treating and finding the cause of the incident is essential.

        “Expert nursing practice is not reactionary and is not just seeing the crisis and dealing with it – although that’s important, but it’s seeing the potential that there could be a crisis down the road and averting it before it happens or minimizing it.

But how effective can an online certificate program be? Very, in fact. Videos, photos, and case studies make up a substantial part of the coursework and students are often able to think of the cases they studied when they are back on the job and at work. As well, Dr. Carter-Snell said she gets to know the students in her online forensic classes better than those in a traditional classroom, stating: “They are writing to me all the time.”

Drawn to Emergency Care Nursing From the Get-Go

As a young adult, Dr. Carter-Snell took many leadership roles, including working as a candy striper in a hospital. Her father was a police officer and although she said she would never marry anyone on the force, that is exactly what she did – married a police officer. And so it evolved from there, she said. After becoming a registered nurse, she began working in intensive care and, about five years later, switched to emergency care. She continues that emergency care work today as part of a sexual assault crisis team responding to calls at a hospital on weekends.

        “Emergency trauma nursing is how I got interested in forensic nursing in the first place.

She did go on to obtain her master’s and doctoral degree in nursing, completing her PhD with a specialization in forensics. Her dissertation, about the relationship between sexual assault of women and PTSD, led to the development of a mnemonic tool called BALD STEP that can help nurses and others distinguish between a victim’s types of injuries in their documentation. (For example, the letter ‘B’ reminds nurses to check for bruising, bleeding, bite marks, and burns.) Knowing how to distinguish between specific types of injuries can be important in outcomes in patient care and in criminal investigations. We know that violence in both the U.S. and Canada accounts for over a third of the health care dollars, she said.

        “What the systems do are try and treat the consequences of violence without trying to great what is going on underneath.

As a nurse, she had always attended conferences and educational programs, and returned to share that knowledge with colleagues, so, it didn’t seem unnatural, after having two children, to take a part-time role through Mount Royal College. This has long since turned into a full-time role. “I was always quite interested in education and in the science behind what it is we do,” she said, “And I enjoy sharing knowledge and seeing the light bulb come on in other people’s heads.”

She also has received two certifications: Emergency Nursing Canada, or ENCC, and Sexual Assault Examiner – Adults and Adolescents, known as SANE-A. As well, she became involved with the Forensic Research Network, a collaboration between Mount Royal College and other research agencies, which provides information and resources to help prevent violence. However, it is her teaching that allows her to have many additional impacts in the emergency and forensic nursing field. She may never know of these effects first-hand, but she trusts that her students are making them.

        “My job is to help my students see the links between the ink that is drying on the page and the patients that they’re seeing.”

Dr. Cathy Carter-Snell was also recognized as a top professor in the field of Forensic Nursing and continues to inspire further research for the advancement in the industry.

For more information on Dr. Carter-Snell, check out her bio here.