Inside New Jersey’s Only Training Course for Forensic Nurses

At the Rutgers School of Nursing, students learn to care for patients of sexual assault and domestic violence, filling a critical service gap in the process

On television, forensic nurses are always on call. From Law and Order: SVUto HBO Max's The Pitt, when a victim of a sex crime seeks help at a hospital, specialized care is never far behind.

Things are quite different in the real world. Fewer than 25% of U.S. hospitalshave any form of forensic nursing support, and in rural parts of the nation, certified forensic nurses - those trained to care for victims and properly collect evidence - are virtually nonexistent.

The forensic nurse examiner courseat the Rutgers School of Nursing, the only program of its kind in New Jersey, is working to close this service gap.

"Our course is designed to deliver a unique level of care after a highly traumatic incident," said Jeannette Manchester, associate dean of the Rutgers Center for Educational Innovation and Quality, and director of the forensic nursing program. "It requires a different learning path than most other services that nurses provide."

In hospitals and healthcare settings, victims of sexual violence and domestic abuse are cared for by specialized sexual assault response teams of medical professionals, forensic specialists, social workers, attorneys, law enforcement and the courts and clergy.

Our course is designed to deliver a unique level of care after a highly traumatic incident. It requires a different learning path than most other services that nurses provide.

Jeannette Manchester

Associate Dean, Rutgers Center for Educational Innovation and Quality, and Director, Forensic Nursing Program

Forensic nurses are typically the first point of contact for patients seeking care after an incident. But availability of specialized nurses varies widely across the country, said Kristen Crespo, a certified forensic nurse examiner in Monmouth County and one of the course's lead instructors.

If you don't have a forensic nurse that comes to your hospital, how does a person who just suffered a sexual assault get good care? Years ago, the answer was doctors. But with Emergency Room visits increasing and limited time for each patient doctors couldn't provide the type of specialized trauma informed care that victims of sexual assault require, Manchester said. Forensic nursing arose from this disconnect.

Rutgers' program was launched in late 2024. In May, it will graduate its fifth cohort. Eighty students have completed the program since inception.

Crespo and co-instructor Nicole Fusco, a certified forensic nurse examiner in Passaic County, lead the course three times annually. During the three-month training, students learn how to conduct a basic forensic sexual assault exam, identify and photograph injuries from nonconsensual sexual contact and prepare for possible defense of exams in court.

Most of the instruction is online. Students spend one weekend in person doing clinical work, when they practice exam skills on manikinsand patient-actors trained to mimic victims.

Students seek training for different reasons, Manchester said. Some aim to add a skillset to their nursing toolkit (to be eligible, students must have two years of professional nursing experience before they apply). Others may have personal experiences and want to help others in their time of need.

Many students come with little or no experience working with genital anatomy, which heightens student anxiety, the instructors said. There also is the higher likelihood that forensic nurses will testify in court, which adds to the pressure and the stakes.

We're not working for the prosecution or the defense. Our job is to treat the patient - who is our main focus.

Kristen Crespo

Lead Instructor and Certified Forensic Nurse Examiner in Monmouth County

"We all become attached to our patients and want to see a good outcome, but we also must remain neutral," Crespo said. "We're not working for the prosecution or the defense. Our job is to treat the patient - who is our main focus."

Whatever the motivation, Crespo said the job is rarely as glamorous - or as scary - as depicted on television.

"Nurses might get nervous because of the things they see on TV, but the job ends up being 10 times worse in their head," she said.

The most important part of being a forensic nurse, Fusco added, is being there for a patient during one of the worst days of their life. That's a skill that our students "are already good at," she said.