Forensic nursing—an area at the intersection of medicine and law—is a specialty only recently recognized by the American Nurses Association (ANA). In fact, the ANA and the International Association of Forensic Nurses (IAFN) co-published the first standards and scope of practice guidelines for forensic nurses in 2009, outlining the necessary education, skills, and typical job responsibilities in this dynamic subfield which helps to accumulate evidence, counsel victims, and ultimately deliver justice to violent criminals.
So what do these medical professionals do? The IAFN and ANA report that forensic nurses have a variety of roles, including caring for victims of traumatic violence both physiologically and psychologically; collecting evidence (e.g., photographs, blood, tissue samples); identifying types of injuries (e.g., trauma, neglect, accident, abuse, exploitation); creating educational programs; shaping public policy and research; liaising with law enforcement and medical personnel; providing consultation to victims and families; and acting as expert witnesses in courtrooms. These crucial functions require advanced instruction in the differentiation of disease and injury; pharmacology; pathophysiology; public health; criminology; mental health; traumatology; victimology; and ethics.
Since forensic nurses may work with sexual assault or domestic violence victims, it can be a difficult (albeit rewarding) profession, requiring a mix of compassion and emotional fortitude in facing the uglier aspects of human behavior. Furthermore, they may choose to get more advanced training in areas including death investigations, risk management, bioterrorism, employee litigation, international civil rights, human trafficking, and other domains, working in a variety of settings such as hospitals, community centers, public health organizations, police departments, and shelters.
Due to the sometimes complex nature of the job, a wealth of professional associations have risen to provide support. For example, the International Association of Forensic Nurses (IAFN 2022) boasts a 6,000+ member group offering online learning opportunities, local chapters, networking, and conferences. Additionally, the Nursing Network on Violence Against Women International (NNVAWI) provides outreach and guidance to those who work to combat violence, exploitation, and other abuses.
Read on to discover how to join the burgeoning field of forensic nursing, including information about accredited educational programs (online and on-campus) and professional certification.
There are varied paths to becoming a forensic nurse. Some choose to receive their associate degree in nursing (ADN); obtain their registered nursing (RN) license; garner experience and specialized education in the field of forensics; and achieve an entry-level professional certification (e.g., SANE). Others, however, choose to push their degree and credentials to a more advanced level to enhance their candidacy for employment and salary prospects. Below is one possible path to becoming a forensic nurse.
Step 1: Graduate from high school. Forensic nurses of all levels must graduate from high school or complete their GED. In addition, prospective forensic nurses are advised to excel in courses such as chemistry, biology, physics, anatomy, and mathematics to enhance their college applications. At this stage, some students may even take an internship or volunteer through local programs at hospitals, police departments, or civic organizations.
Step 2: Attend an accredited bachelor of science in nursing (BSN) program (4 years). Although some aspiring forensic nurses choose to pursue an associate’s degree before earning their registered nursing (RN) license, it may be advisable to enroll in a four-year BSN program that has many advantages.
First, BSN programs may provide a wider variety of classes, including specialized instruction in forensic photography in a healthcare setting; courtroom testimony by a healthcare specialist; and forensic approaches to domestic violence. Second, professional certifications such as the advanced forensic nurse board-certified (AFN-BC) credential require a master’s degree. Finally, getting a BSN fulfills many of the prerequisites of graduate education in nursing.
Above all, when seeking any college degree or certificate, prospective students are urged to verify the program’s accreditation status. There are various types of accreditations for forensic nursing schools. Two typical programmatic accrediting agencies are the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing, Inc. (ACEN).
Schools must also have institutional accreditation through a regional body such as:
In addition to supervised clinical instruction, accredited BSN programs offer didactic courses such as health promotion across the lifespan; health assessment; principles of pharmacology, community & public health nursing; and more.
One standout option is the Ball State University BSN program in Muncie, Indiana. This CCNE-accredited program provides various academic entry points to accommodate applicants of differing levels of education and experience (e.g., entry-level, RN-prepared, non-nursing bachelor’s degree). Boasting a 94-100 percent pass rate among its graduates on the NCLEX-RN exam, Ball State provides specialized instruction in acute & chronic illnesses, rehabilitation methods, the foundation of leadership, and extensive exposure to an array of clinical settings.
For candidates with bachelor’s degrees in another field, there are various “accelerated” BSN options, such as the four-semester program at Duke University, comprising 58 credits of courses and almost 800 hours of clinical experience. Ranked #2 on the U.S. News & World Report’s list of best BSN programs in 2022, this CCNE-accredited program prepares graduates for licensure as registered nurses. With a unique focus on the evolving needs and technologies of modern healthcare, students are trained at multiple clinical sites with opportunities for international study.
There are CCNE- and ACEN-accredited programs across the country, both online and on-campus. For more information on certificates and degrees in this field, please visit the forensic nursing schools page.
Step 3: Pass the NCLEX-RN exam (timeline varies). The National Council of State Boards of Nursing (NCSBN) provides the NCLEX-RN exam, the leading certification for registered nurses (RNs). Since requirements to take the exam vary slightly by state, NCSBN encourages candidates to check with their local state board of nursing. This is a competitive exam comprising computer adaptive testing (CAT) in four “client need categories” including safe & effective care management; health promotion and maintenance; psychosocial integrity; and physiological integrity. In 2021, 68.85 percent of all first-time NCLEX-RN exam takers passed (NCSBN 2021).
Step 4: Garner nursing experience in the field and additional education in forensic nursing (timeline varies). While some aspiring forensic nurses may be eager to jump into graduate education, many people choose to garner RN experience and advance their specialized training through certificate programs or other opportunities. There are various programs available to RNs to advance their preparation in the forensic subfield.
For instance, the University of California—Riverside (UCR) offers an extension program in forensic nursing with instruction in forensic approaches to blunt force & firearm injuries; domestic violence; courtroom testimony; crime scene preservation; and clinical ethics. This program is open to RNs and other licensed medical professionals. Courses include an introduction to forensic science in healthcare settings, sworn testimony for the healthcare specialist, forensic nurse death investigation, and other topics relevant to the forensic nursing field.
Additionally, some schools provide certificates in forensic nursing, such as the University of Colorado in Colorado Springs (UCCS). Offering a graduate 12-credit certificate option, UCCS teaches practice paradigms in forensic nursing; child maltreatment; and substance abuse. Required courses include practice paradigms in forensic nursing, substance abuse: implications for the forensic nurse, and the epidemic of sexual assault, abuse, and exploitation.
Check out the forensic nursing schools page for more information on distance-based and brick-and-mortar forensic nursing certificates.
Step 5: Get entry-level professional certification (timeline varies). At this stage, some candidates choose to pursue certification, enhancing a person’s employment prospects. For example, the International Association of Forensic Nurses (IAFN) provides two sexual assault nurse examiner (SANE) certifications: SANE-P (pediatric) and SANE-A (adults and adolescents).
To become SANE certified, candidates must be RNs with at least two years of experience and 40 hours of classroom instruction. They must also pass a comprehensive exam which is offered twice annually (April and September). These certifications are valid for three years and can be renewed following the completion of 45 hours of continuing education.
Step 6: (Optional): Pursue a master’s degree in forensic nursing. To reach the upper echelons of this field, prospective forensic nurses are encouraged to pursue graduate education in the field.
One outstanding program is Texas A&M University (TAMU) master’s of science (MSN) in forensic nursing, which provides hands-on experience with clinically trained forensic nurses in developing public policy, influencing legislation, and collaborating with medico-legal professionals.
This 36-semester-hour program prepares graduates to observe, recognize, collect, and document forensic evidence for legal prosecution. A feature of this program is 45 hours of clinical hours in two on-campus visits. Courses include victimology, the impact of violence across the lifespan, and leadership and health policy.
Students are advised to visit the forensic nursing education page for additional online and on-campus graduate programs in forensic nursing.
Step 7: (Optional): Receive advanced professional certification. Finally, the International Association of Forensic Nurses (IAFN) has partnered with the American Nurses Credentialing Credentialing Center (ANCC) to provide the advanced forensic nursing board certification (AFN-BC).
Candidates must have an active RN license; two years of experience; a graduate degree in nursing; a minimum of 2,000 hours of practice in forensic nursing within the previous three years; at least 30 continuing education hours in the field; and fulfill two additional requirements (e.g., academic credits, presentations, publications). Those who qualify for this five-year credential may choose to take a certification exam or pass a portfolio review conducted by experts in the field.
Forensic nursing can be a rewarding career for medical professionals due to the nature of the work and monetarily. According to job postings on Monster (2022), these professionals earn median annual salaries of $92,000.
Although the Bureau of Labor Statistics (BLS) does not provide data specifically on forensic nursing, it does give information on two closely related careers: registered nurses (RNs) and nurse practitioners (NPs). Forensic nurses can fall into either of the two categories depending on their training and highest academic degree achieved. Registered nurses typically have at least an associate degree and national licensure from the National Council of State Boards of Nursing (NCSBN).
According to the BLS (2021), RNs make a median salary of $75,330. By contrast, NPs have more advanced education, training, and credentials. Therefore, it’s no surprise that they generally make more money than RNs (BLS 2021) at an estimated $117,670 median annual salary.
Both RNs and NPs are expected to have growing job opportunities in the years to come. As proof of this, in 2021, the BLS estimated that openings for RNs will swell 9 percent between 2020 and 2030, slightly faster than the average growth expected for all occupations during that period (8 percent). The outlook for NPs is even brighter, with 52 percent growth anticipated, more than five times the rate projected for all occupations (BLS 2021).
Please visit the forensic nursing salary page for more detailed information about pay.
Jocelyn Blore is the chief content officer of Sechel Ventures and the co-author of the Women Breaking Barriers series. She graduated summa cum laude from UC Berkeley and traveled the world for five years. She also worked as an addiction specialist for two years in San Francisco. She’s interested in how culture shapes individuals and systems within societies—one of the many themes she writes about in her blog, Blore’s Razor (Instagram: @bloresrazor). She has served as managing editor for several healthcare websites since 2015.