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The Evolution of Nursing


Understanding the differences between various nursing roles performs a vital function in the arrangement of successful collaboration within healthcare settings. Advanced practice nurses are some of the most skilled healthcare specialists who perform many duties to reach the best patient outcomes. However, a more recent specialty, forensic nursing, has gradually become an important component of care. The present paper will compare and contrast the evolution of these two directions and will discuss future implications.

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A Different Direction Specialty: Forensic Nursing

Forensic nursing is a nursing specialty that has developed in a different direction from that of advanced practice nursing. This evolving nursing specialty concentrates on healthcare combined with legal issues (Sekula, 2016). At present, forensic nursing is acknowledged as a separate practice area while recently, it used to be an informal domain due to the lack of standards of education for nurses combining the caring and investigating roles (Sekula, 2016).

The specialty appeared in Canada and the United Kingdom in the 1950s. In the United States, it emerged in the 1970s (Scannell, 2019). The focus of forensic nurses’ practice differed in these countries, as well. In the UK and Canada, the central issue was psychiatric patients and the corrections systems (Sekula, 2016). Meanwhile, in the US, the main emphasis was on the victim of an assault. The most recent tendency in forensic nursing in all countries is to include victims, their abusers, and families.

Depending on specific areas of work, there exists a variety of aspects in forensic nursing practice. Sekula (2016) differentiates between a forensic clinical nurse specialist, forensic (sexual assault) nurse examiner, nurse death investigator, nurse coroner, legal nurse consultant and nurse attorney, forensic correctional nurse, forensic psychiatric nurse, and risk manager. Each of the mentioned specialists needs to receive special education, which was not widely available until 2015 (Sekula, 2016).

Forensic nurses should be competent both in care-related issues and legal aspects. Apart from regular nursing knowledge, forensic nurses are instructed in such areas as trauma-informed care, abuse identification, evidence collection, wound assessment, forensic photography and interview, and death investigations (Scannell, 2019). Therefore, while forensic nursing preparation and practice have some aspects in common with advanced practice nursing, they also have a number of specific requirements and involve some unique areas of knowledge.

Key Differences Between Forensic Nursing and Advanced Practice Nursing Evolution

The major divergence between forensic and advanced practice nurses (APNs) is the scope of practice. The primary requirement to APNs is the ability to provide patients with care by using their clinical management skills combined with the knowledge of evidence-based practice (Schrob, 2016). Meanwhile, the first duty of a forensic nurse is to assess the origin and level of the client’s trauma (Scannell, 2019).

While an APN interviews a patient to inquire about the nature of their complaint, a forensic nurse’s examination is aimed at finding out the reason of an injury (Dunphy, 2018; Scannell, 2019). Also, a rather significant feature of a forensic nurse’s scope of practice is the preparation to work with victims of disasters (Scannell, 2019). Thus, although both AONs and forensic nurses are expected to provide care and support to their patients, they do so at different levels.

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Another difference is in the educational preparation of the two categories of nursing specialists. APNs need to obtain a master’s level education, and many APN programs involve a doctoral level (Schober, 2016). Meanwhile, forensic nurses are not required to complete a doctorate program. However, they need to complete a degree in forensic nursing and become certified in sexual assault nurse examination (Sekula, 2016). By obtaining this degree, one becomes able to perform the function of a nursing detective.

Finally, some of the regulatory mechanisms and practices in each of the two specialties are not the same. APNs can consultant other healthcare employees on some issues whereas forensic nurses cannot (Schober, 2016). Also, APNs have a higher degree of professional autonomy than forensic nurses do. Additionally, APNs can plan and implement various programs at hospitals (Schober, 2016). Meanwhile, forensic nurses have to collaborate with other specialists and report on their findings (Sekula, 2016). Therefore, while both specialties share the main function, the responsibilities and opportunities of each of them have evolved differently.

The Future Vision and Goals

The future vision of both specialties is promising since they are highly important in modern society. The APN perspective involves continuous development with the aim of improving patient care and increasing customer satisfaction. The vision of forensic nursing presupposes the enhancement of these specialists’ educational programs and the inclusion of combined dimensions of work. The emerging healthcare trends and needs are associated with healthcare coverage and insurance.

The goals of both specialties involve improved access to care by different populations. According to Becker and Doherty (2018), APNs will presumably expand their practice roles and increase independence from doctors. Overall, the future for both analyzed specialties is promising, but it will be influenced by a variety of social and political processes.


Both APNs and forensic nurses perform a number of significant roles within the healthcare settings. The analysis of the two specialties allows concluding that closer collaboration between these important groups of nursing professionals is required. The understanding of each other’s scope of practice and roles will enable forensic nurses and APNs to combine their efforts in providing the highest level of care to their customers.


Becker, D., & Doherty, C. (2018). Emerging roles of the advanced practice nurse. In L. A. Joel (Ed.), Advanced practiced nursing: Essentials for role development (4th ed.) (pp. 16-32). Philadelphia, PA: F. A. Davis Company.

Dunphy, L. M. (2018). Advanced practice nursing: Doing what has to be done. In L. A. Joel (Ed.), Advanced practiced nursing: Essentials for role development (4th ed.) (pp. 2-15). Philadelphia, PA: F. A. Davis Company.

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Scannell, M. J. (2019). History of forensic nursing. In M. J. Scannell (Ed.), Fast facts about forensic nursing: What you need to know (pp. 3-10). New York, NY: Springer Publishing Company.

Schober, M. (2016). Introduction to advanced nursing practice: An international focus. Indianapolis, IN: Springer.

Sekula, L. K. (2016). What is forensic nursing? In A. F. Amar & K. L. Sekula (Eds.), A practical guide to forensic nursing: Incorporating forensic principles into nursing practice (pp. 1-17). Indianapolis, IN: Sigma Theta Tau International.

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