General Overview & Description of the
Role of the Nurse in Correctional Facilities
Defining the Role of a Correctional Nurse
msnbc.msn.com
Correctional nursing according to Stamler and Yiu (2012) is “the practice of nursing and the delivery of [client] care within the unique and distinct environment of the criminal justice system” (p. 390). Correctional nurses work in jails, detention centers, prisons, healing lodges, correctional centers, youth custody facilities, and halfway houses (Stamler & Yiu, 2012). Nurses are the largest group of health care professionals in the correctional health (Stamler & Yiu, 2012). However their role has not been adequately defined, leading to misinterpretation by medical and custody personnel (Dumpel, 2005). Defining roles, responsibilities and relationships is necessary as multiple roles sometimes occur (Willmott, 1997). In many facilities, nursing policies and procedures are poorly written and they lack enforcement, compromising effective therapeutic nursing practice (Dumpel, 2005). The prison setting has underlying implicit norms resulting from prison politics; refusing to comply with prison officials directions, even during nursing care, may bring serious undesirable consequences (Dumpel, 2005). Nurses working in correctional facilities receive a lot of professional autonomy, however, with autonomy come a lot of independent work and lack of support which may cause professional isolation (Stamler & Yiu, 2012). “Nursing is actively harmed by rumors, gossip, investigations, custody purposes in criminal proceedings, threats and harm to physical safety, and other forms of intimidation” (Dumpel, 2005, p.24) As a result of this vulnerability, RNs often recognize the need for “union and legal representation to save themselves from what occurs in the course of their normal duties” (Dumpel, 2005, p.24).
In contrast to how they are perceived within facilities, correctional RNs are treated with respect and credibility by courts and have been called more and more frequently to appear in court as an interface with the criminal justice system (Dumpel, 2005). Some researchers suggest that RNs practicing in jails and prisons require recognition that their practice is unique to other nursing specialities, such that it is a speciality on its own requiring distinct skills (Dumpel, 2005; Smith, 2010). Nurses are exposed to individuals with mental illness, aging individuals, women, men, youth and culturally diverse individuals, and each group has unique healthcare needs (Stamler & Yiu, 2012). Nurses require specific training, knowledge and skills in order to be able to perform in such a complex and secure environment (Bennett, Lapworth, & Perry, 2010). “The demands placed upon nurses are unlike any they will have experienced in their previous clinical posts..." (Evans, 1999, p.1324). Prison nurses must take multiple 'dual roles', acting as a care provider and custodian (Dumpel, 2005; Willmott, 1997), as well as a mental health and practice nurse (Evans, 1999). To add to this challenge, ratios of nurses to inmates may be as great as 1 RN for approximately 200 inmates (Stamler & Yiu, 2012) and the prevalence of physical and mental health problems is higher than the general population (Ramluggun et al., 2010). In addition to unique clients, nurses work in a context that tends to be overcrowded and instills specific constraints due to prison rules on protection (Bennett, Perry, Lapworth, Davies, & Preece, 2010). Dumpel (2005) suggests that RNs working in correctional facilities should be labelled as criminal justice RNs rather than correctional RNs to advance their image and define their professional role. Other researchers feel that in order for healthcare services to improve in prisons, it must be integrated with public health services rather than being a speciality (Condon et al., 2010).
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Providing Quality Nursing Care to Offenders
phr.org.il
The greatest challenge to the role of a correctional nurse is the ability to provide equal quality care for offenders, as they would for other individuals; the provision of care may be compromised due to the secure environment (Bennett, Lapworth, & Perry, 2010). Access to inmates can be difficult because nurses have to work around, and be available, during a client's out of cell time (Stamler & Yiu, 2012). As well, nurses may struggle with maintaining confidentiality, as they are typically accompanied by security staffs who are not verified to obtain patient information. Confidentiality is also an issue when safety precautions must be taken in facilities, as nurses are not allowed to interfere by disclosing a diagnosis (Stamler & Yiu, 2012).
Inmates face many barriers to care including (Dumpel, 2005):
Inmates face many barriers to care including (Dumpel, 2005):
- Delays in diagnostic testing and follow-up treatment
- Delays in access to specialty care and emergency medical treatment
- Lack of timely medication refills
- Lack of regular monitoring and treatment for chronic diseases
Despite barriers, many prisoners stated that they viewed their time in custody as a chance to access health services which they would not otherwise seek out (Condon et al., 2007). Nurses are in a position of power in correctional facilities, one which allows them to obtain extensive knowledge about clients through various methods of assessment and evaluation, including continuous monitoring, counselling, and interviews (Perron & Holmes, 2011). Nurses can use this knowledge responsibly to both care for inmates while in prison, as well as provide ongoing care and preparation for returning to the community (Bennett, Lapworth, & Perry, 2010). In all cases, prisoners should receive the same standard of care as community dwellers (Peate, 2011). Due to the secure environments that nurses work in, inmates may be construed as dangerous, and therefore nurses may fail to provide the ideal care (Jacob & Holmes, 2010). Nurses should work to create a safe and comfortable environment so they can provide the prisoners with the quality care they are entitled to (Jacob & Holmes, 2010). It has been suggested by Jacob and Holmes (2010) that the ability to self-identify with the inmates can enable therapeutic nurse-client relationships and interactions. Sometimes providing quality nursing care to inmates is challenging; correctional nurses are encouraged to engage in constant reflection and debriefing to discuss how their restrictive environment impacts nursing care, and methods to prevent this from occurring (Jacob & Holmes, 2011).
General Description and Overview of Nursing Roles in Prison
onsconnect.org
General nursing roles in offender health care include:
• Ensuring offenders receive decent treatment (Perry et al., 2010)
• Ensuring good staffing and supervision in reception (Perry et al., 2010)
• Ensuring any core activities, such as searching, are completed before leaving
reception - a part of the security system (Perry et al., 2010)
• Minimizing risks to prisoners (Peate, 2011), including infection control (Stamler & Yiu,
2012)
• Health promotion (Stamler & Yiu, 2012)
• Due to high rates of chronic conditions (Perry et al., 2010)
• Assessing prisoners healthcare and service needs (ex. implement needle exchange
program, providing condoms, lubricants, other equipment to promote safe needle
injection and safe sex) (Peate, 2011; Perry et al., 2010)
• Ensuring offenders receive decent treatment (Perry et al., 2010)
• Ensuring good staffing and supervision in reception (Perry et al., 2010)
• Ensuring any core activities, such as searching, are completed before leaving
reception - a part of the security system (Perry et al., 2010)
• Minimizing risks to prisoners (Peate, 2011), including infection control (Stamler & Yiu,
2012)
• Health promotion (Stamler & Yiu, 2012)
• Due to high rates of chronic conditions (Perry et al., 2010)
• Assessing prisoners healthcare and service needs (ex. implement needle exchange
program, providing condoms, lubricants, other equipment to promote safe needle
injection and safe sex) (Peate, 2011; Perry et al., 2010)
• Addressing special needs, including any disability, learning difficulties
and language problems (Perry et al., 2010) • Identifying suicide and/or self-harm risks (Perry et al., 2010) • Confirming the offender’s identify and the legal basis for detention (Perry et al., 2010) • Conducting risk assessments for cell-sharing (Perry et al., 2010) • Identifying those offenders subject to public protection measures (Perry et al., 2010) • Recording information and disseminating it to prison staff and other agencies, while maintaining appropriate level of confidentiality according to prison policy and nursing practice standards (Perry et al., 2010) • Educating new offenders about their situation (Perry et al., 2010) • Treatment and medication administration (Stamler & Yiu, 2012) • End of life care (Stamler & Yiu, 2012) • Supplying evidence in court of law on issues of the prison (Willmott, 1997) • May be asked to do non-nursing duties (Willmott, 1997): • Search prisoners or cell • Lock doors on prisoners • Escort a prisoner • Disciplining a prisoner that is in the healthcare center because the prison area is too crowed |
General Overview of Positive Aspects of Nursing in Prisons
sfexaminer.com
Positive aspects of being a prison nurse:
• Challenging aspects of the role (Bennett, Perry, Lapworth, Davies, & Preece, 2010)
• Feeling capable of making a difference in a prisoner's life (Bennett, Perry, Lapworth,
Davies, & Preece, 2010)
• Increased professional autonomy (Stamler & Yiu, 2012)
• Challenging aspects of the role (Bennett, Perry, Lapworth, Davies, & Preece, 2010)
• Feeling capable of making a difference in a prisoner's life (Bennett, Perry, Lapworth,
Davies, & Preece, 2010)
• Increased professional autonomy (Stamler & Yiu, 2012)
General Overview of Challenges to Nursing Role in Prison
correctionalnurse.net
General challenges of prison nursing (Bennett, Perry, Lapworth, Davies, & Preece, 2010):
• Cognitive dissonance
• Dual role of caregiver and correctional officer
• Lack of respect from non-clinical colleagues and patients
• Stigma with role of prison nurse
• Being questioned and second guessed by non-clinical staff at
prison
• Feeling unappreciated
• Providing healthcare beyond professional competence
• General RN’s dealing with acute mental illness
• Mental health RN’s providing physical assessments and
treatment
• Fear of errors brought on by either the pressure of having to work
speedily and beyond typical professional boundaries
• Personal Safety
• Isolation from other professional nurse
• Court cases and legal issues
• Staff in prisons who restrict patient’s access to appropriate care
• Access to clients may be restricted (Willmott, 1997)
• Cognitive dissonance
• Dual role of caregiver and correctional officer
• Lack of respect from non-clinical colleagues and patients
• Stigma with role of prison nurse
• Being questioned and second guessed by non-clinical staff at
prison
• Feeling unappreciated
• Providing healthcare beyond professional competence
• General RN’s dealing with acute mental illness
• Mental health RN’s providing physical assessments and
treatment
• Fear of errors brought on by either the pressure of having to work
speedily and beyond typical professional boundaries
• Personal Safety
• Isolation from other professional nurse
• Court cases and legal issues
• Staff in prisons who restrict patient’s access to appropriate care
• Access to clients may be restricted (Willmott, 1997)
General Nursing Skills and Knowledge that May Require Development
offenderhealth.org.uk
Specific areas of expertise that may require development include:
• “Chronic disease management through appropriate prescribing and early detection and
prevention of disease” (Perry et al, 2010, p.36)
• Ability to implement early interventions (Bennett, Perry, Lapworth, Davies, & Preece,
2010)
• Skills and knowledge required to care for pregant women in prisons
• “Skills in mental health and learning disability”(Perry et al, 2010, p.36)
• “Improving access to secondary care referrals” (Perry et al., 2010, p.36)
• Culturally competent care for ethnic minority prisoners (Perry et al, 2010)
• Ability to promote health of prisoners(Bennett, Perry, Lapworth, Davies, & Preece, 2010)
• Accurate assessment of health needs (Bennett, Perry, Lapworth, Davies, & Preece,
2010)
• Educating prisoners about self-care (Bennett, Perry, Lapworth, Davies, & Preece, 2010;
Peate, 2011)
• Learning whether prisoner is manipulating nurse or whether they have a true health
concern (Willmott, 1997)
• “The psychological game of obtaining medication on a false pretext is popular
with prisoners” (Willmott, 1997, p.336)
• “Chronic disease management through appropriate prescribing and early detection and
prevention of disease” (Perry et al, 2010, p.36)
• Ability to implement early interventions (Bennett, Perry, Lapworth, Davies, & Preece,
2010)
• Skills and knowledge required to care for pregant women in prisons
• “Skills in mental health and learning disability”(Perry et al, 2010, p.36)
• “Improving access to secondary care referrals” (Perry et al., 2010, p.36)
• Culturally competent care for ethnic minority prisoners (Perry et al, 2010)
• Ability to promote health of prisoners(Bennett, Perry, Lapworth, Davies, & Preece, 2010)
• Accurate assessment of health needs (Bennett, Perry, Lapworth, Davies, & Preece,
2010)
• Educating prisoners about self-care (Bennett, Perry, Lapworth, Davies, & Preece, 2010;
Peate, 2011)
• Learning whether prisoner is manipulating nurse or whether they have a true health
concern (Willmott, 1997)
• “The psychological game of obtaining medication on a false pretext is popular
with prisoners” (Willmott, 1997, p.336)
More Specific Nursing Roles in Correctional Facilities
Nurse as an Educator
knoxnews.com
Nurse educators within the prison system require good all around skills such as knowledge about themselves, confidence in their skills, the ability to maintain boundaries, a non-judgmental attitude, and empathy (McGregor, 2004). Communication skills are an asset, and it is important that any nurse within the prison system does not disclose personal information (Newell, 2009). Nurse educators work with the correctional system to advocate for student placements, act as leaders to influence change, and provide health care education to inmates. Specific responsibilities of the nurse educator include the following:
• 6-10% of all female prisoners are pregnant; due to the conditions in prisons they
are given very little or no prenatal care or education. In response nurses may host workshops and clinics on prenatal care and the child birth experience; covering topics such as nutrition and exercise, bonding with one’s baby, infant feeding postpartum expectations, issues of loss and grief (especially if child is expected to leave mother’s care), and birth control/ gynecological health to help correct the lack of care that pregnant prisoners are receiving. These programs provide both education and support for women in this condition. (Ferszt, 2008) • Provide an environment where pregnant women can voice concerns and ask questions regarding their pregnancy (Ferszt, 2008) • The nurses working with pregnant inmates had unique challenges such as providing support to women who were isolated from loved ones during birth, helping them cope with the trauma of being separated from their baby post birth, education and a high rate of complications associated with sexually transmitted disease. (Ferszt, 2008) · • Develop nurse-led education and health promotion services for topics such as smoking cessation, healthy lifestyle, sexual health, cardiovascular disease, diabetes (Bennett, Lapworth, & Perry, 2010), asthma, specific older-adult health care needs (Smith, 2010), substance misuse and mental health (Perry, Bennett, & Lapworth, 2010) • Run vaccination clinics for inmates (Smith, 2010) • Educate on ways to reduce the risk of contracting diseases within the prison (Peate, 2011) • Develop, implement, and evaluate harm reducing strategies within the prison (Peate, 2011) • Encourage inmates who test positive for HIV to access appropriate treatments, maintain a healthy lifestyle, eat well, and get regular exercise and sleep (Peate, 2011) |
In order to prepare future nurses for roles within a prison system, correctional nurse educators must set up partnerships with academic institutions and prisons to secure placements for students in correctional facilities (Weiskopf, 2005, p. 342). Nurse educators within the prison system must continue to advocate for students as well as inmates, educate prisoners on healthy lifestyle choices, and act as leaders of change. Correctional nursing is an amazing opportunity for nurses to provide education and health promotion (Condon et al, 2007).
Clinical Nurse
prisonphotography.wordpress.com
Nurses working in the clinical setting within the prison system must provide the same care as members of the community, but do so in a restrictive environment that is catered to punishment as opposed to therapeutic care. These restrictive boundaries can have adverse effects on the therapeutic relationship (Ramluggun et al., 2010). Roles of clinical nurses within the prison include supporting mental health problems, assessing mental health problems, working with physicians to develop care plans, crisis assessment, providing support and education, and integrating internal and external mental health services (Durcan, 2008). Assertion and advocacy are traits needed from nurses as they deal with officers in prisons who are restricting access of prisoners to proper healthcare, including hospital transfers (Bennett et al., 2010). Clinical prison nurses see a range of health ailments and must be prepared for varying responsibilities including:
• "Providing therapeutic, restorative, and preventative care" (Dumpel,
2006, p. 21) • Primary care may not be the type of preferred care; instead rehabilitation may be the focus of the nursing role (Norman & Parish, 1999) • Visiting wings of the prison to dispense daily medications, provide clinics, or assess emergency situations (Durcan, 2008) • Dealing with accidents, diabetes, arthritis, epilepsy, mental health issues, addiction, fractures, imminent birth, death, and chronic health problems such as cancer, respiratory and cardiac disease (McGregor, 2004; Newell, 2009) • Dealing with high rates of hepatitis, STIs, skin infections, and dog bites in younger offenders (Newell, 2009) • Dispensing detoxification medications under standard order (Newell, 2009) • Dealing with adult prisoners with high rates of blood borne and sexually transmitted diseases (Stamler & Yiu, 2012), TB, HIV (Peate, 2011; Ramluggun et al., 2010), addictions, mental illness (Evans, 1999; Weiskopf, 2005) and debilitating effects of sexual and physical violence from prisoners and staff (Dumpel, 2005) • Higher mobility and mortality rates usually due to inconsistent healthcare prior to incarceration, and for many while in jail may be the first time that certain healthcare issues are cared for (Stamler & Yiu, 2012) |
• Dealing with small and crowded living spaces in jail that increase the susceptibility
and spread of infectious disease (Stamler & Yiu, 2012) • Capital punishment; which can leave residual effects as it goes against a nurses’ ethic of caring • Providing prenatal care to the 6-10% of prisoners who are pregnant; also help prisoners work through trauma associated with separation from their infant post- partum (Ferszt, 2008) |
Clinical nurses experience unique challenges while working in the prison system. Providing care in an environment catered to punishment can impact the establishment of a therapeutic relationship. Being able to distinguish between actual health problems and behavioural problems is a challenge for clinical nurses working in prisons (Newell, 2009). Nurses must be able to make clinical decisions with a clear rationale and cannot be pressured into actions that suit the prisoners or prison staff (Smith, 2010). In order to ensure the safety of prison nurses, prison officers are always in attendance when the nurse sees the patient (Newell, 2009).
Psychiatric Nurse
prisonworldblogtalk.com
Statistically, prisoners have complex and long-standing health needs, and high incidence of mental health problems (Perry et al, 2010). 1/10 men and 1/5 females who enter a correctional facility suffer from a mental disorder, and this rate is only increasing (Stamler & Yiu, 2012). Many complex psychiatric issues face nurses working with prison inmates, including problems with addiction/ substance abuse, and other mental illnesses including depression and grief (Stamler & Yiu, 2012). There are many cases where inmates are suffering from more than one mental health disorder and are kept in the facility instead of being transported to a mental health center (Stamler & Yiu, 2012). Care for the mentally ill is either non-existent or unsatisfactory in a correctional facility as compared to a mental illness hospital (Stamler & Yiu, 2012). Given the high incidence of diagnosable mental illness and substance misuse among offenders, it is vital that they have access to supportive services. Responsibilities of psychiatric nurses include:
• Training in, and specialist knowledge of, substance misuse management and addiction services
• Double-barreled conflict as psychiatric nurses care for ill offenders and promote their interests while also
safeguarding members of society (Weiskopf, 2005)
• Grief counseling:
• "Prisons are environments of enduring loss and while some forms of loss (i.e. the death of
a family member or fellow inmate) are obvious, others (such as loss of liberty, loss of family
contacts and loss of life years) may not be as easily identified and managed" (Hendry, 2009,
p.270)
• Pregnant women that give birth are separated from their newborn at the hospital and placed back
in prison. The majority has up to a year left of their sentence to serve. This is a traumatic event for
both the child and the mother. (Ferszt, 2008). These women are at risk for mental health issues,
psychological damage, as well as exposure to violence and physical as well as sexual abuse
(Ferszt, 2008)
• Training in, and specialist knowledge of, substance misuse management and addiction services
• Double-barreled conflict as psychiatric nurses care for ill offenders and promote their interests while also
safeguarding members of society (Weiskopf, 2005)
• Grief counseling:
• "Prisons are environments of enduring loss and while some forms of loss (i.e. the death of
a family member or fellow inmate) are obvious, others (such as loss of liberty, loss of family
contacts and loss of life years) may not be as easily identified and managed" (Hendry, 2009,
p.270)
• Pregnant women that give birth are separated from their newborn at the hospital and placed back
in prison. The majority has up to a year left of their sentence to serve. This is a traumatic event for
both the child and the mother. (Ferszt, 2008). These women are at risk for mental health issues,
psychological damage, as well as exposure to violence and physical as well as sexual abuse
(Ferszt, 2008)
• Management and care for inmates with other mental health issues including depression,
anxiety, schizophrenia, social isolation, etc. • Advocacy for proper management, care for and understanding of inmates with mental health concerns "One of the most common problematic behaviours in prison is self-harm (Ramluggun et al., 2010, p.63). Knowing this, mental illness and suicidal assessments are always performed on new clients and special care is taken towards those who may develop a mental illness while incarcerated (Stamler & Yiu, 2012). As well, if a client presents with a mental illness, it falls onto the nurse to advocate for that that client to move through the system fast and have a transitional discharge planned for the future (Stamler & Yiu, 2012). At present, insufficient resources and training exist to address mental health issues. Nurses have the obligation in delivering safe, competent and ethical care to advocate for better awareness and programming for inmates living with, or suffering from, mental illness |
Nurse as a Leader
waynecosheriff.org
Nursing leadership is of paramount importance in a complex care environment such as a prison. All nurses must also act as leaders to negotiate and create positive change. Leaders in the prison setting must be seen as competent, capable and caring to gain trust and respect from inmates (Bennett, Perry, Lapworth, 2010). Responsibilities of a nurse leader may include:
• Act as leaders to help prisoners work towards enacting change within their
environment as well as adapting to their situation (Bennett, Perry, & Lapworth,
2010)
• Collaborate with interdisciplinary teams (Bennett, Perry, & Lapworth, 2010)
• Use transformational leadership, which involves recognizing the skills and
expertise of different members of the team and using these to accomplish objectives(Bennett, Perry, & Lapworth, 2010).
• Increased focus on health promotion and illness prevention - stronger leadership among nurses within prisons is
needed to increase prevention intervene early in the case of illnesses and provide support for patients with chronic
health conditions (Bennett, Perry, Lapworth, 2010)
• Strong communication skills both with other professionals and security staff, as well as inmates. Communication skills
include active listening, emotional intelligence (regulate own’s own emotions as well as be in tune with those around
you), and a compassionate interest in delivering client-centred care
• Conflict management - issues such as achieving security, providing health, nurses need to learn to become effective
mediators and transform ‘differences into opportunities’ (Bennett, Perry, Lapworth, 2010), work to minimize conflict, and
be aware that conflict can be resolved and use negotiation skills
• Act as leaders to help prisoners work towards enacting change within their
environment as well as adapting to their situation (Bennett, Perry, & Lapworth,
2010)
• Collaborate with interdisciplinary teams (Bennett, Perry, & Lapworth, 2010)
• Use transformational leadership, which involves recognizing the skills and
expertise of different members of the team and using these to accomplish objectives(Bennett, Perry, & Lapworth, 2010).
• Increased focus on health promotion and illness prevention - stronger leadership among nurses within prisons is
needed to increase prevention intervene early in the case of illnesses and provide support for patients with chronic
health conditions (Bennett, Perry, Lapworth, 2010)
• Strong communication skills both with other professionals and security staff, as well as inmates. Communication skills
include active listening, emotional intelligence (regulate own’s own emotions as well as be in tune with those around
you), and a compassionate interest in delivering client-centred care
• Conflict management - issues such as achieving security, providing health, nurses need to learn to become effective
mediators and transform ‘differences into opportunities’ (Bennett, Perry, Lapworth, 2010), work to minimize conflict, and
be aware that conflict can be resolved and use negotiation skills
Nurse leaders must be seen as competent, capable and caring to gain trust and respect from inmates and prison employees alike (Bennett, Perry, Lapworth, 2010). Nursing leadership is important in all types of nursing, but is specifically important in prision settings because of the increased equity, security, and health needs. Leadership skills necessary for nurses working in criminal justice system include emotional intelligence, strong ability to do teamwork and inter-professional collaboration, negotiation, and conflict management (Bennett, Perry, Lapworth, 2010). Stronger leadership than exists today among nurses within prisons is needed to increase prevention intervene early in the case of illnesses and provide support for patients with chronic health conditions (Bennett, Perry, Lapworth, 2010).
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Nurse as Patient Advocate
oregonlive.com
In a context requiring order, discipline, and control, nursing in prison comes with the role of ensuring that prisoners receive the appropriate access to healthcare (Willmott, 1997). Nurses often are needed to act as an advocate for patients, so clinical supervision and reflective practice should be part of their continuing professional development –health, cultural/diversity/language, disability" (Perry et al, 2010, p.36). Correctional nurses may have a weakened ability to fulfill their role as client-advocate (Dumpel, 2005). The challenge to nurses when attempting to advocate for clients is rooted in the issue that correctional nurses themselves lack advocates (Dumpel, 2005).
Inmate nursing advocates have the following roles and potential responsibilities:
• Maintain communication between healthcare providers for the sake of continuity
of care (Peate, 2011)
• Work collaboratively with colleagues responsible for maintaining high levels of
security, thus acting as advocates for patients (Perry et al, 2010)
• Take active role in policy development for improved health and safety among
both prisoners and the public, while also considering the burden that the
families go through (financially, emotionally and health-wise) (Peate, 2011)
Nurses have the capacity and the skill set to work to better the health and safety landscape of prisons and advocate for better care of inmates. In the interest of developing best practice for nursing in prison settings, further research is needed to advocate for better inmate representation, standards for care, and access to health services.
Inmate nursing advocates have the following roles and potential responsibilities:
• Maintain communication between healthcare providers for the sake of continuity
of care (Peate, 2011)
• Work collaboratively with colleagues responsible for maintaining high levels of
security, thus acting as advocates for patients (Perry et al, 2010)
• Take active role in policy development for improved health and safety among
both prisoners and the public, while also considering the burden that the
families go through (financially, emotionally and health-wise) (Peate, 2011)
Nurses have the capacity and the skill set to work to better the health and safety landscape of prisons and advocate for better care of inmates. In the interest of developing best practice for nursing in prison settings, further research is needed to advocate for better inmate representation, standards for care, and access to health services.
A Personal Account of Prison Nursing
Marien Zanyk, PhD, Personal Communication (February 21, 2012)
ckplus.com
I just received another referral to go into a third prison today from a surgeon. This will be my third Level 4 Prison to go into…they don't call me 'Jail Bait' for nuthin'.
Getting in: Once the Administrator affiliated with the Medical Director of the prison runs your ID (SSN, DL #, DOB) and you have clearance, you can set up an appt to get in.
When I arrive, they have a requisition order for me to be there and someone meets me to escort me in. You always have to have someone with you. No cell phones allowed but I do bring in my laptop.
I drop my DL into the security site and they walk me in through 3 sets of intense doors. Sometimes, X-ray walk-thru, most often not.
Actually, I have been left alone with the prisoners on occasion and I am fine with that…usually only for 15 minutes when someone has to do something quickly. I had a giggle fit with this big black guy, in for assault w deadly and narc until 2017, but is such a nice guy. He needed to laugh and I had him giggling. However, You do have to always be on guard (I tend to be relaxed and friendly, as well.) Professional, cautious as I was warned that the prisoners can use your words (or your pen) against you. But mostly, they are polite and respectful, appreciative of the help that you are giving them.
After a few visits, it becomes a facility like any other, higher security, kind of exciting but it is fine. First time seeing all of the barbed wire catches your breath but you get used to it, like anything else.
Any equipment you leave has to be documented , serial # of item, or description because if you remove the item, and they do their twice daily count on everything and if it is missing, they go into lock down…no one can enter or exit the facility…staff is stuck there for hours until that item is located….very messy. They have been in lock down a few times when I have gone and sometimes they bring me in anyway with clearance and sometimes not.
The knowledge that you will be protected from any mishaps by correctional officers, that they have the most secure situation in place and that the prisoners are respectful/grateful for the medical attention. It is a whole different world in there but very manageable.
Getting in: Once the Administrator affiliated with the Medical Director of the prison runs your ID (SSN, DL #, DOB) and you have clearance, you can set up an appt to get in.
When I arrive, they have a requisition order for me to be there and someone meets me to escort me in. You always have to have someone with you. No cell phones allowed but I do bring in my laptop.
I drop my DL into the security site and they walk me in through 3 sets of intense doors. Sometimes, X-ray walk-thru, most often not.
Actually, I have been left alone with the prisoners on occasion and I am fine with that…usually only for 15 minutes when someone has to do something quickly. I had a giggle fit with this big black guy, in for assault w deadly and narc until 2017, but is such a nice guy. He needed to laugh and I had him giggling. However, You do have to always be on guard (I tend to be relaxed and friendly, as well.) Professional, cautious as I was warned that the prisoners can use your words (or your pen) against you. But mostly, they are polite and respectful, appreciative of the help that you are giving them.
After a few visits, it becomes a facility like any other, higher security, kind of exciting but it is fine. First time seeing all of the barbed wire catches your breath but you get used to it, like anything else.
Any equipment you leave has to be documented , serial # of item, or description because if you remove the item, and they do their twice daily count on everything and if it is missing, they go into lock down…no one can enter or exit the facility…staff is stuck there for hours until that item is located….very messy. They have been in lock down a few times when I have gone and sometimes they bring me in anyway with clearance and sometimes not.
The knowledge that you will be protected from any mishaps by correctional officers, that they have the most secure situation in place and that the prisoners are respectful/grateful for the medical attention. It is a whole different world in there but very manageable.