Every November the Indian Health Service highlights and recognizes the hard work and contributions of its forensic healthcare staff, ensuring American Indian and Alaska Native patients receive the trauma-informed, culturally appropriate care they deserve following violent crimes. This year, November 4 - 10, 2024 is recognized as Forensic Nurses Week. It provides an opportunity to recognize the forensic nursing staff of the Indian Health Service, tribal, and urban Indian organizations, who work tirelessly to help lessen the impact of violence.

Using the nursing process to assess, diagnose, and treat patients affected by violence and trauma, forensic nurses are equipped with a strong sense of compassion, a specialized skill set, and the knowledge of providing one-on-one trauma-informed care. Forensic nurses ensure patients receive optimal care and help minimize potential long-term health consequences. They conduct medical forensic examinations, gather evidence, capture photographs of findings, provide courtroom testimony, patient education, and offer continued connection to appropriate resources that meet the patient's cultural and spiritual needs through local and tribal community sources.

Below are just a few facilities that are highlighting their forensic healthcare nursing staff this week and the impact they are making in their communities.

• SANE/SART Coordinator Anna Lennox with the Whiteriver Service Unit in Whiteriver, Arizona is fortunate to have a robust forensic health care team. Comprised of 18 forensic nurses all from different departments, their goal is to make a sustainable and reproducible program. Every day she is thankful for her team, as they are striving to provide culturally appropriate, trauma-informed care by offering prompt medical forensic exams, consistent individualized follow up care, and education to the hospital staff, patients, and the community on the Fort Apache Indian Reservation.

• Through the Forensic Healthcare Funding Opportunity, the Billings Area Office was able to hire Area Forensic Nurse Consultant Heather Black. With great success, and some hurdles along the way, she is dedicated to establishing standardization and solidarity across all their service units. She recently shared that Dawn Bryant, a forensic nurse at the Northern Cheyenne Service Unit, was subpoenaed to testify regarding an examination. Dawn was praised by the prosecuting attorney for her role in helping secure a conviction.

• The Forensic Nursing Department at Gila River Health Care is honored to serve the Gila River Indian Community, providing support to those affected by sexual violence, domestic violence-including strangulation-and physical abuse of children and elders. They have an amazing team of 15 forensic nurses, ranging from on-call to full-time positions. Recognizing that continuing education is vital in this field, they encourage all their nurses to pursue this growth. Joy Martin, SANE medical director, believes this commitment to professional development is one of their strongest assets. Currently, three of their nurses hold SANE-A certifications, one has a SANE-P, and five additional nurses have recently taken their certification tests and are awaiting results, with remaining nurses on target to complete them during the next cycle. They are immensely proud of their dedication, especially as on-call nurses are balancing multiple responsibilities.

In addition to the focus on education, they have emphasized the importance of compassionate listening. This week, one of their nurses shared a touching story from a patient she met while hosting an informational booth at the primary care clinic. The patient opened up about her journey through domestic violence, reminding us of the profound impact our work can have. Patients sharing stories with the nurses is a frequent occurrence. These nurses take great pride in being a supportive presence in these healing journeys.

Are You Interested in Becoming a Forensic Nurse Examiner? Build capacity in providing trauma-informed care? Enhance your injury identification and documentation skills? Or gain knowledge in understanding what resources are available to help boost the health and wellness of American Indian and Alaska Natives?

To practice as a forensic nurse examiner within the IHS health system, any registered nurse or advanced practice registered nurse can complete a 40-hour didactic nurse examiner certificate training course, followed by 16 hours of clinical hands-on training.

Once a nurse successfully completes the required forensic nursing training requirements and gains related experience, they can obtain credentials through national board certification, such as SANE-A and SANE-P. Obtaining forensic nursing-related credentials offers a tangible professional recognition, allows for greater confidence and competence in practice, and highlights dedication to Native patients and the field. Please know that obtaining credentials is not a requirement to practice, but rather a journey of personal growth, professional development, and dedication to the forensic nursing field.

The IHS Division of Nursing Services recognizes forensic nurse examiners and the incredible work they are doing to mitigate violence and to providing a safe space for patients. We ask that you join us in celebrating every forensic nurse across the IHS health care systems. Let us celebrate and recognize the important work they are doing to lift the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Please show your support by wearing lilac on November 8- Forensic Nurses Day.

Additional Resources:

• Indian Health Service Forensic Healthcare Webpages
  • Forensic Healthcare | Indian Health Service (IHS)

• Texas A&M University Center of Excellence in Forensic Nursing provides related training and education through the IHS Forensic Nursing Consultation Program contract.
  • The contract offers the 40-hour SANE/SAE training courses for both the Adult/Adolescent and Pediatric courses, monthly webinars, human trafficking training, mentorship opportunities, and all educational events include FREE CE/CME.
  • The Domestic/Intimate Partner Violence training will be available soon. Stay tuned!

• International Association of Forensic Nurses -
  • Forensic Nurses Week Toolkit
    • Includes Thank You notes, Certificate of Recognition and more
  • How to Become a Sexual Assault Nurse Examiner (SANE)
  • SANE Training Courses
  • Certification Central webpages

• Academy of Forensic Nursing

Nicole Stahlmann, MN, RN, SANE-A, AFN-BC, SANE-P, FNE-A/P, serves as the forensic nursing consultant with the IHS Division of Nursing Services. Prior to her work with IHS, she served as a forensic nursing specialist with the International Association of Forensic Nurses and was the clinical program manager for the District of Columbia Forensic Nurse Examiners. Stahlmann was an emergency department nurse and adjunct instructor, teaching both undergraduate and master prepared students at Georgetown University. She continues to practice clinically, providing care for patients who have experienced violence.