children, vulnerable older adults, or persons with disabilities). Veracity within the clinical setting refers to “accurate, timely, objective and comprehensive transmission of information, as well as to the way the professional fosters the patient’s understanding” (Beauchamp & Childress, 2013). Concern may 24 be raised about the ability to uphold veracity in the context of multidisciplinary responses to violence where professionals from different disciplines have very different roles and responsibilities. Similar concerns can be raised about privacy and confidentiality. Although closely related, privacy and confidentiality are different in that privacy addresses a person’s choice to share information and confidentiality refers to protection of shared or collected information about a patient (Beauchamp & Childress, 2013). Last, issues may arise that threaten the fidelity, or trusting relationship that the patient’s interest remain priority (Beauchamp & Childress, 2013), between the forensic nurse and patient because the patient’s expectations may not be compatible with the role and capabilities of the forensic nurse (e.g., privacy and confidentiality). Conflicting interests are not as well described in the literature as conflicts of interest. In conducting a literature review on conflicting interests, the specific phrase was identified in a few titles or abstracts, however the associated journal articles did not delineate the concept from conflicts of interest. In other articles, conflicting interests was used interchangeably with conflicts of interest. For forensic nurses, conflicting interests may be secondary to the integrated role itself or secondary to the varied interests of multidisciplinary collaborations when healthcare and legal systems intersect. Nurse educators have been described as nurses who adopt a second profession, that of education. Nurse educators are socialized first as nursing professionals, with the associated internal and external expectations, and then incorporate education into their existing nursing role. This second role layers additional internal and external expectations onto the existing ones and hence, these two sets of professional expectations must be reconciled or role confusion and 25 conflict will occur (Fain, 1987). Similarly, forensic nurses are socialized as nurses initially and then incorporate aspects of forensic science, legal processes, and population health into their new, specialized roles. Considering the use of the “nurses first” statements in presentations, formal and informal discourse, and even as taglines on the internet, it appears that the forensic nursing profession has yet to reconcile the additional professional expectations associated with this specialty practice into an integrated specialty role. Additional research exploring and defining the integrated forensic nursing role is greatly needed. As long as forensic nurses perceive a need to identify themselves as “nurses first”, an incongruence or confusion clearly exists regarding roles and role expectations. Recognizing that the “nurses first” declaration is used both within and outside the forensic nursing profession, there exists confusion both internally among forensic nurses and externally among their multidisciplinary colleagues and the public. Without role clarification, a consistent norm for socialization into the specialty cannot exist. These inconsistencies in role identification and role expectations can result in inequities across patient populations, such as patients who are identified as victims versus those who are identified as suspects or the accused. Additional Considerations Conflict arising from the nurse-doctor relationship has been identified as one of the five main stressors affecting nurses (Leatt & Schneck, 1985). Nurses have also been identified as lacking assertiveness related to communicating the scope of their valuable services when interacting with physicians (Nelson, et. al, 2008). This suggests the following question: does this lack of communication and assertiveness also exist when forensic nurses interact with law enforcement officers, attorneys, or other multidisciplinary professionals? If so, this may further magnify role confusion and conflict. Research has shown significant differences between 26 physicians’ views of nursing practice roles and nurses perspectives of their own roles as nurses (ASRN, 2008). These findings suggest that further research exploring the perspectives and expectations of multidisciplinary team members as compared with forensic nurses’ role identification could be useful. An additional area not found in the literature, yet deserving of consideration, is the potential for moral distress or moral disengagement related to role confusion, role conflict, competing interests and conflicting obligations among forensic nurses. This is especially relevant as forensic nurses may find themselves in roles where they may have more responsibility than authority. Additionally, pressures from outside entities (e.g., law enforcement, employers, community, or even family members of patients) to “collect evidence” may be in direct conflict with respecting the informed choices of patients. For example, consider a case involving a series of sexual assaults during a 3-month time frame where each assault has become more aggressive. The assailant is targeting teenage girls in a certain area of the community, an area where the forensic nurse happens to live also. To date, samples