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A role for nurses in police station?
JOURNAL
OF
CLINICAL FORENSIC MEDICINE CORRESPONDENCE
A role for nurses in police stations?
Sir, There having being a lot of discussion in recent months as to the appointment or not of forensic nurses to assist forensic medical officers worldwide, I outline my thoughts on the subject in relation to the Metropolitan Police Service in London, IJK. I proposed the idea of ‘nurses’ in Metropolitan Police Stations in the 1970s. I put forward the idea of a nurse to supervise a ‘soak out pit’ which would be used for drunks and/or those under the influence of drugs. The duties of the nurse would have been to monitor the airways for obstruction, recording blood pressure, pulse, maintaining the recovery position and also to carry out the instructions from the Forensic Medical Examiner (FME) formerly called police surgeons. The goal was to help reduce the number of deaths in police custody -. relieving the jailer and custody officer (the police officer responsible for the prisoner in custody) of the responsibility of looking after such at risk persons. The idea was not actively pursued. I believe there is a definite role for nurses in the custody setting nowadays and would make the following suggestions.
It is NOT envisaged that the forensic nurse would:
Advise the custody officer concerning prisoners without them having first been seen by the FME. Would not dispense medication without permission of the FME. Would not clean or dress wounds without them first having been seen by the FME. Would not act on their own initiative except in a medical emergency. The requirements for such a nurse could therefore be:
1. Someone of either sex. 2. Of at least staff nurse status. 3. Someone with additional experience such as: a) having been district nurse, district midwife or practice nurse b) holding a Diploma (or equivalent) in Mental Health c) holding a certificate or Diploma in Occupational Health 4. Trained in first aid and cardio-pulmonary resuscitation techniques. 5. Trained in the packing and collecting of forensic samples under the direction of the FME.
The nurse of today could:
1. Act as chaperone for the FME. 2. Dispense medicines prescribed by the FME, change
3.
4.
5. 6. 7. 8. 9.
The nurse would be responsible to the duty FME. Insurance against litigation would have to be arranged by the police or the Royal College of Nursing. The nurse would be in contact with the FME at all times via the custody officer and would act under the police disciplinary code. The appointed nurse would be expected to undergo continuing medical education whilst in post. It appears that in the US the forensic nursing service is based on the UK police surgeon system. I do not think that is appropriate in the UK. I would have thought that the combination of ideas put forward for nursing in the UK in this discussion document would be a better way of developing the forensic services of the UK far better. It goes without saying that a career structure would have to be arranged and the castings of such a service may well be excessive for the service provided. Referring back to the Metropolitan Police Service in London I would propose the following:
or apply dressings, under written police orders from the senior medical examiner or chief medical officer. Be in charge of drunks, drug addicts and ex-hospital cases returned to police custody who were originally sent to the hospital by the FME, or may have been taken directly to hospital by the police following a road traffic accident involving injuries. The nurse could possibly take dictated notes of examinations carried out by the FME in relation to forensic examinations. Assist in the examinations. Help in the assessment and care of mentally ill persons (if the Diploma of Mental Health is held). Advise on diet (e.g. for diabetics and vegetarians). Ensure that the cells are clean and habitable. Advising on decontamination of cells after human bodily fluid contamination i.e. HIV. 165
166
Journal
of Clinical
Forensic
Medicine
Structure
Office
1. Senior Nurse for each Metropolitan Area 2. Nurses (available for 24 hours per day, 365 days per annum) 3. Trainee nurses 4. A nurse in overall charge of all areas
Office space will be required. Perhaps Victim Examination Suites could be adapted. Transport and communication would also be required for each nurse. Clearly the key factors are cost (in relation to numbers of full-time employees that will need to be recruited) and practicality as no police station is identical. It seems to me that a full explanation of these ideas in terms of need, cost-effectiveness and safety must be undertaken, not only in the Metropolitan Police Service but in all settings where prisoners are detained in police custody.
Rank Rank would depend upon the additional qualifications of the nurse and one assumes the starting rank to be one of sergeant (at a seniority level to be decided) and further promotion governed by police regulations.
David Jenkins Pay Pay would have to start at senior staff nurse level.
Forensic Physician London, UK.
OF
CLINICAL FORENSIC MEDICINE CORRESPONDENCE
A role for nurses in police stations?
Sir, There having being a lot of discussion in recent months as to the appointment or not of forensic nurses to assist forensic medical officers worldwide, I outline my thoughts on the subject in relation to the Metropolitan Police Service in London, IJK. I proposed the idea of ‘nurses’ in Metropolitan Police Stations in the 1970s. I put forward the idea of a nurse to supervise a ‘soak out pit’ which would be used for drunks and/or those under the influence of drugs. The duties of the nurse would have been to monitor the airways for obstruction, recording blood pressure, pulse, maintaining the recovery position and also to carry out the instructions from the Forensic Medical Examiner (FME) formerly called police surgeons. The goal was to help reduce the number of deaths in police custody -. relieving the jailer and custody officer (the police officer responsible for the prisoner in custody) of the responsibility of looking after such at risk persons. The idea was not actively pursued. I believe there is a definite role for nurses in the custody setting nowadays and would make the following suggestions.
It is NOT envisaged that the forensic nurse would:
Advise the custody officer concerning prisoners without them having first been seen by the FME. Would not dispense medication without permission of the FME. Would not clean or dress wounds without them first having been seen by the FME. Would not act on their own initiative except in a medical emergency. The requirements for such a nurse could therefore be:
1. Someone of either sex. 2. Of at least staff nurse status. 3. Someone with additional experience such as: a) having been district nurse, district midwife or practice nurse b) holding a Diploma (or equivalent) in Mental Health c) holding a certificate or Diploma in Occupational Health 4. Trained in first aid and cardio-pulmonary resuscitation techniques. 5. Trained in the packing and collecting of forensic samples under the direction of the FME.
The nurse of today could:
1. Act as chaperone for the FME. 2. Dispense medicines prescribed by the FME, change
3.
4.
5. 6. 7. 8. 9.
The nurse would be responsible to the duty FME. Insurance against litigation would have to be arranged by the police or the Royal College of Nursing. The nurse would be in contact with the FME at all times via the custody officer and would act under the police disciplinary code. The appointed nurse would be expected to undergo continuing medical education whilst in post. It appears that in the US the forensic nursing service is based on the UK police surgeon system. I do not think that is appropriate in the UK. I would have thought that the combination of ideas put forward for nursing in the UK in this discussion document would be a better way of developing the forensic services of the UK far better. It goes without saying that a career structure would have to be arranged and the castings of such a service may well be excessive for the service provided. Referring back to the Metropolitan Police Service in London I would propose the following:
or apply dressings, under written police orders from the senior medical examiner or chief medical officer. Be in charge of drunks, drug addicts and ex-hospital cases returned to police custody who were originally sent to the hospital by the FME, or may have been taken directly to hospital by the police following a road traffic accident involving injuries. The nurse could possibly take dictated notes of examinations carried out by the FME in relation to forensic examinations. Assist in the examinations. Help in the assessment and care of mentally ill persons (if the Diploma of Mental Health is held). Advise on diet (e.g. for diabetics and vegetarians). Ensure that the cells are clean and habitable. Advising on decontamination of cells after human bodily fluid contamination i.e. HIV. 165
166
Journal
of Clinical
Forensic
Medicine
Structure
Office
1. Senior Nurse for each Metropolitan Area 2. Nurses (available for 24 hours per day, 365 days per annum) 3. Trainee nurses 4. A nurse in overall charge of all areas
Office space will be required. Perhaps Victim Examination Suites could be adapted. Transport and communication would also be required for each nurse. Clearly the key factors are cost (in relation to numbers of full-time employees that will need to be recruited) and practicality as no police station is identical. It seems to me that a full explanation of these ideas in terms of need, cost-effectiveness and safety must be undertaken, not only in the Metropolitan Police Service but in all settings where prisoners are detained in police custody.
Rank Rank would depend upon the additional qualifications of the nurse and one assumes the starting rank to be one of sergeant (at a seniority level to be decided) and further promotion governed by police regulations.
David Jenkins Pay Pay would have to start at senior staff nurse level.
Forensic Physician London, UK.