Virginia Lynch, MSN, RN, FAAN, truly is America's pioneer of forensic nursing. She didn't invent it, of course, but she did give it a name years before the International Association of Forensic Nurses formed in 1992 and the American Nurses Association recognized it as a specialty in 1995.

Emergency room and other nurses long have been expected to identify, document and preserve legal evidence in cases of rape, domestic violence and other injuries suffered as the result of a crime or suspected crime, Lynch said. They've been expected to do it without formal forensic training and in a medical community where the prevailing philosophy is "we're here to save lives, not collect evidence."

During two years of independent study at the Southwestern Institute of Forensic Sciences in Dallas, Lynch became increasingly interested in Alberta, Canada's successful use of RNs as death team investigators, which began in 1975. She said that in her studies, from 1982 to 1984, she was learning what other RNs should know but weren't taught in nursing programs.

"I came to realize there should be a discipline of forensic nursing that involved the sexual assault nurse, the death investigator, the legal nurse consultant, the clinical forensic nurse and the emergency department, the psychiatric nurse and nursing attorneys. They were all practicing in unique areas and they didn't have a label. What I did was bring them together under an umbrella," she said. "I wrote the very first master's degree program to forensic nursing, basically for myself," at the University of Texas-Arlington.

Today Lynch is director of forensic nursing and forensic health science at Beth-el College of Nursing, University of Colorado, Colorado Springs. She said it's an exciting privilege to develop concepts, roles, titles, language and terminology, and set the standards for a young but growing field.

Lynch's expertise in establishing forensic nursing programs often has taken her abroad: to Zimbabwe, El Salvador, Honduras, Costa Rica and Wales. She's been a visiting scholar in Bangkok, Thailand; Shanghai, China; Singapore, Malaysia; Brunei; and Australia.

Among the lessons Lynch imparts to graduate-level RNs at Beth-el, particularly those who aspire to follow in her footsteps and deal with the most negative aspects of human life as a death investigator, is that "first you must be an excellent clinician, because that's what sets you apart from being a police officer. If you want to be a police officer, be a criminal justice major."

"First and foremost, I'm a nurse," Lynch said, but one educated in criminalistics, scientific evaluation, and the psycho-social and legal aspects of patients and the deceased."The role I've developed is that of a forensic specialist in nursing, not a nursing specialist in criminal justice."

That's a distinction important to families who lost loved ones in the attacks of Sept. 11.

Communication and compassion
The difficult task of death notification historically has been given to law enforcement, Lynch said. The image of one or two blue-uniformed police officers ringing a doorbell in the middle of the night to deliver heartbreaking news may be a cliché, but it's based in fact.

"Human consolation is not an objective of criminal investigation. But it is of nursing," Lynch said. "It's one of the things we do best."

Forensic nurses, as part of a death investigation team, are able to speak medical language and interpret physicians' notes and medical records in ways that police officers cannot.

Nurses are adept at taking death notifications off the doorstep, Lynch said. "We're taught to reach out and touch," and are prepared to offer on-the-spot grief counseling. "We are the only discipline that brings this gift of communication and compassion to the science."