Forensic Nurses Capture Unseen Evidence with New Photo System

Forensic nurses will attest that some of the most telling physical evidence on a victim of violent crime isn’t always visible. Bruising on the neck of a strangulation victim may not intensify until days after their visit to an Emergency Department. Dried semen may be hard to spot on the body or clothing of a sexual assault victim.

A new forensic photodocumentation system is changing that. Thanks to a Victims of Crime Act grant through the State of Ohio, Cleveland Clinic Akron General, Fairview and Hillcrest hospitals have installed this new photo system.

According to James Bryant, DNP, RN, CEN, Associate Chief Nursing Officer of Emergency Services at Cleveland Clinic, the system will help Cleveland Clinic’s approximately 80 forensic nurses more thoroughly examine victims and capture photographic evidence not always apparent to the naked eye.

The system includes:

• High-resolution photography that shows micro details, as small as a hair follicle
• A negative invert filter to show tissue damage below the skin
• Contrast capability to show other hard-to-see evidence, such as dried semen (which fluoresces under ultraviolet light)
• Military-level encryption for secure storage of images
• A secure file portal through which to transmit court-ready photographs

Responsibilities of forensic nurses

“Forensic nurses are specially trained to care for patients who are survivors of sexual assault, child abuse, elder abuse and other violent crimes, such as gunshots and stabbings,” says Dr. Bryant. “They manage highly emotional situations and typically are the initial support for victims, providing counsel and reassurance.”

In addition to conducting sensitive medical exams and photodocumenting evidence, Cleveland Clinic forensic nurses:

• Collect and preserve clothing, weapons and other physical evidence (from both victims and perpetrators) to be referenced by law enforcement, attorneys and the court system
• Testify in courts of law as expert witnesses
• Educate other medical personnel on signs of human trafficking and identifying potential victims
• Educate community members to help curtail cases of abuse, neglect and physical violence

While forensic nurses are on call 24/7 in ED forensic exam rooms, many work outside the ED — in pediatrics, obstetrics or geriatrics, including inpatient areas — helping victims document their story as they seek closure and begin to move beyond the pain of the event.

Healthcare’s link to criminal justice

Cleveland Clinic forensic nurses received extensive training before beginning to use the new system in June 2017.

“Before installing this new technology, nurses used regular cameras,” Dr. Bryant says. “Not only could they not capture some of the harder-to-see evidence, they had to store and distribute images by CD. Burning CDs took an extra step, and mailing them took extra time. There was always a chance that images could get lost.”

The new high-tech photographic capabilities and storage and distribution safeguards alleviate those concerns.

“This technology is the gold standard in forensic nursing,” Dr. Bryant says. “We anticipate it will help further our forensic program and continue our success with helping prosecute crimes and secure justice for victims.”