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POST GRADUATE DIPLOMA IN FORENSIC NURSING

INTRODUCTION

Forensic nursing is one of the newest forms of forensic sciences. Forensics is scientific methods used to solve crimes and find out who committed them. Forensic Nursing is the application of forensic science, combined with clinical nursing practice as they are applied to public or legal proceedings in the law enforcement arena. It is the application of forensic aspects of health care combined with biopsychosocial education of the registered nurse in the scientific investigation and treatment of trauma, death, violent or criminal activity, and traumatic accidents within the clinical or community institution. Daily, nurses encounter the results of human behaviour extremes: abused children, women, spouse, elderly, victims of neglect, self inflicted injury, firearm injuries, knife wounds and other assaults. Victimization and violence is on the increase. Forensic nursing is a new and challenging field of practice for nurses. The scope of forensic nursing includes acute health care facilities, correctional institutions, law related agencies and courts etc. Thus the nurses trained as forensic Nurse specialist can provide direct services to individual clients, consultation services to nursing, medical and law-related agencies, as well as providing expert court testimony in areas dealing with trauma and/or questioned death investigative processes, adequacy of services delivered, and specialized diagnoses of specific medical conditions. This would help in establishing a caring relationship with the victims

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Forensic nursing’s scientific knowledge base emerges from theories of nursing, forensic science, criminal justice, police science and legal studies. As a public service profession, nursing has a responsibility to maintain standards of practice while processing victims of human violence. Frequently cases are won or lost based on the handling of evidence. If health care professionals fail to incorporate forensic guidelines, misinterpretation or omission of evidence may result in a miscarriage of justice. Forensic nursing represents a new era of nursing practice that is evolving in direct response to the sequelae of criminal and interpersonal violence. Therefore Post Basic diploma in forensic nursing is designed to train forensic nurse specialist. The outcome of the programme will be to have more nurses prepared as forensic nurse specialists providing care at the institutional and community levels. PHILOSOPHY Indian Nursing Council believes that registered nurses need to be trained in forensic nursing in clinical and community settings in order to provide competent care to clients in forensic care settings. Expanding roles of nurses and advances in forensic science and technology necessitates additional training to prepare nurses for effective participation in nursing care of clients in forensic care settings. PURPOSE The purpose of this course is to train the nurses to:

1. Provide quality care to clients in forensic care settings 2. Manage and supervise care of clients in forensic care settings

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3. Collaborate and coordinate with nurses, legal & police personnel, allied health professionals, families and communities in areas related to clients in forensic families care settings

4. Conduct research in areas of forensic nursing COURSE DESCRIPTION The course is designed to train registered nurses (B.Sc.) as forensic nurse specialist with specialized knowledge, skills and attitude in providing quality care to clients, their families and communities in primary, secondary and tertiary levels in forensic care settings. GUIDELINES FOR STARTING POST GRADUATE DIPLOMA IN FORENSIC NURSING THE PROGRAMME MAY BE OFFERED AT The Government (State/Centre/Autonomous) College of Nursing offering degree programmes in nursing attached to a Government Medical College having 500 bedded hospital with diagnostic, therapeutic and state of the art clinical forensic medicine and nursing care facilities. RECOGNITION PROCEDURE

1. Any institution which wishes to start post graduate diploma in Forensic nursing should obtain the No objection/Essentiality certificate from the State Government. The institutions which are already recognized by INC for offering diploma/degree programmes in nursing are exempted for obtaining No objection/essentiality certificate.

2. The Indian Nursing Council on receipt of the proposal from the Institution to start nursing programme will undertake the inspection to assess suitability with regard to physical

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infrastructure, clinical facility and teaching facility in order to give permission to start the programme.

3. After the receipt of the permission to start the nursing programme from Indian Nursing Council, the institution shall obtain the approval from the state nursing council and examination/board University

4. Institution will admit the students only after taking approval of State Nursing Council and Examination Board/University.

5. The Indian Nursing Council will conduct inspection for two consecutive years for continuation of the permission to conduct the programme.

STAFFING

1. Full time teaching Faculty in the ratio of 1:5 Qualification:

a. M.Sc. Nursing with forensic nursing speciality b. Post Graduate Diploma in Forensic Nursing with Basic B.Sc.

(N)/P.B.B.Sc. (N) Experience: Minimum three years

2. Guest Faculty – multi – disciplinary in related specialities i.e. Forensic Science, Law enforcing authorities, Insurance, Psychology, Psychiatry, criminology and victimology etc.

BUDGET These should have budgetary provision for staff salary, honorariums for guest faculty, and part time teachers, clerical assistance, library and contingency expenditure for the programme in the overall budget of the institution.

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PHYSICAL FACILITIES 1. Class Room – 1

2. Library: Library having current books, journals and periodicals

related to forensic nursing, forensic science, forensic medicine, Psychiatry, Psychology, Psychiatric Nursing, Nursing Administration, Nursing Education, Nursing Research and Statistics, Medico – Legal aspects of medical records; violence and nursing practice, Forensic nursing: Scope and standards of practice, Forensic victimology, Criminology and Law enforcements.

3. Teaching Aids – Facilities for use of Over – head Projectors, Slide Projector TV with VCP or VCR LCD Projector Computer Psychometric instruments Narco analysis equipment GSR (galvanic skin response equipment) Videos on crime detection procedures and forensic nursing

4. Official facilities

Services of typist, peon, Safai Karmachari Facilities for office, equipment and supplies such as

- Stationery - Computer with printer - Xerox machine/Risograph - Telephone and Fax

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CLINICAL FACILITIES A General Central/State government hospital attached to Medical College having advanced diagnostic, therapeutic and state of the art clinical forensic medicine and nursing care facilities. ADMISSION TERMS AND CONDITIONS The student seeking admission to this course should:

1. Be a registered nurse (R.N & R.M) or equivalent (B.Sc Nursing/PB B.Sc N)

2. Possess a minimum of one year experience as a staff nurse. 3. Nurses from other countries must obtain an equivalence certificate

from INC before admission. 4. Be physically fit. 5. No. of seats – 20

ORGANIZATION OF THE COURSE

A. Duration: Duration of the course is one academic year. B. Distribution of the Course:

1. Teaching: Theory & Clinical practice 42 weeks 2. Internship 4 weeks 3. Examination (including preparation) 2 weeks 4. Vacation 2 weeks 5. Public holidays 2 weeks -------------------- 52 weeks -------------------

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C. Course objectives: General Objective At the end of the course the student will be able to develop an understanding of philosophy, principles, methods and issues, management, education and research in Forensic nursing.

Specific Objectives:

1. Apply knowledge and skills of nursing and forensic science to identify and collect forensic evidence within the health care setting to ensure it will with stand legal scrutiny

2. Determine treatment for triage and emergency intervention for patients who exhibit potential forensic issues

3. Identify basic policies and procedures required for conducting sexual assault examination for children and adults

4. Perform the Forensic/Medical examination and evaluation of sexual trauma

5. Collect and preserve biological, trace/physical evidences with least/without physical and emotional trauma to the victim

6. Collect and preserve other evidences involving various other trauma/Accidents/Assaults

7. Collect, preserve and forward the evidences to the concerned organisations/laboratories for further examination

8. Maintain necessary documentation with legal implications 9. Assist medical examiners in assessing and evaluating psychiatric

morbidity 10. Assist medical examiners in assessing the various causes of death

in unnatural circumstances 11. Assist in Assessing the manner and time since death 12. Provide nursing care in poisoning cases 13. Apply the nursing process to public or legal proceedings and

psychological profiling in the risk groups 14. Analyse the criminal profile using various psychological tests 15. Provide psychiatric counselling to the risk groups

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16. Provide psychiatric nursing care and crisis intervention 17. Communicate with the various members of the multidisciplinary.

Forensic team, including victim advocates, law enforcement authorities and the legal community.

18. Communicate effectively with patients and families 19. Analyse the social and political implications of escalating violence

as it related to law enforcement, criminal justice and domestic living.

20. Maintain necessary documents (records and reports) with legal implications.

D. Course of Studies:

Subject Theory Practical

Paper I - Forensic Nursing – I Including i. Fundamentals of Forensic

Nursing ii. Medico – legal Investigative

Aspects of Nursing

210 Hours

1280

Paper II - Forensic Nursing-II Including i. Clinical and Forensic Psychology ii. Forensic Psychiatry

200 Hours

Paper III - Supervision and Management, (Clinical teaching) and (Elementary Research and Statistics)

90 Hours (30+30+30)

IV. Internship 160 Hours

TOTAL 500 Hours 1440 Hours

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Hour distribution for theory and practice: 42 weeks X 40hours/week

= 1680 hours Block classes 4 weeks X 40 hours/week

= 160 hours Integrated theory & clinical practice 38 weeks X 40 hours/week

= 1520 hours - (Theory 400 hrs) Theory 6 hours /week 38 weeks X 6 hours/week

= 240 hours - Clinical experience 34 hours/weeks 38 weeks X 34 hours/week

= 1280 hours Internship 4 weeks x 40 hours = 160 hours E. Clinical Experience

Total 1280 hours will be distributed on the following clinical areas. Clinical rotation: Students will spend 5 hours per day in clinical area.

Sl. No Area of posting Duration

1 Counselling Centres 4 weeks 2 Casuality, Emergency and Trauma Centre 4 weeks

3 Forensic department (Autopsy dept., Pathology dept etc.)

8 weeks

4 Forensic Lab 8 weeks

5 Police Administration 4 weeks

6 Witnessing different court proceedings 4 weeks

7 Organ Transplant centres 2 weeks

8 Fertility centres 1 week

9 Toxicology unit 1 week

10 Correctional facilities 2 weeks

Total 38 weeks

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EXAMINATION SCHEME

Subjects Int. Ass. Marks

Ext. Ass.

Marks

Total marks

Exam hours

A. Theory Paper I-Forensic Nursing I 50 150 200 3 Paper II-Forensic Nursing II 50 150 200 3 Paper III- Supervision & Management, Clinical Teaching, Elementary Research & Statistics

25 75 100 3

B. Practical Forensic Nursing 100 200 300 Grand Total 225 575 800 C. Conditions for Admission to Examination The Student:

1. Has attended not less than 75% of the theoretical instruction hours in each subject during the year.

2. Has done not less than 75% of the clinical practical hours. However, students should make up 100% of attendance for integrated practice experience and internship in term of hours and activities before awarding the certificate.

EXAMINATION

The examination to be conducted by the University to which the College of Nursing is affiliated.

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Standard of Passing 1 In order to pass a candidate should obtain at least 50%

marks separately in internal Assessment and external examination in each of the theory practical and papers.

2 a) Less than 60% is Second division, b) 60 % and above and below 75% is First division, c) 75 % and above is Distinction.

3. Students will be given opportunity of maximum of 3 attempts for passing

CERTIFICATION

A. TITLE - Post Graduate Diploma in Forensic Nursing B. A diploma is awarded upon successful completion of the

prescribed study programme, which will state that i) Candidate has completed the prescribed course of

Forensic Nursing. ii) Candidate has completed 100% clinical experience

requirements. iii) Candidate has passed the prescribed examination.

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POST GRADUATE DIPLOMA IN FORENSIC NURSING

DESCRIPTION OF CURRICULUM

Paper I – Forensic Nursing I

Hours 210

Subject Hours Content PAPER I – Forensic Nursing including

i. Fundamentals of forensic nursing

ii. Medico – legal and Investigative aspects of nursing

35 UNIT I – Forensic Science – Definition – introduction – history and development – scope and need – principles – services provided by Forensic science laboratory Forensic nursing – introduction – definition – concepts – features – importance of nursing in investigations – scope and need – application in scientific investigations – Domain of forensic nursing – Ethical issues in nursing Police administration – Hierachy of police – importance of FIR – Police – Medical Examiner relationships. Doctor – nurse relationship – Police forensic nurse relationship Legal procedure - types of courts – their jurisdiction and their powers – inquest – types. Dying declaration and dying deposition – oral evidences – Emergency room management & documentation, Domestic violence, child abuse & crime against women Importance of nursing in emergency. Uses of radiations in visualisation of evidences.

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30 UNIT II Serology and biology – Blood and its composition – forensic significance – Blood alcohol analysis – Composition of semen and other body fluids Introduction to DNA - chemical structure forensic DNA forensic analysis -and its importance in criminal investigations. Procedure for collection and preservation of biological samples for DNA analysis – Identification form for DNA profiling and forwarding note. Application of examination of hair, fibre, lip prints and bite marks.

20 UNIT III Ballistics - introduction to firearms and ammunitions – wound ballistics – entry and exit wounds created by different weapons – their Characteristics – and determination of range in case of firearm injuries. GSR – Mechanism of formation, collection and preservation. Methods of collection and preservation of firearms and fire arm injury related evidences. Frequently examined miscellaneous trace evidences: glass paint – Evidences in vehicular accidents – photography of the evidences

20 UNIT IV Computer applications for a patient care delivery system and nursing practice – Use of computers in teaching –learning – research and nursing practice. Windows MS – Office – Word – Excel – Power Point – Internet.

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Hospital management information system (MIS) Forensic Science and Computers

- Data storage - Forensic analysis of Internet data

25 UNIT V Toxicology – introduction – classification of poisons – actions of poisons – methods of administration – factors affecting the poisoning – absorption and elimination – diagnosis in living and dead – and management – of poisoning cases Procedures in poisoning cases – selection of viscera and techniques for collection of viscera and techniques for collection of additional visceral samples in special cases. Preservation, packing & forwarding of viscera samples to the laboratory. Interpretation of toxicological results. Introduction to NDPS act, its provision and their importance in forensic nursing Type of Drugs, Drug identification Collection & preservation of drug evidence Drug analysis by FTIR and HPLC

20 UNIT VI Sexual offences – medico legal aspects – examination of victim and accused – external signs – collection and preservation of evidences unnatural sexual offences – sexual perversions – medico legal aspects Child abuse – Definition – types – victims of child abuse signs – forensic nursing

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care Crimes against women – in various forms – dowry harassment, sexual harassment, domestic violence, Consequences of Altered sex ratio, forensic importance Abortion – legal and criminal – methods of procuring evidences of criminal abortion – medico legal aspects – Signs of recent delivery Impotency and sterility – causes – medico legal aspects Legitimacy and Paternity – evidence collection – forensic importance – Surrogate mother – legal implications Infanticide – still born and killing newborn after birth, medico legal aspects

10 UNIT VII Asphyxia types and their medico legal importance. Collection of evidences. Death from starvation, cold, heat their medico legal importance

20 UNIT VIII Injuries – Types and medico legal aspects, injuries due to vehicular accidents, burns, electrical injuries and their medico legal aspects

10 UNIT IX Organ Transplant – Organ Transplant Issues Concerning Donor and cadaver transplant, counselling, consent, Documentation, Videography

20 UNIT X Death - signs of death – modes of death – presumption of death – postmortem changes – time since death – disposal of the dead body, collecting necessary evidences before cremation.

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Medico legal autopsy and its objectives – Types – causes of death – examination of decomposed bodies – mutilated bodies – fragmented remains and bones Disaster management – manmade and natural – importance of forensic nursing Personal identity – obliteration of identity medico legal aspects

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Paper II – Forensic Nursing II Hours 200

Subject Hours Content

PAPER II – Forensic Nursing II including

i. Clinical and Forensic Psychology

ii. Forensic Psychiatry

20 UNIT I Definition and scope of psychology – application of psychology in nursing. Normality and Abnormality: different Models, difference between Mental Health and Mental Illness.

20 UNIT II Aggression: Definition of Aggression, Theories of Aggression, Determinants of Aggression (Psychological, Social, Biological, cultural). Self harm behaviour: Determinants of self harm behaviour (Psychological, Social, Biological, cultural). Psychological management for internal / external aggression.

20 UNIT III Stress, coping and adjustment: over view of stress and its influences, strategy for coping, coping with illness and disability Overview of rehabilitation of criminals

20 UNIT IV Criminal Behaviour: What is Criminal Behaviour? Theories of Crime (Ecological, Social, Psychological and Biological) Psychological Impact of Crime: Domestic Violence, Sexual Abuse, and Child Abuse

20 UNIT V Psychological Method of Investigation:

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Interview Techniques, Psychological Testing/screening methods, Technologies in Investigation

20 UNIT VI Psychiatric Conditions: Relationship with crime (Specifically to impulse control disorders, Psychotic conditions, Organic mental disorders, Anti social personality disorder, Epilepsy, Mental Retardation, Alcohol and substance abuse)

20 UNIT VII Mental Health Act, Indian Evidence Act, Forensic Psychiatry: Testamentary capacity, competency to stand trial – Probation and Parole.

40 UNIT VIII Basics of counselling: Definition of counselling: Process – Rapport establishment, listening, empathising, treatment planning: Characteristics of an effective counsellor, Ethical guidelines for counsellor Types of Counselling Process: Models of Counselling

20 UNIT IX Crisis intervention: Definition and process of crisis intervention, dealing with the cases of mass disaster, role of nurses in crisis intervention

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Paper III – Supervision and Management, clinical teaching and Elementary Research and statistics

Hours 90 Subject Hours Content

30 SUPERVISION AND MANAGEMENT Management: Definition & Principles, Elements of management of victim care:- planning, organisation, reporting and recording. Clinical Supervision: Introduction, Definition and objectives of Supervision, Principles and Functions of supervision, Qualities of supervisors, Responsibilities of clinical supervisor, Practice standards of various units: Policies and Procedures, Establishing Standing orders and Protocols, Orientation programme for new recruits, Quality assurance Programme in various units, Performance appraisal. Staff development – introduction, purposes, in-service education and continuing education. Medico legal aspects – legislation and regulations related to psychiatric care and other victims, consumer protection acts – negligence and malpractice. Legal responsibilities of nurses – case studies of judgment with regard to negligence of services in the psychiatric care services and other areas Role of nurses in legal issues

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30 Teaching leaning process Introduction and concepts Principles of teaching and learning Formulation of learning objectives Formulation of learning objectives Lesson planning Teaching methods

- Lecture - Demonstration, simulation - Discussion - Role play - Psycho drama - Clinical teaching methods - Micro teaching - Self learning - Computer assisted learning

Evaluation - Assessment of students

Purposes Type Steps Tools for assessing

knowledge, skill and attitude Use of media in teaching learning

process 30 Research

Research and research process Types of research Research problem/question Review of literature Research approaches and designs Sampling Data collection: Tools and techniques Analysis and interpretation of data

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Communication and utilisation of research

Research priorities in Forensic Nursing Preparing a research proposal in forensic

nursing Statistics Source and presentation of Data

- Qualitative and quantitative - Tabulation; frequency

distribution, percentiles - Graphical presentation

Measures of central tendency – mean; median, mode

Measures of variance Normal probability and tests of

significance Co-efficient of correlation Statistical packages and its

application

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PRACTICALS – FORENSIC NURSING I

1. Collection, preservation and examination of evidences in the crimes related sexual offences

2. Collection, preservation and processing of evidences n burns cases 3. Collection, preservation and examination of evidences in cases of

asphyxia deaths 4. Collection of evidences in cases of dowry deaths 5. Collection of evidences in cases of child abuse 6. Collection, preservation and examination of evidences in injuries of

all types and forms 7. Documentation in emergency rooms in the relevant cases 8. Evidence collection for toxicological analysis in cases of poisoning 9. Examination of victims of child abuse 10. Emergency room nursing management – forensic perspective 11. Identification features for personal identity

PRACTICALS – FORENSIC NURSING II

1. Observation, History taking, Interview, Mental Status Evaluation, Investigations and Recording of Collected information (with special reference to Forensic Cases)

2. Forensic Counselling of victims/witnesses/criminals 3. Psychological Rehabilitation of the victims/criminals 4. Forensic investigative methods for the assessment of perpetrators 5. Counselling Techniques from rehabilitation aspects 6. Forensic Rehabilitation and Family counselling 7. Minimum five case studies/case presentation

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Suggested References books in Forensic Nursing

1. Forensic Nursing: A Handbook for Practice by Rita Hammer, Barbara Moynihan, Ph.D., Elaine M. Pagliaro – 2009 – 879 pages – Preview

2. Forensic Nursing by Kelly Pyrek – 2006 – 650 pages – No preview 3. Forensic Nursing: A Concise Mannual by Donna M. Garbacz

Bader, Sue Gabriel – 2009 – 441 pages – No preview 4. Forensic Nursing by Virginia Anne Lynch, Janet Barber Duval –

2005 – 749 pages – Snippet view 5. Basic concepts of psychiatric mental helath nursing – Page 69

by Louise Rebraca Shives – 2007 – 749 pages – Preview 6. Medical legal aspects of medical recors – Page 810 by Patricia

W. Iyer, Barabara J. Levin, Mary Ann Shea – 2006 – 964 pages – Preview

7. Manual of Forensic Emergency Medicine: A Guide for Clinicians Page 5 by Ralph Riviello – 2010 – 303 pages – Preview

8. Carrer Opportunities in Forensic Science – Page 142 by Susan Echaore McDavid, Richard A. McDavid – 2008 – 318 pages – Preview

9. Forensic Nursing: Scope and Standards of Practice by International Association of Forensic Nurses, Ana – 2009 – 107 pages – No preview

10. Family Violence and Nursing Practice – Page 70 by Janice Humphreys, Jacquelyn C. Campbell – 2010 – 496 pages – Preview

11. Community Health Nursing: Caring for the public’s health – Page 205 by Karen Saucier Lundy, Sharyn Janes – 2009 – 1129 pages – Preview

12. Forensic Nurse: The New Role of the Nurse in Law Enforcement by Serita Stevens – 2006 – 288 pages – No preview

13. Community and public health nursing – page 896 by Marcia Stanhope, Jeanette Lancaster – 2004 – 1129 pages – Preview

14. 101 Careers in Nursing – Page 57 by Jeanne M. Novotny, Nicole K. Saunders, Doris T. Lippman – 2006 – 222 pages - Preview

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15. Forensic Nursing and mental disorder in clinical practice by Norman McClelland – 2001 – 143 pages – Preview

16. Psychiatric and mental health nursing for Canadian practice – Page 836 by Austin – 2010 – Preview

17. Opportunities in Forensic Science – Page 86 by Blythe Camenson – 2008 – 160 pages – Preview

18. Forensic nursing: an option for improving responses to reported ... by Great Britain. Home Office. Research, Development and Statistics Directorate – No 2004 -8 pages – No preview

19. Forensic Victimology: Examining Violent Crime Victims in ... Page 97 by Brent E. Turvey, Wayne Petheric – 2008 – 608 pages – Preview

20. Current issues in nursing – page 250 by Perle Slavik Cowen, Sue Moorhead – 2006 – 865 pages – Preview

21. Therapeutic interventions for forensic mental health nurses – Page 206 by Alyson Kettles, Phill Woods, Mick Collings – 2001 – 288 pages – Preview

22. Essentials of community based nursing – Page 286 by Karen Saucier Lundy, Sharyn Janes – 2003 – 574 pages - Preview

23. Nursing and multidisciplinary care of the mentally disordered offender – Page 14 by David Robinson, Alyson Kettles – 200 – 320 pages – Preview

24. Schaum’s Outline of Psychiatric Nursing – Page 68 by Daminga Bynum – Grant, Margaret Travis – Dinkins – 2010 – 256 pages – Preview

25. Opportunities in forensic science careers – Page 67 by Blythe Camenson – 2001 – 149 pages – Preview

26. Forensic mental health nursing: current approaches – Pages 6 by Chris Chaloner, Michael Coffey – 1999 – 312 pages – Preview

27. Forensic Nursing Science by Virginia A. Lynch, Janet Barber Duval – 2010 – 768 pages – No preview

28. Encyclopedia of Forensic Science by Suzanne Bell – 2008 – 402 pages – Preview

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29. Careers in Focus: Forensics by Ferguson – 2010 – 204 pages – Preview

30. Scope and standards of forensic nursing practice by International Association of Forensic Nurses, Joette McHugh, Debbie Leake – 1997 – 31 pages – Snippet view