on the factors that must exist for potential and actual conflicts of interest and provides an example in the context of financial gain of an institution in conflict to the nurse’s concern for patients’ best interests. Forensic nursing practice incorporates nursing science, forensic science, principles of public health, and the legal system. These diverse roots inherently add to the potential for competing and oftentimes conflicting roles or duties. Kent-Wilkinson (2008), identified the uniqueness of forensic nursing as a role of providing care and a matching forensic role unique to each forensic nursing subspecialty. Wilkinson emphasized the importance of using “and” to describe these roles to emphasize that the aspects of the forensic nursing role are not a dichotomy of one or the other, but both/and (Kent-Wilkinson, 2008). As seen in Wilkinson’s research, forensic nursing is often explored in the context of separate dual roles rather than an integrated role with multiple duties specific to that integrated role. In considering the “nurses first” language, discussed earlier in this paper, a prioritizing of roles may perpetuate the perspective that forensic nursing consists of dual roles requiring a prioritizing of allegiances - allegiance first to the patient’s biopsychosocial needs and second to collecting items holding potential evidentiary value. While limited, there are additional discussions of dual-roles associated with forensic nursing practice, including subspecialty practices, in the literature (Downing & Macking, 2012; DuMont & Parnis, 2003; Mason, 2002). For example, some authors have explored how 14 competing or conflicting roles, duties, or loyalties can adversely affect patient care, suggesting further exploration, understanding, and development of strategies to reduce conflict and confusion (Benne & Bennis, 1959; Fain, 1987; Rosse, 1981; Tarrant & Sabo, 2010). An area that has received less attention is defining existing conflicting interests among forensic nurses and determining if, or when, conflicting interests rise to the level of a conflict of interest. This important topic has yet to be explored in the literature. Methods To address the aims of this paper three focused reviews of the literature were conducted using PubMed, CINAHL and WorldCat. Relevant abstracts were scanned and citations selected and reviewed. To address the first aim, to explore the concepts of role confusion and role conflict, a purposeful article selection was completed to ensure representation of role confusion and role conflict across the history of professional nursing, across the domains of nursing, and practice areas relevant to forensic nursing. To address the second aim, to introduce the concept of dual duties within a single role as an alternative to dual roles or dual loyalties, a second, more abbreviated, purposeful literature review was conducted to explore role conflict and role confusion resulting from dual loyalties or dual roles. Finally, to address the third aim, to highlight the difference between conflicts of interests and conflicting interests, a targeted review was conducted focusing on the concepts of conflicting interest and conflicts of interests. Role Confusion and Role Conflict Focused literature searches on role confusion and role conflict in nursing resulted in citations dating from 1959 (Benne & Bennis, 1959, 1959a) to the present. Search results included articles related to the domains of nursing practice (Heikkinen, et al., 2007, 2006; BryantLukosius, Alba, Browne, & Pinelli, 2004; Hazel, 1985), education (Fain, 1987), research 15 (Colbourne, 2004), administration (Tarrant & Sabo, 2010) and nursing as a whole (ASRN, 2008). Discussions specifically related to role confusion in nursing revealed three main areas of concern: 1) role confusion stemming from licensing or scope of practice (e.g., confusion about the roles of registered nurses, clinical nurse specialists, advanced practice nurses, nurse practitioners and physicians), 2) confusion arising from nomenclature and inconsistent definitions (e.g. nurse specialist, advanced practice nursing, advanced nursing practice, nurse practitioner), and 3) role confusion related to specific roles within settings (e.g. nurse/nurse executive, nurse/nurse educator, nurse/nurse researcher). The first two focal areas appeared to correspond to historical shifts in nursing practice, for example, development of a specialty or advanced practice roles. These three areas of concern are discussed in more depth below. Role Confusion Stemming from Licensing or Scope of Practice Benne & Bennis (1959) approached role conflict and role confusion from the perspective of the social environment of nursing (e.g. professional organization, facility, self, etc.) and associated role expectations of these social environments. Different sources of expectations may reinforce each other, or together the meaning becomes ambiguous leading to role confusion. Alternatively, sometimes different role expectations may be in tension with each other leading to role conflict. Benne & Bennis’ second publication (1959a) explored tensions resulting from role conflict and confusion including the difference between an individual nurse’s image of a ‘real nurse’ and his/her actual nursing practice, the nurse-doctor relationship, and promotions that create conflict between new duties and a continued desire to provide direct patient care. Benne &