Most of us imagine violence as something personal, a crime between individuals, an assault that happens in the shadows. But today, nurses are witnessing a new reality. Violence is happening not only secretly — it’s also being perpetrated in broad daylight through the authority exercised by those wearing badges, masks, and uniforms. It plays out on our televisions nearly every night.
Across the United States — in detention centers, jails, and emergency departments — nurses are providing care to individuals who have been harmed not by strangers or partners, but by law enforcement and immigration officers. These survivors are often terrified and mistrustful of seeking care, as they have been harmed by a system that was meant to protect them.
Many are further marginalized due to their identities as Black, Indigenous, undocumented, or disabled individuals. Their physical, psychological, and emotional injuries are compounded by a healthcare system that too often mirrors the violence they are seeking help from.
Positioned at the intersection of healthcare and law, forensic nurses are on the frontlines of this crisis. We are trained to provide trauma- and violence-informed, patient-centered care, yet we are expected to deliver that care within systems that can actively reinforce harm: police stationed outside exam rooms, immigration officers demanding documentation, and administrators insisting on “objectivity.”
Above all else, a forensic nurse’s primary obligation is the health and safety of the patient. Ignoring the very forces that are distressing or endangering that patient, under the guise of neutrality, is not objectivity, nor is it an option when people’s lives are at stake.
In our 2024 publication, Patient-Centered Forensic Nursing Model of Care for Victims of Law Enforcement Violence, forensic nursing care is reframed as more than just a clinical response, but a form of resistance and repair.
While some may argue that integrating advocacy and social justice into forensic nursing blurs the boundaries between medical care and activism, the Patient-Centered Forensic Nursing Model of Care (Anderson et al., 2024) demonstrates that such integration strengthens clinical and ethical practice. Critics express concern that addressing systemic inequities and law enforcement violence as part of first-line medical care may compromise relationships or create tension within and between healthcare and legal systems. However, the evolution of forensic nursing has resulted in an evidence-based, trauma- and violence-informed practice that upholds both scientific rigor and moral responsibility.
By centering the patient’s lived experience and contextualizing trauma within broader systems of power, the model is designed to foster trust, improve survivor outcomes, and preserve the integrity of forensic evidence. It establishes forensic nursing as a discipline uniquely positioned to bridge health and justice through compassionate, equitable care. Ultimately, this approach reinforces the profession’s ethical duty to not only document trauma, but to humanize and transform the systems that perpetuate it.
The patient-centered model of forensic nursing empowers providers to:
- Deliver trauma- and violence-informed care that centers the patient’s voice, safety, and agency.
- Recognize how systemic racism, policing practices, and immigration enforcement shape the trauma patients carry into healthcare spaces.
- Advocate for institutional accountability — within both hospitals and law enforcement — to prevent re-traumatization.
- Care for themselves and their colleagues through reflective practice and organizational support that addresses moral injury and vicarious trauma.
In short, we demand that nurses treat the body, witness the injustice, and refuse to be silent in the face of structural harm. Importantly, we encourage institutions and policy makers to recognize this as a fundamental part of providing comprehensive, individualized treatment to people who have experienced law enforcement violence. Simply put, it’s essential care.
The nursing profession has long held that care is an activist act, not a passive one. To care for those harmed by the state is to acknowledge power, challenge silence, and restore dignity in spaces where it has been systematically stripped away. The moral responsibility of forensic nurses caring for patients who experienced state-sanctioned violence extends beyond clinical treatment. It encompasses bearing witness, advocating for justice, restoring dignity, and transforming systems that perpetuate trauma. In doing so, forensic nurses fulfill their highest ethical calling: to protect the health and human rights of patients, and to help those most marginalized by all types of violence.
As nurses, we have all been told to “stay in our lane” — whether that means limiting our advocacy for our individual or collective patients, restricting our knowledge base to the commonplace and letting others deal with more complex and challenging work, or accepting the outdated view that nurses are simply order-takers rather than clinicians. It may be easier, both individually and as a profession, if nurses chose to sit out the hard and uncomfortable work, but that isn’t what nursing is or who nurses are.
If we want to build a healthcare system that truly heals, we must begin by acknowledging how deeply it is intertwined with systems of control and punishment.
Hospitals, policymakers, and nursing leaders must:
- Fund and implement trauma-informed, culturally safe forensic nursing programs that include care for victims of law enforcement, immigration enforcement, and other state-sanctioned violence.
- Protect patient autonomy by ensuring care can be delivered without surveillance or interference from law enforcement.
- Support the caregivers — through debriefing, mentorship, and institutional acknowledgment of the emotional toll this work carries.
Forensic nursing occupies a position that is both vulnerable and powerful. We liaise between healthcare and legal systems and are asked to bear witness to and care for those impacted by violence and trauma within this landscape. However, when our work challenges institutional hierarchies and confronts systemic failures, forensic nursing can be misunderstood or marginalized within broader healthcare and legal systems.
Forensic nursing must be recognized as science in practice, producing distinct knowledge about trauma, embodiment, and the pursuit of justice that neither healthcare nor law can fully capture on their own. Forensic nurses already embody courage. What we need now is collective will from the public, from healthcare systems, and from lawmakers to support them as they uphold the ethics of care in the face of state-sanctioned harm. When the state harms, nurses must heal. Every act of compassionate, trauma-informed care in these spaces is an act of moral resistance. And every forensic nurse who listens, documents, and stands beside a patient is not only saving a life and reshaping the meaning of justice itself.
Jacqueline Callari Robinson, Maija Anderson, Jocelyn C. Anderson, Erin Pollitt, Elizabeth Louden, and Margaret M. Glembocki are each nursing educators and researchers who are members of the Forensic Nursing Social Justice Collaborative.