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Forensic nurses are there for their patients in very difficult times. They care for survivors of assaults or violent accidents. They may also treat victims of negligence, abuse or violent crimes. Some specialize in death investigation. Dealing with these sensitive situations requires training and compassion.

Cathy Carter-Snell is a forensic nurse. She has been nursing for over 30 years and stands out in her field. She has been recognized and honored by the International Association of Forensic Nurses for her contributions to forensic nursing.

Carter-Snell recalls an emergency nurse who was being interviewed to join her forensic nursing team. They asked the nurse why she wanted the job. The nurse described watching victims of crime come in to the emergency department. They had their heads down, made no eye contact and were visibly upset.

She told Carter-Snell, "They spend two or three hours with you folks and come out with their heads up, a smile on their face and giving you a hug or laughing at some shared moment -- I had to be part of that."

"If that's all we accomplish, we can be proud," says Carter-Snell.

Carter-Snell teaches online forensic classes to registered nurses full time. Her clinical work is primarily as a sexual assault nurse examiner. Her patients often also include victims of domestic violence. She also teaches online forensic courses to registered nurses.

Her job starts when a client (male or female) comes in to an emergency department. She receives a page from the emergency department and meets the client. She takes time to review the client's options with them. The client then chooses what he or she wishes to have done.

The job can be emotionally taxing. Nurses need to carefully consider whether or not they would be able to handle the situations forensic nurses face.

Carter-Snell finds it difficult when she is not able to assist patients fully. She's seen a woman return to her abusive husband because the shelters were full and welfare payments didn't provide enough money for her to live on her own.

"We know the outcome may well be fatal for her as the beatings will only get worse," she says.

"Most of our victims are young women who become intoxicated and vulnerable to young men they have recently met. Many wake up and do not know if they have been assaulted or not, which is hard for them," says Carter-Snell.

She says forensic nurses must have a solid knowledge of violence and cycles of violence. It's also important for nurses to confidentially share their feelings with colleagues after difficult cases.

"A number of us recently found it helpful to participate in community education projects to educate young people and try to break the cycle of violence for them and attempt to increase their awareness of risk. On an individual level we also need to find ways to balance our work with relaxation, fun, exercise and good nutrition to prevent burnout," says Carter-Snell.

Carter-Snell has male colleagues working in areas of domestic violence, child abuse, death investigation, forensic psychiatry and disaster nursing.

"There are very few male sexual assault nurse examiners, however, primarily because the majority of the clients are female and assumptions have been made by managers that clients would prefer female examiners. A few male nurses have entered the field and have been well received by clients," says Carter-Snell.

Dan Sheridan is one of those nurses. He is a sexual assault nurse examiner. He regularly treats adolescents and adults, including women.

"The most important characteristics are empathy and caring. Gender is not the issue," he says. "Because you're a woman who is a nurse, it doesn't give you the ability to come across with empathy and caring." He says men are still a small population of nurses, making up only seven or eight percent of the ranks in the U.S. He says nurses need to put gender behind them.

He's been a nurse since 1982. He would recommend the field to anyone -- male or female.

Sheridan has a PhD in nursing, and he's a forensic nursing professor at Johns Hopkins University School of Nursing. In addition to teaching future nurses, he keeps up his clinical practice. He specializes in elder abuse and works with victims of domestic violence.

"You have lots of autonomy," he says. "You believe what you do makes a difference in someone's life." He doesn't measure his success by the number of criminal cases in which someone goes to jail. There are too many factors that are beyond the control of nurses. For him, if his patient leaves the examination more empowered and more knowledgeable, he's done his job. He wants his patients to move from victim to survivor to someone who thrives.

"We help move them on this path. Millions of people are victimized each year. Nurses spend time with them first. We are able to plant the seeds that begin the healing process," he says. By giving people hope and options, they begin to feel empowered. They can recover from the experience and move on with their lives.

Georgia Pasqualone has been nursing since 1969. She began to specialize in forensic nursing in the early 1990s. Her work as a forensic nurse has taken her as far as the Ukraine. She went to teach her Ukrainian counterparts about domestic violence. Her team focused on how to recognize and document the cases. She said many people had been afraid to discuss the issue. But once it was brought up they realized that they weren't alone and could get help.

"It was one of the most rewarding experiences I've had," she says. She loves the role of forensic nurse as educator. She's able to teach nurses how to best help people, and how people can help themselves.

She says curious people who love solving mysteries, performing investigations and finding answers to puzzles would make excellent forensic nurses. These people should be able to ask questions and have a thirst for knowledge. If there's an unanswered question, they don't let it rest. And they're always on the lookout for those less fortunate.

"People have a sixth sense. They know from a young age that they wanted to do something like this but didn't have a name for it," she says. She has always had a passion for forensic nursing, and she has found its name.