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Nursing Evolution: Future Perspectives and Challenges


As a relatively young discipline, nursing is in the process of constant change and improvement, both within the United States and worldwide. New disciplines and qualifications emerge, legislation changes and new knowledge alters the nature of care. Over time, different career paths for nurses have emerged that do not necessarily involve advanced practice. Nevertheless, the author of this essay has chosen the nursing practitioner role after evaluating various options. This paper will demonstrate the author’s understanding of the evolution of forensic nursing, evaluate the future vision and goals of the advanced practice nurse, and the challenges before nursing practitioners in Florida.

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Forensic Nursing

Forensic nursing is the branch of the profession that deals with patients that are involved in various legal issues. In particular, the profession deals with working in correctional facilities, investigating crime scenes, and treating the victims of various crimes. As such, these types of nurses have to be aware of various police procedures, both on the crime scene and in the institutions where they work. Besides, they have to understand the types of evidence that are required by the police and be able to procure them. None of these competencies are required for advanced practice nurses, and so the role is unique.

However, forensic nurses still share most of their expertise with their traditional counterparts and have many of the same objectives. According to Amar and Sekula (2016), their role is to minimize the negative consequences for both patients and the system. As such, they have to accommodate the trauma experienced by victims of crimes such as sexual assault while still collecting the pertinent evidence. Forensic nurses are also expected to care for injured crime perpetrators, observing the relevant security protocols in the process. Overall, forensic nurses do not specialize in any specific branch of medicine and have legal expertise that advanced practice nurses will usually not possess.

The Evolution of Forensic Nursing

Forensics is a well-established discipline with a long history that has traditionally been considered the domain of physicians. However, the need for clinicians to know about patient assessment, evidence preservation, and legal system interfacing to avoid loss of crucial information during treatment emerged (Amar and Sekula, 2016). As nurses administered most of such procedures, they required special education most of all. Amar and Sekula (2016) claim that the practice began with sexual assault nurse examiners and expanded into what would eventually become the International Association of Forensic Nurses. Since then, forensic training has become a commonplace part of nursing, and the specialization is recognized throughout the world.

Nurse Practitioner Vision and Goals

The author of this essay intends to work towards becoming a nurse practitioner in the future. Nurse practitioners are highly competent nurses who are capable of diagnosing and treating a wide variety of conditions but may lack the specialized knowledge necessary to recognize rare and complex issues. As such, they can operate in a wide variety of care settings, especially rural ones, where there may not necessarily be a medical office nearby. Many common issues do not require specialized physician expertise to diagnose and treat, and so nurse practitioners can fulfill the needs of many patients.

In addition to general service, the broad specialization of nurse practitioners enables them to see the nursing field in detail. Stewart and DeNisco (2019) claim that their professional goals are “dynamic practice, professional efficacy, and clinical leadership” (p. 18). Nurse practitioners should identify the latest practices in every field and oversee their implementation. Their extensive experience enables them to see the best possible approaches and adjust organizational attitudes to ensure the best possible patient outcomes. They can also understand the concerns of nurses and represent them during interactions with the broader context of the healthcare system.

Nurse Practitioner Challenges in Florida

Florida is well known for its laws and their restrictions on nursing practice that interfere with nurse practitioners’ ability to operate. According to Buppert (2018), they have to be overseen by a physician or dentist and cannot prescribe medications without physician collaboration, with additional limitations on Schedule II drugs. As such, nurse practitioners in Florida cannot operate independently as in many other states, especially with regards to conditions that require prescriptions. As such, other healthcare team members should be aware of the limitation and take it into account during work while advocating for a policy change that enables advanced practice nurses to operate more effectively.

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Forensic nurses are a variety of professions that forgoes advanced practice to help address patients affected by legal issues, both living and dead. They still follow the principles of nursing, but they also receive training in evidence collection and preservation as well as police protocol for crime scenes and correctional facilities. The role emerged in response to the inadequacy of forensic physicians for the task of providing care while collecting evidence and became a widely recognized branch of the profession. The author of this essay has chosen to become a nursing practitioner, which is a branch of advanced nursing that focuses on general expertise. However, there are significant issues with advanced practice in Florida, and so care team members should be aware of the fact and ready to address it.


Amar, A.F., & Sekula, L.K. (2016). A practical guide to forensic nursing: Incorporating forensic principles into nursing practice. Indianapolis, IN: Sigma Tau Theta International.

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Burlington, MA: Jones & Bartlett.

Stewart, J.G., & DeNisco, S.M. (2019). Role development for the nurse practitioner (2nd ed.). Burlington, MA: Jones & Bartlett.

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