This article describes the need for a collaborative relationship between the advanced practice forensic nurse in the emergency department and critical care settings with law enforcement officials. The relationship is necessary when working with victims and/or perpetrators in the context of the 27 categories of forensic patients.

Violence has been identified as one of the leading public health hazards of our time. The majority of the victims of violence are being seen in emergency departments and critical care areas. This compels today's nurse to be educated in the proper recognition, interpretation, collection, documentation, and photo-documentation of the ramifications of violence and the associated forensic evidence. The categorization of these patients should be determined by the critical care nurse. Categorical determinations will ensure that the nurse develops a systematic, algorithmic management plan for any client with potential forensic implications associated with their care. It will also assist the nurse in recognizing the mandated reporting that must be completed in certain instances. The additional benefit is to determine what educational needs are required by the critical care nurse staff to posit the forensic population; and, to consider what future research must be accomplished in order to better serve this unique clientele.

Munchausen by Proxy Syndrome (MBPS) is a rare form of abuse in which a caregiver fabricates or produces symptoms of an illness in a child, elder, or disabled person. The deception is usually repeated on numerous occasions, resulting in many hospitalizations, considerable morbidity, and sometimes death. MBPS is a factitious disorder in which caregivers injure their victims in order to gain sympathy or attention for themselves. It was named after Baron Karl von Munchausen, the 18th century cavalry officer who returned home from war and told embellished tales of his adventures. MBPS is a very horrifying circumstance of abuse. Unwillingness or the inability to recognize this abuse deprives the victim of the opportunity to be shielded from future harm. There is a need for strategic protocols and a multidisciplinary approach to this baffling problem. Discussing the clinical profile of the perpetrator, the victim, and the family may help nurses distinguish medical fact from fiction.

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