Correctional Nursing

Correctional Nursing

• Who? Correctional Nursing is for LVNs, RNs and

NPs. Care is provided for Women, Men, and Kids.
• What? Providing a broad spectrum of care to
patients who happen to be incarcerated.
• Where? Prisons and Jails
• When? 8, 10 and 12 hour shift
• Why? Provide care in a controlled, regulated
environment. Be an unbiased member of the
judicial system.
Core Functions & 10
Essential Services in Prison
Monitoring Health:
• Correctional Nurses are responsible for assessing
the overall health state of every prisoner.
Administering prescribed medication, including
PRN over the counter medication .
• MD is not on site and the nurse assesses to
determine if the inmate’s complaint warrants and
visit by the MD or a trip to the hospital. Overall
health management. (Almost, J. et al, 2013)
Core Functions & 10
Essential Services in Prison
Diagnosing and Investigating:
• Assessing physical complaints in an infirmary
setting.
• Triaging and first response in an emergent
situation such as AMI or prison related
violence.
• New inmates get a head to toe COMPLETE
physical, including body cavity searches, all
done by a nurse. (Almost, J. et al, 2013)
 Core Functions & 10
Essential Services in Prison
Inform, Educate, Empower:
Nurses have the opportunity to educate a prisoner about lifestyle
changes that will make their time more comfortable.
“prisoners listen to your suggestions and implement your nursing
interventions because they have such limited resources. They are
more likely to try your idea to cut down on sugar to reduce
headaches as they are unable to reach for Tylenol whenever they
feel like it.”
“I’ve even gotten prisoners to to partake in yoga & meditation to
reduce their stress because it’s hard to get a Xanax prescription
unless they are violent, but I certainly can’t tell them that.”
(Interview, 2017)

Nurses also have the responsibility to educate and prevent

disease in prison, which spreads very quickly in that environment.
 Core Functions & 10
Essential Services in Prison
• Enforce laws and regulations- Boundaries must be kept
between nurses and prisoners and it’s important that the
line is not crossed, even into friendship. “They will try to
manipulate you, and it’s a game to some. It’s a professional
relationship and you as the nurse need to enforce that.”
(Interview, 2017) Also, “If you hear about a fight about to
happen or some sort of nonsense planned, you need to
alert the guards. Otherwise a lot of people could get hurt”
• Assure competent workforce- Supervisor positions ensure
appropriate treatment of the prisoners is the operating
basis.
• Evaluation & Research- Monitoring the effectiveness of
care and escalate at needed.
Preparation, Training, Salary
• RNs are there for assessment, triage
and all other functions of nursing.
• In present day, Med pass nurses are a
role most commonly filled by LVNs.
• Most prisons prefer ER or hospital
floor experience.
• BSN preferred.
• Nurse Practitioners are often used as
the main provider with MD and
hospitals available for back up and for
diagnoses that cannot be handled on
site.
• In California, in 2017, average salary is
$110,000. In Ohio, $58,000 In New
York, In Florida, 62,000 Some prisons
operate on 12 hour shifts, others are 8
hour shifts.
 Positions Available
• There is a projected 16% growth rate
projection by 2024. In California, there were
339 open positions listed on Indeed.com
sometimes hired directly through the state,
other times, through hiring agencies.
• Working as a Public Health nurse for
correctional facilities includes visiting various
jails and prisons to see that standards of basic
human rights are being met.
 Interview
Interview information came from a nurse who
worked in a correctional facility. Information from
the interview is put throughout this slide show.
Additional quotes from this nurse include:
• “ It’s a good job if you like the age population you are
working with (adults, women, kids) and you have good co-
workers.”
• “Your patient’s are often very appreciative of you because
they have rarely been to the doctor since they were kids.”
• “I definitely feel safer in the prison than in an ER because
there are guards around you all the time and generally the
prisoners don’t want to hurt you. In my prison, I have never
heard of a nurse being attacked”
• “You constantly have to be vigilant though and never ever
be alone with a prisoner.” (Interview, 2017)
 Advantages
• Above average pay
• Generally good benefits, including retirement.
• Considered a federal job if not going through an agency
for employment.
• Treating the same patients for long periods of time.
• 3+ weeks of paid vacation from start of hire and
increased after that.
• Autonomy- Expected and encouraged to work
independently and use professional judgment.
• Job security. (Bouchand, 2017)
 Disadvantages
• Working with criminals. More likely to
get harassment, manipulated and
physically attacked.
• Depending on the level of security,
often there is a long distance and many
“steps” to get in to work equaling
added time outside of your work hours.
• Prisons tend to be remotely located so
either commute or live in a rural area.
Alternatively, working in a jail setting
can be anywhere!
• Incidents that take place require much
more detailed paperwork.
• Supplies are bare bones, old
equipment. (Holwick, A., 2016)
Typical Day- Medications
Dispensary Nurse:
• Responsible for all scheduled and requested
meds for assigned inmates and responsible for
seeing that they have swallowed them.
• Typically working off of a medication cart and
given protection in the form of two guards so
you can focus on the work .
• Similar role as in a for medication passing in a
Skilled Nursing Facility.
 Typical Day-Clinical
and Triage

• Clinical nurse: Triaging in an infirmary setting, ruling

out serious disease, trouble shooting illness with PRN
meds, communicating with providers. Transferring to
higher level of care. Monitoring ill patient’s away
from their cells.
• Triage and Emergency: First health care provider on
scene for medical accident or incident. Triaging in
mass incident. Monitoring for signs and symptoms of
suicide and managing attempts.
(Dhaliwal, 2016 )
 Professional
Associations/Organizations

• National Commission on Correctional Health

Care (ncchc.org)
• International Forensic Nurses
(forensicnurses.org)
• American Correctional Health Services
Association (achsa.org)
 References
• Almost, J. Gifford, W. Doran, D. , Ogilvie, L., Miller, C., Rose, D., Squires, M. (2013) Correctional Nursing: a study protocol to develop and
educational intervention to optimize nursing practice in a unique contex, Implementation Science, Vol 8: Issue 71.

• Stanhope, M., & Lancaster, J. (2013). Foundations of nursing in the community: Community-oriented practice (4th ed.). St. Louis, MO:
Elsevier.

• Bouchaud, M. (2017) Integrating Correctional and Community Health Care: An Innovative Approach for Clinical Learning in a
Baccalaureate Nursing Program. Nursing Forum Vol. 52 (1), pp. 38-49

• Holwick, A. (2016) Correctional Nursing: Caring for the least of these. Journal of Christian Nursing Vol. 12:3

• Dhaliwal, K. (2016) Caring in Correctional Nursing. Journal of Forensic Nursing, Vol 12:1 pg 3-15

• Williams, T. (2014) How to meet the challenges of correctional nursing. Nursing Vol. 44 (1), pp. 51-4.

• Diaz, D. (2014) Simulation: Introduction to Correctional Nursing in a Prison Setting. Journal of Correctional Health Care Vol. 20 (3) p.
240-248

• Thompson, T. (2016) What it’s like working as a prison nurse, VICE Magazine Retrieved
from:https://www.vice.com/en_ca/article/8gebkv/what-its-like-working-as-a-prison-nurse on October 2, 2017

• Nursing Behind the Wall: Care Guide (NA) Retrieved from http://nursingbehindthewall.com/mrsa/mrsa.html on October 3, 2017