and investigation. Clinical practice focuses on geriatrics, pediatrics, psychiatry, and women’s health. Additionally, there is room for development in clinical investigation, risk management, disaster response, insurance fraud, and correctional institutions. Since 2006, forensic nursing has been recognized as a practice area in over 27 countries worldwide.7 Although this article will focus primarily on the function of the SANE role, it is important to note all the potential roles and/or tasks of the professional forensic nurse include, but are not limited to: sexual assault nurse examiner: pediatric, adolescent, and adult populations; death investigator/coroner/morgue technician/medical examiner assistant; Perioperative Nurse, Naval Medical Center, 620 John Paul Jones Circle, Portsmouth, VA 23708. I am a military service member. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the U.S. government.” Title 17 U.S.C. 101 defines a U.S. government work as a work prepared by a military service member or employee of the U.S. government as part of that person’s official duties. The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. government. This manuscript was received for review in May 2007. The revised manuscript was accepted for publication in October 2007. Reprint & Copyright © by Association of Military Surgeons of U.S., 2008. 42 MILITARY MEDICINE, Vol. 173, January 2008 Downloaded from https://academic.oup.com/milmed/article/173/1/42/4557710 by guest on 08 April 2022 legal nurse consultant/clinical investigator; domestic violence specialist; child abuse/neglect specialist; elder abuse specialist; correctional facility nurse; and education/research/ consulting/epidemiology. THE MILITARY CONNECTION Some U.S. military nurses hold memberships in IAFN; however, the exact numbers are not known because registrants are not specifically asked whether or not they have a military affiliation when they apply for IAFN membership. However, as recently as 2005, an active duty Navy nurse was nominated as a candidate for the presidency of IAFN. There are military nurses from all branches of service who hold forensic degrees and certificates, and who make forensic contributions and referrals daily. Most are not employed in a forensic nursing billet or capacity, but instead are used on an “as needed” basis. It is not unheard of for military nurses who are being deployed to an austere or isolated setting to be sent to a 40-hour SANE didactic course, minus the clinical component, with the expectation that they are now responsible for all sexual assault examinations that need to be performed “in the field.” The sexual assault examination, which typically encompasses a full head-to-toe examination coupled with pelvic, and potentially anorectal, inspection is sensitive and complicated and requires the examiner to be well-prepared and well-educated both in forensic theory and practice. Any registered nurse can be designated to perform the sexual assault examination according to the directions supplied in the evidence collection kit. However, if nurses are not formally credentialed as SANEs (as evidenced by passing the IAFN national certification examination) or as advanced practice nurses, then the examination must legally be precepted and/or cosigned by a credentialed provider. This lack of certification creates the additional expense of a preceptor. Also, consider the caliber of evidence and testimony of an expertly trained and certified SANE nurse compared to a nurse who has never been formally trained or precepted. RNs seeking SANE certification ideally are clinically precepted by an expert SANE to collect evidence and learn how to properly document a sexual assault case. This would result in no additional cost if the SANE in training and the preceptor were military nurses. More importantly, the skillful training of properly credentialed and certified SANES’ helps to ensure far superior evidence collection processes, especially in difficult and complicated cases, and better prosecution rates of offenders. Intuition is as important as education and clinical competency acquired by such training. Winfrey and Smith8 state that the expert nurse must learn to trust his or her intuition. Intuition is not learned in a textbook or from a didactic course, but is gained and reinforced with experience. Competence in all forensic areas involves clinical exposure, literature review, seminar attendance, and membership in a professional organization such as IAFN.2 A SANE must also be an effective communicator in the courtroom, a setting in which most military nurses do not have extensive experience. PARADIGM SHIFT Military nurses with an interest in forensic science must challenge the Department of Defense (DoD) to expand its paradigm of nursing to include forensic practice. The first step is to organize by creating a member section within IAFN solely for military nurses. This forum would provide an electronic “meeting place” for military nurses with forensic interests and education to collaborate. This could easily be accomplished through a bulletin in IAFNs official newsletter On The Edge and its